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IZZAH MUNIRA HAMIDIN C11108791
MASYITA AHMAD OPIER C11108184RAISSA ALFAATHIR HERI C11108197
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Patients IdentityName : Kornelius Kadang
Gender : Male
Age : 52 years old
Marital Status : Married
Address : PERUM Stella Maris,
Tidung 10, Makassar
Admission Date : 29 January 2012
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History TakingChief complaint : red patches and
scaling almost the whole body
Happen 1 week ago, starts with itchy and thereare red spots at the face and it spreaded all ofthe body.
Post operation of prostate (1 month before)
Medication History : Cefadroxil, Mefenamicacid, Transamin, Ranitidin
Fever (+) before itch presented
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Physical ExaminationAnemic (-), icterus (-), cyanoses (-)
Diffuse erythema with overlying scale covering> 90% of the body surface area, pus and wound
on the left ear
Cor / Pulmonal : Normal
Abdomen : Normal, peristaltic (+)
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Current Status General status
Composmentis
Moderate Sickness
Adequate nutrition Moderate Hygiene
Vital sign (in normal limit)
Blood pressure : 120/80 mmHg
Pulse rate : 96 x/min
Respiration rate : 24 x/min
Temperature : 36,8 C
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Dermato-venerology Status
Location 1 : Regio Universalis
Effloresensi : Erythema Macule,
Squamatous, Erosion, Crust
Location 2 : Regio Facialis, auricularis
dextra et sinistra
Effloresensi : Erosion, Edema, Pustule,
Crust, Erythema
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Laboratory Result
Ureum : 20 mg/dl
Creatinin : 1,7 mg/dl
GDS : 87 mg/dl SGOT : 22 U/l
SGPT : 47 U/l
Natrium : 134 mmol/l
Kalium : 3,9 mmol/l
Chloride : 109 mmol/l
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Recommended examinationXray
Consult diet
Consult ENT
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ResumeA 57 years old man came to the hospital with complain
of having red patches and squamation on all over thebody since 1 week ago.
History of fever 1 week before red spot appeared
History of prostate operation
History of medication; cefadroxil, mefenamic acids,
ranitidin, transaminNo history of allergic
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DiagnosisErythroderma e.c Drug Eruption
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Treatment
1. IVFD RL 20 drops/min
2. Dexamethasone inj. 1 amp/ 6 h./ iv
3. Gentamicin 1 amp/12 h./ iv
4. Lanolin 10% + Vaseline add 100 gr
5. Fuson cr.
6. Compress NaCl
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PICTURES
(30-01-2012)
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(03-02-2012)
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ERYTHRODERMA
Universal redness and scaling of theskin affecting 90-100% of the body
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Idiopathic - 30%
Drug allergy - 28%
Seborrheic dermatitis - 2%
Contact dermatitis - 3%
Atopic dermatitis - 10%
Lymphoma and leukemia - 14%
Psoriasis - 8%
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Medications Implicated in
ErythrodermaThe most commonly implicated drugs include: Anti-epileptics Allopurinol
AntibioticsPenicillinSulfonamidesVancomycin
Calcium channel blockers
Cimetidine Dapsone Gold Lithium Quinidine
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Present with universal erythema. Scaling appears 2-6days after the onset of erythema usually starting fromflexural area.
Common symptoms : fevers, chills, malaise & pruritus Pruritus result in excoriation. When erythroderma
persist for weeks, hair may sheds, nails may becomeridge and thickened and also may shed.
A fine brawny scaling in drug-induced
A heavy scaling and silvery white scales in psoriasis
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Dilatation ofcapillary
Large amounts of
warm blood arepresent in the skin
heat dissipation
through insensiblefluid loss and byconvection
the loss of scales throughexfoliation (9 g/m2ofbody surface per day)
reduction in serumalbumin
the edema of the
lower extremities
fatigue, weakness, malaise,and shivering
Metabolic response to erythroderma:
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DiagnosisAnamnesis & history taking
Physical examination
Laboratory examinationo Low serum albumin and increase in gammaglobulins;
electrolyte imbalance; acute-phase proteins increased.
o
Leukocytosis
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Treatment
Remove any potential offending and unnecessary
medications
Address nutrition, fluid and electrolyte balance
Oral corticosteroid
Local skin care with compression to weeping orcrusted sites, bland emollients and mid-potencytopical corticosteroids
Oral antihistamines for relief of pruritus For secondary infection with systemic antibiotics
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