Dermatitis

Numularis
 “
2

○ Suatu kelainan kulit inflamatif berupa papul dan

papulovesikel yang berkonfluensi membentuk plak
berbentuk koin berbatas tegas dengan oozing,
krusta, dan skuama.
○ Sangat gatal, predileksi ekstremitas atas dan bawah
○ Sinonim = eksema diskoid
 3

○ Seperti dermatitis tipe lain, penyebabnya

adalah karena disfungsi barrier lipid
Patofisiologi epidermis dan respon imunologis.
○ Disfungsi barrier lipid bisa diakibatkan
karena :
1.Kulit yang terlalu kering
2.Konsumsi obat yang menginduksi
kekeringan pada kulit
 4

Gambaran
Klinis
○ Plak berbentuk koin
yang terdiri dari
sekelompok papul
kecil dan vesikel pada
area dengan dasar
eritem.
○ Bisa disertai adanya
scale dan krusta
 5

Diagnosis
Banding & DIAGNOSIS BANDING PEMERIKSAAN PENUNJANG
1. Dermatitis kontak ○ Untuk penegakan diagnosis
Pemeriksaan alergi tidak perlu pemeriksaan
Penunjang 2. Dermatitis stasis penunjang khusus

3. Dermatitis atopik ○ Apabila diperlukan, dapat

dilakukan pemeriksaan
penunjang sesuai diagnosis
banding
○ Pada kasus berat atau
rekalsitran, dilakukan uji tempel
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Non-Medikamentosa
Medikamentosa
1. Topikal

Terapi 1. Hindari/atasi ○ Kompres pada lesi akut

○ Antiinflamasi dan/atau antimitotik:
faktor pencetus  Pilihan utama = kortikosteroid topikal
potensi sedang hingga kuat
2. Berikan emolien  Pilihan lain = inhibitor kalsineurin
seperti takrolimus dan pimekrolimus
apabila 2. Sistemik

ditemukan kulit ○ Antihistamin oral

kering ○ Pada kasus dermatitis numularis berat dan
refrakter, dapat diberi :
 kortikosteroid sistemik
 pada anak = metotreksat 5-10
mg/minggu
○ Pada kasus dermatitis numularis dengan lesi
generalisata dapat ditambahkan fototerapi
broad/narrow band UVB
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Topikal Sistemik Non Medikamentosa

Terapi ○ Kompres pada lesi ○ Antihistamin oral ○ Hindari/atasi faktor
akut ○ Pada kasus dermatitis pencetus
○ Antiinflamasi numularis berat dan ○ Berikan emolien
refrakter, dapat diberi :
dan/atau antimitotik: apabila ditemukan
 kortikosteroid kulit kering
 Pilihan utama = sistemik
kortikosteroid
topikal potensi  pada anak =
sedang hingga kuat metotreksat 5-10
mg/minggu
 Pilihan lain =
○ Pada kasus dermatitis
inhibitor
numularis dengan lesi
kalsineurin seperti generalisata dapat
takrolimus dan ditambahkan fototerapi
pimekrolimus broad/narrow band
UVB
 8

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