Yunita Hapsari
Bagian Ilmu Kesehatan Kulit dan
Kelamin
Fakultas Kedokteran Universitas
Mataram
PYODERMA
Infeksi pada kulit, yang disebabkan
oleh bakteri yg membentuk nanah
atau piogenik dan mudah menular
Etiologi :
Staphylococcus S.aureus
Streptococcus Streptococcus grup A
Kedua-duanya
Faktor predisposisi :
Daya tahan tubuh rendah
Higiene individu kurang
Higiene lingkungan kurang
Telah ada penyakit kulit sebelumnya
Klasifikasi pyoderma :
PRIMER
Impetigo
Folikulitis
Furunkel
Karbunkel
Paronikia
Ektima
SEKUNDER
Impetigenisata
Hidradenitis
supurativa
Intertrigo
Ulkus
IMPETIGO
Pyoderma superfisial
Etiology : Streptococcus grup A
S.aureus
2 bentuk :
Bulosa
Non-bulosa / krustosa
IMPETIGO BULOSA
Impetigo vesiko-bulosa, cacar monyet
Etiology : phage group II S.aureus (strain
77 & 55) exfoliatin toxin type A and B
Clinical :
IMPETIGO BULOSA
IMPETIGO BULOSA
Lab :
Pengecatan Gram
Kultur
histoPA
DD/ :
Dermatitis kontak
Insect bite
Erupsi obat tipe bulosa
IMPETIGO BULOSA
Complication :
Cellulitis
Lymphangitis
Bacteremia
Osteomyelitis
Septic arthritis
Pneumonitis
Septicemia
SSSS
DD/ :
Atopic dermatitis
Allergic contact dermatitis
Varicella
Dermatophyte infection
MANAGEMENT OF IMPETIGO
Washing (removal of dirt, crusts and
debris by soaking with soap & water)
Good hygiene
Pharmacology: topical and systemic
Topical & Systemic Antibiotic
FOLIKULITIS
Def : a pyoderma that begins within
the hair follicles
Classified :
Depth of invasion : superficial and deep
Microbial etiology : bacterial, fungal, viral
and parasite infestation
FOLIKULITIS SUPERFISIAL
Impetigo Bockhart;
follicular impetigo
Etiology : S.aureus
Clinical finding:
Location : scalp
(children); beard area,
axillae, extremities,
buttocks (adults)
A small, fragile, domeshaped pustule
infudibulum of a hair
follicle
DD/ : -
gram-negative
folliculitis
Pityrosporum
folliculitis
Herpes simplex
Deep folliculitis
sycosis barbae
FURUNKEL
Boil / bisul
Deep-seated inflammatory nodule that
develops around a hair follicle, usually from a
preceding, more superficial folliculitis and
often evolving into an abcess
Etiology: S.aureus
Clinical finding :
Pain surrounding the lesion
Nodule (hard, tender, red folliculocentric)
enlarge fluctuant abcess formation rupture
Single/multiple
Furunkel / Furunkulosis ?
FURUNKEL
Lab:
Leukocytosis
Gram stain of pus
Culture
Complication
Not common
Recurrent
furunculosis
KARBUNKEL
Larger, more serious
inflammatory lesion
with a deeper base
Extremely painful
Fever, malaise
Location : nape of the
neck, the back or
thighs
Efl : red, indurated,
multiple pustules
confluent
EKTIMA
A cutaneous pyoderma
characterized by thick
crusted erosions or
ulceration
Etiology: S.aureus &/ group A
Streptococcus
Clinical finding:
Poor hygiene & neglect
Location : lower extremities
(children, DM, elderly)
Efl: ulcer punched-out,
indurated, raised, violaceous,
granulating base
slow to heal need several
weeks of antibiotic treatments
ERISIPELAS
Soft tissue infection erysipelas &
cellulitis
Usually present at an antecedent
lesion or site
Local pain, variable degrees of
erythema, systemic symptoms
ERISIPELAS
Distinct type of
superficial cutaneous
cellulitis with marked
dermal lymphatic vessel
involvement
Etiology : group A hemolytic Streptococcus
(>>) ; S.aureus (<<)
Clinical finding :
Face, lower extremities
Pain, superficial erythema
and plaque-like edema
with sharply defined
margin to normal tissue
Recurrent lymphedema
SELULITIS
Extends deeper into the dermis and
subcutaneous tissue
Etiology : S.aureus and group A
Streptococcus (>>)
Clinical finding :
Erythema, tenderness, pain
Lack of distinctive margins between affected and
normal skin
Deeper, firmer form of tender induration
Crepitus on palpation
Bulla and necrosis
Regional lymphadenopathy
SELULITIS
PENATALAKSANAAN
Istirahat tirah baring & elevasi tungkai
Sistemik antibiotic
Topikal : kompres dingin dengan normal
saline steril
Intervensi bedah