Peran Dan Prosedur Uji Kulit Untuk Identifikasi Penyebab Pada Kasus Reaksi Simpang Obat
DOI:
https://doi.org/10.33820/mdvi.v45i3.34Abstract
Pada tatalaksana kasus erupsi obat alergik (EOA), identifikasi obat penyebab merupakan langkah utama untuk mencegah pajanan ulang terhadap obat yang menyebabkan EOA. Sebagian besar kasus EOA sulit menentukan obat penyebabnya, sehingga dibutuhkan uji provokasi beberapa obat yang diduga sebagai obat penyebab.Uji provokasi oral merupakan baku emas untuk menentukan obat penyebab, namun merupakan kontraindikasi pada kasus EOA berat. Uji tempel, tusuk, dan intradermal merupakan metode in vivo yang relatif lebih aman digunakan untuk identifikasi obat penyebab, walaupun terdapat beberapa keterbatasan. Dasar pemilihan uji kulit adalah berdasarkan patomekanisme dan manifestasi klinis EOA, diduga paling sering dimediasi oleh reaksi hipersensitivitas Coombs dan Gel tipe I dan IV. Uji tempel dapat bermanfaat pada kasus EOA tipe maku lopapular dan fixed drug eruption, sedangkan uji tusuk dapat bermanfaat untuk tipe urtikaria dan angioedema. Untuk mendapatkan hasil uji yang sahih, perlu diperhatikan konsentrasi alergen obat dan vehikulum yang digunakan, serta persyaratan uji. Indikasi uji tempel pada kasus EOA semakin meningkat, tetapi terdapat variasi antar pusat layanan dan belum ada panduan yang di sepakati bersama.Kata kunci:erupsi obat alergik, identifikasi obat, uji kulit
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References
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19. Lachapelle JM. Testing in Cutaneous Systemic Adverse Drug Reactions. Dalam: Lachapelle JM, Maibach HI, penyunting. Patch testing and Prick Testing. Edisi ke-2. Berlin: Springer; 2009.h. 155-66.
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2. Mockenhaupt M. Epidemiology of cutaneous adverse drug reaction. Dalam: French LE, penyunting. Adverse Cutaneous Drug Eruptions. Chemical Immunology and Allergy. Edisi ke-1. Basel: Karger; 2012.h. 1-17. 3. Data Kunjungan Pasien Departemen Ilmu Kesehatan Kulit dan Kelamin tahun 2014, 2015, dan 2016.
4. Sidoroff A. Acute Generalized Exanthematous Pustulosis. Dalam: LE F, penyunting. Epidemiology of cutaneous adverse drug reaction. 97. Basel: Karger; 2012.h. 139-48.
5. Shiohara T. Drug-Induced Hypersensitivity Syndrome. Dalam: LE F, penyunting. Epidemiology of cutaneous adverse drug reaction. 97. Basel: Karger; 2012.h. 122-38.
6. Harr T. Diagnostic approach to drug allergy. Dalam: French LE, penyunting. Adverse Cutaneous Drug Eruptions. Chemical Immunology and Allergy. Edisi ke-1. Basel: Karger; 2012.h. 47-60.
7. Hannuksela M. Skin Testing in Drug Hypersensitivity. Dalam: Kauppinen K, Alanko K, Hannuksela M, Hannuksela M, penyunting. Skin Reactions To Drugs. Edisi ke-1. New York: CRC Press; 1998.h. 81-95.
8. Barbaud A. Place of drug skin tests in investigating systemic cutaneous drug reactions. Dalam: Pichler WJ, penyunting. Drug Hypersensitivity. Edisi ke-1. Basel: Karger; 2007. h. 366-79.
9. Soebaryo RW, Nugrohowati T, Effendi EH. Skin test in drug eruption: Five years experience at Dr. Cipto Mangunkusumo General Hospital, Jakarta. Med J Indones. 2004;13:81-5.
10. Barbaud A, Collet E, Milpied B. A multicentre study to determine the value and safety of drug patch tests for the three main classes of severe cutaneous adverse drug reactions. Br J Dermatol. 2013;168:555-62.
11. Barbaud A, Gonçalo M, Bruynzeel D, Bircher A. Guidelines for performing skin tests with drugs in the investigation of cutaneous adverse drug reactions. Contact Dermatitis. 2001;45:321-8.
12. Aquino MR, Sher J, Fonacier L. Patch Testing for Drugs. Dermatitis. 2013;24:205-14.
13. Brockow K, Romano A, Blanca M, Ring J, Pichler W, Demoly P. General considerations for skin test procedures in the diagnosis of drug hypersensitivity. Allergy. 2002;57:4551.
14. Friedmann PS, Ardern-Jones M. Patch testing in drug allergy. Curr opin in aller and clin immunol. 2010;10:291-6.
15. Mygind K, Sell L, Flyvholm M-A, Jepsen KF. High-fat petrolatum-based moisturizers and prevention of work-related skin prob;lems in wet-work occupations. Contact Dermatitis. 2006;56:35-41.
16. Heinzerling L, Mari A, Bergmann KC, Bresciani M, Burbach G, Darsow U, dkk. The skin prick test - European standards. Clin and transl aller. 2013;3:3.
17. Lachapelle JM, Maibach HI. The Methodology of Open (Non-prick) Testing, prick Testing, and its Variants. Dalam: Lachapelle JM, Maibach HI, penyunting. Patch testing and Prick Testing. Edisi ke-2. Berlin: Springer; 2009.h. 141-52.
18. Barbaud A, Trechot P, Webber-Muller F, Ulrich G, Commun N, Schmutz J. Drug skin test in cutaneous adverse drug reactions to pristinamycin. Contact Dermatitis. 2004;50:22-6.
19. Lachapelle JM. Testing in Cutaneous Systemic Adverse Drug Reactions. Dalam: Lachapelle JM, Maibach HI, penyunting. Patch testing and Prick Testing. Edisi ke-2. Berlin: Springer; 2009.h. 155-66.
20. Parker CW, Shapiro J, Kern M, Eisen HN. Hypersensitivity to penicillenic acid derivatives in human beings with penicillin allergy. The J Exper Med. 1962;115:821-38.
21. Lachapelle JM, Maibach H. Clinical Relevance of Patch Test Reactions. Dalam: Lachapelle JM, Maibach HI, penyunting. Patch testing and Prick Testing. Edisi ke-2. Berlin: Springer; 2009. h. 113-20.
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Published
2019-05-09
How to Cite
Budianti, W. K., Pradana, P., & Ramadhiani, M. (2019). Peran Dan Prosedur Uji Kulit Untuk Identifikasi Penyebab Pada Kasus Reaksi Simpang Obat. Media Dermato-Venereologica Indonesiana, 45(3). https://doi.org/10.33820/mdvi.v45i3.34
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