M.

Taufik Amrullah (C 111 09 257)

Nur Raisah Ulfah (C 111 09 382)
Nabila S. Ahmad(C 111 09 792)
Patient Identity
Nama : Ny. Soho Dg Ati
Umur : 48 tahun
Alamat : Jl.
Status : Menikah
Agama :
Suku :
Tanggal Masuk RS : July 18, 2012
 History :
Autoanamnesis
Main complaint:
itching and redness on the skin
Guided history:
Experienced since 6 months ago
Continues felt itchy and itching felt on the whole body,
initially just itching and swelling around the mouth, and
then the redness appears on the chest and continues to the
whole body. After four month the itching redness felt on the
whole body except on the face
History of treatment (+) betamethason
Family history of similar complaints (-)
History of food allergy (unknown)
History of DM (-)
History of Hypertension (-)
 Patient Identity
General condition: moderate condition, awareness of
compostmentis, obesity
Vital signs: blood pressure 100/70 mmHg, pulse
84x/min, breathing 24x/min, temperature 36.7 C
Head : - sclera jaundice (-)
- Anemic conjunctiva (-)
- Lip cianosis (-)
Heart / lung: within normal limits
Abdomen: flat following the movement of breath,
peristaltic (+) normal impression, tympanic (+)
Extremities: edema (-)
Lymph glands: no enlargement
Dermatovenerologi Status
Dermatovenerologi Status

Location: Generelized region

Effluorescence: plaques, erythem, scales
Laboratory
WBC = 17.5 SGOT = 24
LYM= 1.9 SGPT = 21
RBC = 4.79
HB = 14.2
PLT=558
Resume
42-years-old woman was hospitalized with main
complaints itching and redness since 6 months
ago. Continues felt itchy and itching felt on the
whole body, initially just itching and swelling
around the mouth, and then the redness appears
on the chest and continues to the whole body.
After four month the itching redness felt on the
whole body except on the face
History of treatment (+) the name of drugs
unknown. Family history of similar complaints (-).
History of food allergy (unknown). History of DM
(-). History of Hypertension (+)
The internal status: vital signs blood pressure
150/80 mmHg; pulse 88x/min; breathing 26x/min;
temperature 36.6 C
Status of dermatology: generelized region.
Efloresensi : Erythematous macules, scales, the
active edge
Treatment
CTM 0-1-1
Betametason cr 10 gr
Salicyl acid 2%
Lanolin 10%
Neurodex 0-1-1
Discussion
Psoriasis vulgaris is the most common form of
psoriasis, seen in approximately 90 percent of patients.
Red, scaly, symmetrically distributed plaques are
characteristically localized to the extensor aspects of
the extremities, particularly the elbows and knees,
along with scalp, lower lumbosacral, buttocks, and
genital involvement
Etiology and Pathogenesis
Psoriasis is a chronic inflammatory skin disease, with
a strong genetic basis, characterized by complex alterations
in epidermal growth and differentiation and multiple
biochemical, immunologic, and vascular abnormalities,
and a poorly understood relationship to nervous system
function. Its root cause remains unknown. Historically,
psoriasis was widely considered to be a primary disorder of
keratinocytes. With the discovery that the T-cell specific
immunosuppressant cyc1osporin A (CsA) was highly active
against psoriasis, most researchers have focused on the
immune system.
Clinical Manifestation
Skin Symptoms Pruritus is reasonably common, especially
in scalp and anogenital psoriasis.
Skin Lesions The classic lesion of psoriasis is a sharply
marginated erythematous papule with a silvery-white scale.
Scales are lamellar, loose, and easily removed by scratching.
Removal of scale results in the appearance of minute blood
droplets. Papules grow to sharply marginated plaques with
lamellar scaling that coalesce to form polycyclic or
serpiginous patterns. May occur anywhere on the body but
there are classic predilection sites.
Clinical Manifestation
Palms and Soles May be the only areas involved. There is
massive silvery white or yellowish hyperkeratosis and
scaling, which in contrast to lesions on the trunk, is not
easily removed.
Scalp Plaques, sharply marginated, with thick adherent
scales. Scattered discrete or diffuse involvement of entire
scalp. Often very pruritic.
Face Uncommonly involved, and when involved, usually
associated with a refractory type of psoriasis.
Diagnosis and Differential Diagnosis
Diagnosis is made on clinical grounds.
Acute Guttate Psoriasis Any maculopapular drug
eruption, secondary syphilis, pityriasis rosea.
Small Scaling Plaques Seborrheic dermatitis may be
indistinguishable in sites involved and morphology;
sometimes termed seborrhiasis. Lichen simplex chronicus
may complicate psoriasis as a result of pruritus.
Psoriasiform drug eruptions especially beta blockers,
gold, and methyldopa. Tinea corporis KOH examination
is mandatory, particularly in single lesions. Mycosis
fungoides scaling plaques can be an initial stage of
mycosis fungoides. Biopsy.
Large Geographic Plaques Tinea corporis, mycosis
fungoides.
Diagnosis and Differential Diagnosis
Scalp Psoriasis Seborrheic dermatitis, tinea capitis.
Inverse Psoriasis Tinea, candidiasis, intertrigo,
extramammary Paget disease. Glucagonoma syndrome
an important differential because this is a serious disease;
the lesions look like inverse psoriasis. Langerhans cell
histiocytosis, Hailey-Hailey disease.
Treatment
Systemic Medication
Corticosteroid : Prednison 30mg/day
Sitostatic Medicine: Metotreksat
Etretinat
Siklosporin
Topical Medication
Preparat Ter
Topical Corticosteroid
Ditranol
Emolien
Prognosis
Although psoriasis cant make mortality, but it can
cause chronic infection and make reinfection if didnt treat
correctly.