View
226
Download
0
Category
Preview:
Citation preview
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
1/49
MORBUS HANSENMORBUS HANSEN
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
2/49
SinonimSinonim
Zaraath (bahasa Hebrew, Kitab Injil);Zaraath (bahasa Hebrew, Kitab Injil);
Kushtha (Hini) berasal !Kushnati" #Kushtha (Hini) berasal !Kushnati" #
!eatin$ awa%"!eatin$ awa%"
Aussat& ('eran); e*re (+renh);Aussat& ('eran); e*re (+renh);-r./a&a (Rusia)-r./a&a (Rusia)
Ma0un$ (1hina); Raib%. (2a*an);Ma0un$ (1hina); Raib%. (2a*an);
2uha (Arab)2uha (Arab) e*r.s%; M.rbus Hansen (M3H);e*r.s%; M.rbus Hansen (M3H);
Hansen 4iseaseHansen 4isease
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
3/49
DefinisiDefinisi
-en%a/it in0e/si /r.nis, isebab/an-en%a/it in0e/si /r.nis, isebab/an
Mycobacteroium lepraeMycobacteroium leprae
Mula5ula en$enai SS te*i,Mula5ula en$enai SS te*i,
lalulalu
/ulit/ulit 66u/.sa tra/tus res*irat.riusu/.sa tra/tus res*irat.rius
atas, RES, ata, .t.t, tulan$, testis 6atas, RES, ata, .t.t, tulan$, testis 6
.r$an lain,.r$an lain, /euali SS-/euali SS-33
1enerun$ en%ebab/an aat1enerun$ en%ebab/an aat
tan$an an /a/itan$an an /a/i
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
4/49
EtiologiEtiologi
Mycobacterium lepraeMycobacterium lepraeatau basil Hansenatau basil Hansen
4iteu/an th 789: .leh4iteu/an th 789: .leh '3H3A Hansen,'3H3A Hansen,N.rwe$iaN.rwe$ia
Basil tahan asa, batan$, *3 758 6 l3
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
5/49
EpidemiologiEpidemiologi
15 20 juta penderita di dunia 15 20 juta penderita di dunia
Penyakit endemisPenyakit endemis tropis dan subtropis (ditropis dan subtropis (di
AAsia,sia, AAfrika & Amerika Latin a. !rasi, "#ii$frika & Amerika Latin a. !rasi, "#ii$
% juta penduduk di ndia % juta penduduk di ndia
200.000 pend 200.000 penderitaeritadi ndodi ndo..(rian & 'u'e,(rian & 'u'e,
auku, )**, +a!ar, 'umatra, a-a & !ai$auku, )**, +a!ar, 'umatra, a-a & !ai$
'osia ekonomi, #iiene dan inkunan #idup'osia ekonomi, #iiene dan inkunan #idup
burukburuk
/sia 25 5 ta#un (1 anak 1% ta#un3/sia 25 5 ta#un (1 anak 1% ta#un3 taktak
perna# bayiperna# bayi 1 ta#un$ 1 ta#un$
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
6/49
PatogenesisPatogenesis
Suber *enularan *enerita MB (ulti5Suber *enularan *enerita MB (ulti5
basiler) seba$ai /.nta/basiler) seba$ai /.nta/ ((@@))elaluielalui K.nta/ lan$sun$ erat an laaK.nta/ lan$sun$ erat an laa lesi /ulitlesi /ulit
@ suhu in$in (terutaa@ suhu in$in (terutaa SusceptibleSusceptible
personspersons))
Droplet infection (aerogen)Droplet infection (aerogen)ariC elaluiariC elalui
u/.sa hiun$ (in0e/si elalui .ralu/.sa hiun$ (in0e/si elalui .ral
labun$ 6 /ulit utuh itentan$ ahli)labun$ 6 /ulit utuh itentan$ ahli)
4a*at itular/an elalui te*at tiur,4a*at itular/an elalui te*at tiur,*a/aian, ll .3/*a/aian, ll .3/ i%a/inii%a/ini M3le*rae a*atM3le*rae a*at
bertahan hiu* bbertahan hiu* beebbeerraa**aahari i luar tubuhhari i luar tubuh
