DIAGNOSIS DAN TATA LAKSANA TERKINI PITIRIASIS ROSEA
DOI:
https://doi.org/10.33820/mdvi.v51i3.389Keywords:
dermoskopi, diagnosis, histopatologis, pitiriasis rosea, tatalaksanaAbstract
Pitiriasis rosea (PR) merupakan kelainan kulit jinak akut papuloskuamosa yang swasirna. Kejadian PR di seluruh dunia dilaporkan sebanyak 0,3 - 1,2%. Infeksi human herpes virus (HHV) 6, 7, dan beberapa obat diduga sebagai pencetus PR. Gejala klinis diawali lesi primer berupa herald patch, diikuti lesi sekunder berukuran lebih kecil yang tersebar pada garis Langer (lipatan tubuh), dapat meluas ke lengan dan paha atas. Klasifikasi PR terbagi menjadi tipikal dan atipikal berdasarkan keberadaan herald patch, lokasi lesi, morfologi lesi, dan perjalan penyakit. Diagnosis PR dapat ditegakkan berdasarkan tiga kriteria, yaitu: kriteria esensial, opsional, dan eksklusi. Derajat keparahan PR ditentukan dengan Pityriasis Rosea Severity Score (PRSS). Pemeriksaan dermoskopi dan histopatologis dapat membantu dalam mendiagnosis PR. Gambaran dermoskopi yang dilihat di antaranya: background, warna skuama, susunan skuama, dan pola pembuluh darah. Pemeriksaan histopatologis merupakan baku emas. Terapi PR di antaranya antihistamin, kortikosteroid, asiklovir, makrolida, dan narrowband UVB (NB UVB) phototerapy. Berdasarkan studi dengan Level of Evidence (LoE) tertinggi asiklovir dianggap aman dan efektif dalam mengobati PR pada fase awal dengan cara meredakan eritema pada lesi lama dan mengurangi jumlah lesi baru.
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