tinea korporis
TRANSCRIPT
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TINEA CORPORIS
Nurotus Saniyah G9911112115
Pembimbing: Dr. Nugrohoaji Dharmawan, SpKK, M.Kes
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SYNONIMS
Tinea circinata Tinea glabrosa Schrende Fletche Herpes circine trichophytique Ringworm of the body Kurap
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DEFINITION
Tinea corporis
All dermatophytosis of glaborous skin (facial, body, upper and lower extremity)
Dermatophytosisdisease caused by dermatophyte
A group of taxonomically related fungi that has ability to form molecular attachments to keratin and use it as a source of nutrients allow s them to colonize keratinized tissues, including the stratum corneum of epidermis, hair, and nails.
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EPIDEMIOLOGY
• All age• Man:Woman = 1:1• Usually occurred in areas with high humidity• Depends on body and environment hygiene
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ETIOLOGY
Dermatophytes
Tricophyton
Epidermophyton
Mycrosporum
Tinea CorporisT. rubrum, T.
mentagrophytes, M. canis, T. tonsurans
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PATHOGENESIS
3 main steps
adherence
penetration
Development of a host respons
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Adherence Dermatophytes must overcome several obstacles (UV light, variation of temperature and moisture, and competition from normal flora) in order to adhere to keratinized tissue
Penetration Secretion of keratinase enzyme by dermatophytes that will invate stratum korneum and keratin to provides a source of nutrition for the dermatophytes
Development of host response
To create clinical symptoms, the dermatophytes must overcome non spesifik and spesifik immune of the host
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SIGN AND SYMPTOMS
Many variants The classic presentation : annular lesion with
scale across the entire erythematous border, some lesions are often confluented.
Lesion: Erythematous with skuama, centra healing
Erosion and crusta sometimes appear caused by scratching of the skin
Itchy, especially when the patient is sweating
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LABORATORY STUDIES
Skin scraping with KOH 10-20% hyphae or fungi’s spore
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DIAGNOSIS
From the clinical manifestation Add the laboratories finding
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DIFFERENTIAL DIAGNOSIS
Dermatitis seborroik Psoriasis Morbus Hansen Pitiriasis Rosea Dermatitis Numularis Candidiasis Neurodermatitis Circumscripta
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TREATMENT : NON MEDIKAMENTOSA
Education for increase body and environment hygiene
Recommend for avoiding tight and non sweat absorbable clothing
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TREATMENT : MEDIKAMENTOSA
Derivat imidazole (mikonazole, klotrimazole, tiokonazole, ketokonazole)
Derivat alilamin (terbinafin, naftitin HCl)
Griseofulvin1st line Itrakonazol
Broad Fungisid Ketokonazole
Fungistatic Flukonazole
Non hepatotoxic
Topical Systemic
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PROGNOSIS
With proper treatment Commonly are good Important to prevent re-infection
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CASE REPORT
Name : Mrs. M Age : 56 years old Sex : woman Address : Griyan RT 2/1
baturan Colomadu, Karanganyar
Date of inspection : 29 May 2012 Number of MR : 01121232
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CHIEF OF COMPLAIN Feeling itch in the upper arm and back
Approximately 1 year before goes to hospital, the patient complain some lesions at upper arm, then she lubricates some aloe vera to the lesions. After that the lesion become itchy and spread to the back. Previously, patient checked up at the puskesmas for 6 times. She got mikonazole zalf, after that the complain reduced but not totally healed.
HISTORY OF DISEASE
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HISTORY OF PREVIOUS DISEASE
History of similar disease : (-)History of food allergy : (-)History of drug allergy : (-)History of hypertension : (-)History of DM : (-)History of atopic : (+)
HISTORY OF FAMILY DISEASEHistory of similar disease : (-)History of food allergy : (-)History of drug allergy : (-)
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HISTORY OF HABIT
The patient usually take a bath 2 times for a day with the soap and using different towel with other family. The patient often scratch her skin when she feels itch.
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PHYSICAL EXAMINATION
A. Generalis status Generally : good, compos mentis,
sufficient nutrient impressive Head : normally Face : normally Neck : normally Back : look at dermatology status Axilla : look at dermatology status Thorax : normally Abdomen : normally Gluteus : normally Upper extremity : look at dermatology status Lower extremity : normally
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DERMATOLOGY STATUS
Regio upper extremity, axilla, and thorax posterior (back): some macula erythematous lesions with skuama and centra healing.
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SKIN SCRAPING WITH KOH LONG HYPHAE
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DIFFERENTIAL DIAGNOSIS
Tinea corporis Psoriasis vulgaris Pitiriasis rosea
DIAGNOSIS
Tinea corporis
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TREATMENTNon medikamentosao keep the hygiene of body, clothes, and
environmento Keep the lesion area away from sweat and high
humidity conditiono Use different towel with other familieso Not scratch the skin
Medikamentosao Ketokonazole 2x200 mg (for 14 days)o Cetirizin 1x10 mg (for 7 days, if the patient feels
itch)o Miconazole cream gr 50
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PROGNOSE
Ad vitam : good ad sanam : good Ad functional : good Ad cosmeticum : good
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