Identity

Name : Mr. S
Age
: seventy one years
Gender : Male
Education: Graduated from senior high school
Address : Sumbermanjing
Status : Married
Occupation: Farmer
religion : Islam
Check Date: December 24, 2014

 anamnesis
The main complaint: Red scaly patches occurred on the
head, elbows and knee
Now medical history:
Patients Tn.S, seventy-one years of coming to the hospital
with complaints appear reddish patches on the head,
elbows and knees since two months ago.
Spotting a small initially increasingly widened and began
scaly. If carded raised red spots and if scratched white as
wax. The patches do not itch, pain (-), heat (-) and
tenderness (-). Itchy red patches do not increase when
sweating. Not preceded by fever, or injury to another place.

 Complaints perceived to be getting worse

when cold place, the patient had never treat
the complaint.
There is no previous history of similar
complaints, history of infectious disease, a
history of allergy or use of certain drugs. No
family members who have similar complaints
by patients or a history of allergies.

 Formerly Disease history:

The patient had never had symptoms like this before.
Hypertension (-), DM (-), asthma (-), heart disease (-).
Family Disease History:
A history of complaints that
the same (-)
Family history of HT (-)
History of asthma (-)
A history of heart disease (-)
History of diabetes (-)
History of drug allergy and food (-)

 physical examination
1. General condition:
compos mentis consciousness (GCS E4V5M6)
2. Vital signs:
Tension: not done
Nadi: not done
Respiratory: not done
Temperature: not done

 There is a skin abnormality

 Appear macular & Plaques demarcated

erythema. Squama grainy (+) which is
transparent and layered, drip wax (+), auspitz
sign (+),

 foto

 Histopathology
hyperkeratosis, parakeratosis, acanthosis,
elongation of rete ridges, elongation papillary
dermis, mitotic basal stratum , Thinning to
the loss of the granular layer, micro-abscesses
Munro, dermal edema, infiltration of
monocytes and lymphocytes.

 Tn.S patient, 71 years came to the hospital with

complaints appear reddish spots on the head,
elbows and knees since two months ago.
Spotting a small initially increasingly widened and
began scaly. If carded raised red spots and if
scratched white as wax. The patches do not itch,
pain (-), heat (-) and tenderness (-). Itchy red
patches do not increase when sweating. Not
preceded by fever, or injury to another place.

 Complaints perceived to be getting worse when cold

place, the patient had never treat the complaint.
There is no previous history of similar complaints,
history of infectious disease, a history of allergy or use
of certain drugs. No family members who have similar
complaints by patients or a history of allergies.
From a physical examination appear macular,
erythematous plaques demarcated, grainy squama
transparent and layered, drip wax (+), auspitz sign (+) in
the region of the superior limb capitis and d / s and
inferior d / s.

 The diagnosis of

 According PASI score total: Psoriasis degrees

Lightweight
diagnosis

 DIFFERENTIAL DIAGNOSIS
1. Seborrheic dermatitis
2. Dermatophytosis
3. Syphilis psoriaformis

 Management terapi

Definisi
Is the cause of autoimmune diseases, chronic
and recurrent nature, characterized by
patches demarcated erythema with scaling
grainy, layered layers and transparent, with
the phenomenon of wax droplets, Auspitz sign
and Kobner phenomenon.

epi
1-3% of the population
=
The incidence varies
Often the white man
All ages, adults >>
genetic factors

etio
Not clearly known, suspected autoimmune
genetic factors
immunologic factors
Variety of factors precipitating