TIGA KOMBINASI TERAPI PADA PERIANAL GIANT CONDYLOMA ACUMINATA DENGAN KOINFEKSI HIV
DOI:
https://doi.org/10.33820/mdvi.v51i1.306Keywords:
elektrokauter, giant condylomata acuminata, HIV, simetidin, trichloroacetic acidAbstract
Giant condyloma acuminata (GCA) atau tumor Buschke- Löwenstein, merupakan varian kutil anogenital yang jarang dan unik. Kondisi imunokompromais terutama infeksi Human Immunodeficiency Virus (HIV) berkaitan dengan perkembangan GCA. Sampai saat ini belum ada pedoman baku emas dalam penatalaksanaan GCA dan masih menjadi tantangan bagi dokter spesialis dermatologi dan venereologi, karena ukuran lesi yang besar, kemungkinan invasi dan transformasi maligna, serta tingginya risiko rekurensi. Dilaporkan sebuah kasus GCA perianal pada pasien laki-laki berusia 20 tahun dengan koinfeksi HIV. Gejala klinis berupa vegetasi bertangkai sewarna kulit, permukaan verukosa, berbentuk cauliflower, multipel, berukuran 5 x 2 x 2,5 cm di regio perianal sampai menutup regio anal dengan beberapa papul verukosa kecil di sekitarnya. Diagnosis ditegakkan berdasarkan pemeriksaan fisik, tes acetowhite positif dan pemeriksaan histopatologis. Pasien diberikan terapi kombinasi menggunakan elektrokauter dan Trichloroacetic Acid (TCA) 90% setiap minggu serta cimetidine per oral dengan dosis 3 x 500 mg setiap hari selama 3 bulan. Resolusi pada seluruh lesi GCA setelah 5 minggu terapi dan tidak didapatkan rekurensi pada follow up bulan ke-5. Tiga kombinasi terapi: elektrokauter, TCA dan cimetidine dapat dipertimbangkan sebagai penatalaksanaan GCA dengan koinfeksi HIV karena teknik invasif minimal dan cimetidine sebagai imunomodulator bekerja sinergis mendorong resolusi dan mencegah rekurensi GCA.
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