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STEVEN JOHNSON SYNDROME DENGAN IMPLIKASI ORAL PARAH SERTA PENATALAKSANAANNYA : LAPORAN KASUS Fika Faradillah Drakel; Tenny Setiani Dewi
Denta Journal Kedokteran Gigi Vol 16 No 1 (2022): February
Publisher : Fakultas Kedokteran Gigi Universitas Hang Tuah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30649/denta.v16i1.7

Abstract

Background: Steven Johnson Syndrome (SJS) is an acute mucocutaneous syndrome that predominantly involve the skin and mucous membranes. SJS is an immune-mediated disease that have been associated with erythema multiforme (EM). The most common triggers are viruses, food allergies, autoimmune reactions and medicine. The medicines that most commonly cause SJS are non-steroidal anti-inflammatory drugs, antibiotics, antifungals, and anticonvulsants. Case: A 32-year-old man was consulted from the Dermatology Department with a diagnosis of drug induce SJS and was given cetirizine and dexamethasone. The patient presented to the Oral Medicine Department complaining of mouth pain, dysphagia, ulcers, oedema and haemorrhagic of the lips, difficult eating, drinking and speaking. Extra-oral examination found that the surface of the lips was covered with a white layer, bloody and crusted, and erythematous rash on his neck, arm, abdomen, palms and feet, with a diameter of 2-6 mm. Intra-oral examination found multiple ulcers and erosive lesions that spread on the tongue, palate, buccal and labial mucosa. This condition established as an oral lesion related to SJS. Case Management: The management of the oral lesion was given corticosteroid mouthwash, 0.12% chlorhexidine digluconate, lip compress with 0.9% NaCl and 1% hydrocortisone ointment. Conclusion: Steroid mouthwash to suppress inflammation as well as a combination of 0.12% chlorhexidine digluconate antiseptic drug suppresses the infection process and complications that continue in the oral cavity and 0.9% NaCl solution as a moist wound healing. This therapy plays an important role in the healing process of oral lesions in patients with SJS.
Oral Opportunistic Infections in Patient with HIV Wasting Syndrome Mega Rafika; Tenny Setiani Dewi
Scientific Dental Journal VOLUME 3, ISSUE 1, JANUARY 2019
Publisher : Faculty of Dentistry, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25105/sdj.v3i1.3608

Abstract

Background: Human immunodeficiency virus (HIV) wasting syndrome is a condition in which weight loss, fever, and chronic diarrhea occur for more than 30 days without any causes other than HIV infection. HIV causes an immunocompromised condition resulting in susceptibility to infection. The opportunistic infections are oral candidiasis, herpes simplex virus (HSV), and tuberculosis. This study aims to explain oral opportunistic infections in a patient with wasting syndrome. Case Report: A 20-year-old female, who was 165 cm in height and 33.75 kg in weight, with wasting syndrome, pulmonary tuberculosis, oral candidiasis, and angular cheilitis was referred from an internist in Hasan Sadikin Hospital. Extraoral examination showed a yellowish brownish crust on the lips. Intraoral examination showed multiple ulcers covered by a yellowish membrane on the labial mucosa. The white plaques were scrapable, and an erythematous was found on the dorsum of the tongue, buccal mucosa, and palate. Laboratory results revealed a decrease in hemoglobin, hematocrit, leucocyte, erythrocyte, basophil, neutrophil, lymphocyte, albumin, reactive anti-HSV IgG, CD4 16 cell/µl, mycology culture test, chest x-ray, and sputum. On the basis of anamnesis, clinical features, and laboratory examination, the patient was diagnosed with stomatitis herpetica and oral candidiasis. Chlorhexidine gluconate 0.2%, nystatin oral suspension, vitamin B12, folic acid, and vaseline album were administered on the lips. Clinical recovery of oral candidiasis was accomplished after five weeks of therapy. Conclusion: Opportunistic infections in patient with wasting syndrome are oral candidiasis, herpetic stomatitis, and tuberculosis.