KERION CELSI YANG DISEBABKAN OLEH TRICOPHYTON VERRUCOSUM PADA PASIEN IMUNOKOMPROMAIS
DOI:
https://doi.org/10.33820/mdvi.v46i1.51Abstract
Kerion celsi merupakan manifestasi inflamasi pada infeksi dermatofita zoofilik diskalp. Salah satu penyebabnya adalah Trichophyton verrucosum. Imunitas seluler pada pasien imunokompromais terganggu sehingga rentan terinfeksi dermatofita.
Pria, 73 tahun mengeluh benjolan bernanah di kepala yang nyeri dan gatal sejak 3 bulan sebelum konsultasi. Pada pemeriksaan dermatologis parietal skalp didapatkan alopesia berbatas tegas dengan boggy eritematosa 5 cm dan pustul folikular. Pemeriksaan dengan lampu Wood tidak menunjukkan fluoresensi. Pemeriksaan mikroskopik dengan KOH 20% didapatkan hifa dan artrokonidia ektotriks. Numerical rating score (NRS) nyeri 8, dan gatal 4. Identifikasi kultur kerokan kulit kepala dan rambut menunjukkan Trichophyton verrucosum. Pasien didiagnosis kerion celsi ,diterapi dengan griseofulvin microsized 20 mg/kg berat badan/hari selama 8 minggu, dan prednison 0,5 mg/kg berat badan/hari selama 10 hari yang kemudian diturunkan perlahan. Ditambahkan krim terbinafine HCL 1 % didahului kompres basah dua kali sehari. Setelah 8 minggu, perbaikan NRS mencapai nol, tanpa efek samping.
Kerion celsi seringkali terjadi pada anak, jarang pada dewasa. Pada kasus ini terjadi pada pasien neoplasma berusia lanjut dalam kemoterapi. Usia lanjut, kanker paru, kemoterapi geftinib, diabetes mellitus dan kontak langsung dengan hewan peliharaan merupakan faktor risiko kondisi imunokompromais dan inokulasi patogen sehingga mempermudah dermatofita menginvasi rambut.
Kata kunci: kerion celsi, Tricophyton verrucosum, imunokompromais, griseofulvin
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