Tatalaksana Pasien dengan Eritroderma Psoriasis: Sebuah Laporan Kasus
Keywords:
eritroderma, psoriasis, tatalaksana, metotreksat, terapi topikalAbstract
Pendahuluan: Eritroderma psoriasis (EP) adalah subtipe yamg jarang dari psoriasis vulgaris dengan prevalensi 1-2% dari pasien psoriasis. EP memiliki ciri berupa eritema generalisata dan skuama yang melibatkan lebih dari 75-90% luas permukaan tubuh. Pasien dengan psoriasis yang tidak terkontrol lebih mungkin untuk mendapatkan kondisi ini dan tanpa pengobatan yang tepat, dapat mengakibatkan morbiditas yang signifikan dan, dalam beberapa keadaan, mortalitas. Kami melaporkan sebuah kasus EP dengan tatalaksana yang berhasil di Rumah Sakit Umum Daerah Nunukan, Kalimantan Utara.
Ilustrasi kasus: Seorang wanita berusia 42 tahun datang dengan keluhan rasa gatal dan terbakar di kulit sekujur tubuhnya disertai kulit yang mengelupas sejak 3 bulan terakhir. Pasien memiliki riwayat psoriasis selama 24 tahun tetapi tidak rutin berobat. Tanda-tanda vital stabil dan pemeriksaan laboratorium dalam batas normal. Pemeriksaan fisik menunjukkan plak hiperkeratosis generalisata dengan skuama psoriasiform. Skor PASI sebesar 41.9. Pasien tersebut mendapatkan metotreksat 7.5 mg, asam folat, vitamin D, cetirizine, dan terapi topikal (asam salisilat, antibiotik, lanolin, dan salep kortikosteroid poten). Setelah 1 minggu, kondisi kulit pasien membaik secara signifikan, tidak ada lagi keluhan gatal dan panas. Skor PASI berkurang sebanyak 75.2% menjadi 10.4.
Kesimpulan: EP merupakan kegawatdaruratan di bidang dermatologi yang memerlukan pendekatan secara holistik dan respon cepat. Tatalaksana pasien termasuk stabilisasi, koreksi ketidakseimbangan, menjaga fungsi barier kulit, dan mencegah infeksi. Terapi topikal dan agen sistemik harus dipertimbangkan secara individual pada setiap pasien.
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Copyright (c) 2026 Nurlaela Sari, Erlina Ari Windyareski (Author)
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