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PREVALENSI DAN KARAKTERISTIK PENDERITA REAKSI KUSTA TIPE 1 DI POLIKLINIK KULIT DAN KELAMIN RSUP SANGLAH PERIODE JANUARI – DESEMBER 2014 Luh Putu Venny Cempaka Sari; I Gusti Ketut Darmada
E-Jurnal Medika Udayana Vol 7 No 11 (2018): vol 7 no11 2018 E-jurnal medika udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (182.498 KB)

Abstract

Kusta atau Hansen’s disease merupakan salah satu penyakit infeksi pada kulit yang sangat menular dan bersifat kronis dan disebabkan oleh bakteri Mycobacterium leprae. Penderita penyakit kusta dalam perjalanan klinisnya dapat mengalami suatu kondisi akut yang disebut sebagai reaksi kusta. Reaksi kusta ditandai dengan adanya lesi radang akut yang kerap kali disertai dengan gejala sistemik.Reaksi kusta pada penderita kusta merupakan suatu hal yang serius, karena 20-30% dari seluruh penderita cepat atau lambat akan mengalami reaksi kusta yang dapat menyebabkan kecacatan permanen.Penelitian ini dilakukan dengan tujuan untuk dapat menggambarkan karakteristik penderita kusta dan reaksi kusta berdasarkan sosiodemografi dari segi usia, jenis kelamin, serta onset terjadinya reaksi.Penelitian reaksi kusta ini merupakan penelitian deskriptif dengan menggunakan data skunder yang diambil dari Poliklinik Kulit dan Kelamin, RSUP Sanglah Denpasar periode Januari-Desember 2014.Populasi target pada penelitian ini adalah semua penderitakusta dan reaksi kusta baik yang baru ataupun yang sudah terdiagnosis sebelumnya.Sampel pada penelitian ini diambil dengan menggunakan teknik total sampling.Hasil penelitian ini didapat total 107penderita kusta yang diteliti, dimana 76 orang menderita kusta BB (26,3%), BL (59,2%) dan BT (14,5%), dan 17 orang menderita reaksi kusta tipe 1 (reversal). Kelompok usia yang paling banyak terkena reaksi kusta adalah 16-35 tahun yaitu 14 orang (82,4%), jenis kelamin yang lebih sering ditemukan pada reaksi kusta adalah laki-laki dengan sampel sebanyak 12 orang (70,6%) dan onset terjadinya reaksi paling sering terjadi pada saat lebih dari 3 sampai 6 bulan masa pengobatan yaitu sebanyak 9 orang (52,9%). Kesimpulan dari penelitian ini adalah penderita dengan reaksi kusta di RSUP Sanglah masih cukup tinggi dengan gambaran karakteristik penderita berdasarkan sosiodemografi yang bervariasi. Kata Kunci: Kusta, Reaksi Kusta, Reversal, Prevalensi
The Oral-Skin Axis in Autoinflammation: A Case Report of Severe Refractory Generalized Pustular Psoriasis (GPP) Resolved by Comprehensive Periodontal Intervention Ni Putu Wina Widyastuti; Prima Sanjiwani Saraswati Sudarsa; Herman Saputra; Handelia Phinari; Luh Putu Venny Cempaka Sari; Kevin Jonathan Djuanda; Mario Korwa
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1499

Abstract

Background: Generalized pustular psoriasis (GPP) is a severe, IL-36-driven autoinflammatory dermatosis, distinct from psoriasis vulgaris. Chronic periodontitis (CP) is a dysbiotic inflammatory disease sharing pathogenic pathways (IL-1, IL-17). An "oral-skin axis" has been hypothesized, but definitive clinical evidence of CP driving a GPP flare is scarce. Case presentation: We present a 37-year-old male with a history of plaque psoriasis who developed a severe, refractory GPP flare (GPPASI 35.8) with high-grade fever (38.9°C), profound neutrophilic leukocytosis (22.5 x 10³/µL), and markedly elevated CRP (150 mg/L). The flare was resistant to maintenance methotrexate. Workup revealed severe CP with multiple periapical abscesses, culture from which grew Porphyromonas gingivalis and Fusobacterium nucleatum. The patient underwent a comprehensive dental intervention, including emergency extractions and full-mouth debridement, with concurrent peri-operative Amoxicillin-Clavulanate therapy. This combined intervention led to a rapid resolution of fever, neutrophilia, and cutaneous pustulation within 72 hours, without any escalation of systemic immunomodulators. He achieved complete remission (GPPASI 1.0) at 3-month follow-up. Conclusion: This case provides a strong temporal association supporting the oral-skin axis, highlighting severe periodontitis as a potent trigger and amplifier for GPP. The rapid resolution following a combined surgical and antibiotic intervention suggests that targeting the oral inflammatory and microbial reservoir is a critical, actionable strategy. We strongly recommend consideration of a comprehensive dental/oral screening in patients with refractory GPP.
The Oral-Skin Axis in Autoinflammation: A Case Report of Severe Refractory Generalized Pustular Psoriasis (GPP) Resolved by Comprehensive Periodontal Intervention Ni Putu Wina Widyastuti; Prima Sanjiwani Saraswati Sudarsa; Herman Saputra; Handelia Phinari; Luh Putu Venny Cempaka Sari; Kevin Jonathan Djuanda; Mario Korwa
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1499

Abstract

Background: Generalized pustular psoriasis (GPP) is a severe, IL-36-driven autoinflammatory dermatosis, distinct from psoriasis vulgaris. Chronic periodontitis (CP) is a dysbiotic inflammatory disease sharing pathogenic pathways (IL-1, IL-17). An "oral-skin axis" has been hypothesized, but definitive clinical evidence of CP driving a GPP flare is scarce. Case presentation: We present a 37-year-old male with a history of plaque psoriasis who developed a severe, refractory GPP flare (GPPASI 35.8) with high-grade fever (38.9°C), profound neutrophilic leukocytosis (22.5 x 10³/µL), and markedly elevated CRP (150 mg/L). The flare was resistant to maintenance methotrexate. Workup revealed severe CP with multiple periapical abscesses, culture from which grew Porphyromonas gingivalis and Fusobacterium nucleatum. The patient underwent a comprehensive dental intervention, including emergency extractions and full-mouth debridement, with concurrent peri-operative Amoxicillin-Clavulanate therapy. This combined intervention led to a rapid resolution of fever, neutrophilia, and cutaneous pustulation within 72 hours, without any escalation of systemic immunomodulators. He achieved complete remission (GPPASI 1.0) at 3-month follow-up. Conclusion: This case provides a strong temporal association supporting the oral-skin axis, highlighting severe periodontitis as a potent trigger and amplifier for GPP. The rapid resolution following a combined surgical and antibiotic intervention suggests that targeting the oral inflammatory and microbial reservoir is a critical, actionable strategy. We strongly recommend consideration of a comprehensive dental/oral screening in patients with refractory GPP.