clinical skill mh
DESCRIPTION
kulitkelaminTRANSCRIPT
![Page 1: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/1.jpg)
Morbus Hansen
Clinical skill
![Page 2: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/2.jpg)
GAMBARAN KLINIK DAN
KLASIFIKASI MORBUS HANSEN
![Page 3: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/3.jpg)
• WHO (1997) Cardinal sign1. Kelainan kulit hipopigmentasi atau
eritematus dengan anastesi yang jelas2. Kelainan saraf tepi berupa penebalan saraf
dengan anastesi3. Hapusan kulit: BTA+
DIAGNOSIS
![Page 4: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/4.jpg)
BERCAK KUSTA YANG SPESIFIK :
Memiliki sifat 4 – A :
• Anaesthesi• Anhydrosis• Achromia• Atrophy
![Page 5: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/5.jpg)
Central healing
![Page 6: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/6.jpg)
Rasa nyeriTES SENSIBILITAS
![Page 7: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/7.jpg)
Rasa rabaTES SENSIBILITAS
![Page 8: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/8.jpg)
Panas dinginTES SENSIBILITAS
![Page 9: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/9.jpg)
Penebalan N. Auric. magnus
![Page 10: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/10.jpg)
![Page 11: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/11.jpg)
n.ulnaris
![Page 12: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/12.jpg)
n. peronealis
![Page 13: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/13.jpg)
Kecacatan pada kusta
![Page 14: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/14.jpg)
Claw Hand
![Page 15: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/15.jpg)
Ulcus Pedis pada “weight bearing area “
![Page 16: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/16.jpg)
Deformitas akibat kusta
![Page 17: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/17.jpg)
Penebalan saraf tepi
![Page 18: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/18.jpg)
KLASIFIKASI MORBUS HANSEN
Pausi Basiler : TT BT
Multi Basiler : BB BL LL
![Page 19: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/19.jpg)
![Page 20: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/20.jpg)
GAMBARAN KLINIK M.H.
TUBERCULOID BORDERLINE LEPROMATOUS
CELLULAIR IMMUNITY
HUMORAL IMMUNITY
JUMLAH BASIL KUSTA
![Page 21: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/21.jpg)
Type Polar Tuberculoid ( TT )
![Page 22: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/22.jpg)
Borderline Tuberculoid ( BT )
![Page 23: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/23.jpg)
Tipe :
Mid-borderline
( BB – type)
![Page 24: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/24.jpg)
Type Borderline Lepromatous( BL )
![Page 25: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/25.jpg)
Type Borderline Lepromatous (BL)
![Page 26: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/26.jpg)
Type Polar Lepromatous ( LL )
![Page 27: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/27.jpg)
POLAR LEPROMATOUS LEPROSYLL – type
![Page 28: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/28.jpg)
FACIES LEONINA
![Page 29: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/29.jpg)
A. ANAMNESA
adakah bercak mati rasa ? adakah rasa semutan / geringgingen ? sudah berapa lama ? dari mana asal penderita ? adakah luka yang tak jelas sebabnya ? adakah pilek, hidung buntu, mimisan ?
![Page 30: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/30.jpg)
B. BUKA DAN PERIKSA cari gejala kulit : gangguan estesi, bercak
putih / kemerahan, nodul, ulkus periksa saraf tepi tanda lain kusta : madarosis, saddle nose,
penebalan cuping telinga dll. kecacatan : atrofi otot, drop foot dll.
![Page 31: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/31.jpg)
![Page 32: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/32.jpg)
![Page 33: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/33.jpg)
TATA-LAKSANA (1)
1. PENGOBATAN KAUSAL : MDT-WHO
Obat PB (6 bulan) MB (12 bulan)
Rifampicin 600mg /bln, *supervised
600mg /bln *supervised
DDS 100mg /hari
100mg/hari
Lamprene - 300mg/ bln* + 50mg/hari
![Page 34: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/34.jpg)
REAKSI KUSTA
SUATU EPISODE AKUT DALAM PERJALANAN KRONIS PENYAKIT KUSTA YANG MERUPAKAN SUATU REAKSI IMUNOLOGIS DENGAN AKIBAT MERUGIKAN PENDERITA
![Page 35: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/35.jpg)
REAKSI KUSTA
TIPE 1( REAKSI REVERSAL)
TIPE 2( E . N . L )
ONSET Awal terapi (1-3 bulan pertama)
Pertengahan / Akhir( > 6 bulan / RFT )
TIPE M.H. PB/MB MB
KLINIS Lesi lama menjadi aktif, menebal
Timbul nodule baru yang meradang
SISTEMIK Jarang, febris ringan, oedem
Sering, febris, artralgi, sefalgi dll.
![Page 36: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/36.jpg)
Reaksi Kusta tipe 1 ( Reversal Reaction )
![Page 37: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/37.jpg)
Reaksi kusta tipe 1 ( Reversal Reaction )
![Page 38: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/38.jpg)
Reaksi kusta tipe 1 ( Reversal Reaction )
![Page 39: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/39.jpg)
Reaksi Kusta tipe 2 ( Eryhtema Nodosum Leprosum / ENL )
Erythema Nodosum Leprosum (ENL)
![Page 40: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/40.jpg)
Penatalaksanaan Reaksi Kusta
Prinsip : obat anti kusta / MDT harus diteruskan
Tx Reaksi tipe 1 : - ringan : simtomatis- berat dgn neuritis : anti inflamasiTx Reaksi tipe 2 : - Steroid sistemik
![Page 41: Clinical Skill MH](https://reader033.vdocuments.site/reader033/viewer/2022052212/55cf926d550346f57b96731b/html5/thumbnails/41.jpg)
PENTINGNYA PENEMUAN PENDERITA KUSTA SECARA DINI
• Pengobatan secara dini akan mencegah terjadinya cacat kusta
• Pengobatan secara dini menghilangkan sumber penularan di masyarakat
• Pemberantasan penyakit kusta akan menyelamatkan masa depan generasi penerus