Keun$/inan *enularan elalui $i$itanKeun$/inan *enularan elalui $i$itan
seran$$a ia/uiseran$$a ia/ui
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
7/49
-at.$enesa-at.$enesa
Basil /ustaBasil /usta Dasu/ tubuhDselDasu/ tubuhDsel
shwan *aa s%ara0 te*iD*eah Dshwan *aa s%ara0 te*iD*eah D
en%ebar /e sel shwan an /uliten%ebar /e sel shwan an /ulit
Rea/si iun seluler ber*eran alaRea/si iun seluler ber*eran ala
enentu/an tienentu/an ti**e *en%a/ite *en%a/it
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
8/49
KONTAK
Infeksi Non - Infeksi
Subklinis
Indeterminate (I)
Determinate
TT
Tuberkuloid
(polar/stabil)
Pausibasiler
BT BB
Borderline
(tak stabil)
BLLL
Lepromatosa
(polar/stabil)
Multibasiler
Sel Sc!ann
"akrofa#
Sel Datia Lan#ans
Sembu
$#l Simpatikus$#l Spinalis
%&'
'
*&'
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
9/49
1ell Meiate Iune
Ba/teri.s/.*i/
?? B? BB B
-ausibasiler (-B) Multibasiler(MB)
Klasi/asi Rile%52.*in$, 7FF=
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
10/49
Gambaran KlinisGambaran Klinis
1erin /e/ebalan seluler *enerita1erin /e/ebalan seluler *enerita(1MI)(1MI)
4ari b4ari bb*b*/lasi/asi %$ i/eban$/an,/lasi/asi %$ i/eban$/an,/lasi/asi Rile% 6 j.*lin$/lasi/asi Rile% 6 j.*lin$(7FG=) %$(7FG=) %$
eba$i le*ra enjai > /el.*./eba$i le*ra enjai > /el.*./atas asar $abaran /linatas asar $abaran /liniis,s,
ba/teri.l.$i/, hist.*at.l.$i/ anba/teri.l.$i/, hist.*at.l.$i/ an
iun.l.$is, %an$ i$una/an liun.l.$is, %an$ i$una/an lbian$ *enelitian se/aran$ seara luasbian$ *enelitian se/aran$ seara luas
i*a/ai ala /lini/ an e*iei.l.$ii*a/ai ala /lini/ an e*iei.l.$i
(ut/ *eberantasan)(ut/ *eberantasan)
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
11/49
?i*e?i*e TT & LLTT & LLti*e *.lar %an$ tia/ti*e *.lar %an$ tia/
berubahberubah
?i*e?i*e BBBB ?i*e ten$ah?i*e ten$ah
-alin$ tia/ stabil, a*at berubah /e ti*e lain-alin$ tia/ stabil, a*at berubah /e ti*e lain
esi berbentu/esi berbentu/ makula infltratimakula infltrati
-eru/aan ber/ilat-eru/aan ber/ilat
Batas lesi /uran$ jelasBatas lesi /uran$ jelas 66enerun$ sietrisenerun$ sietris
esi san$at berariasi bai/ u/uran, bentu/ anesi san$at berariasi bai/ u/uran, bentu/ an
istribusin%aistribusin%a
Khas lesiKhas lesipunch outpunch out## a/ula hi*.*i$entasia/ula hi*.*i$entasi%an$ .al e/un$ ba$ ten$ah en$an batas%an$ .al e/un$ ba$ ten$ah en$an batas
jelas en$an lesi5lesi /eil i te*in%ajelas en$an lesi5lesi /eil i te*in%a
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
12/49
Perbedaan TT dan LLPerbedaan TT dan LL
Perbedaan Tuberkuloid
(TT)
Lepromatosa (LL)
Jumlah lesi 14 bbrp !anyak
Efloresensi akua4 pakat Pape, nodu & infitrat
Distribusi Asimetris 'imetris
PermukaanLesi
Lebi# kasar Lebi# #aus dan menkiap
Tepi lesi !atas jeas !atas tak jeas
Anestesi eas stad dini *ak jeas, biasa stad anjut
Kontraktur 'erin stad dini *erutama stad anjut
Bakterioskopi !*A atausedikit
!*A banyak
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
13/49
-erbeaan ??3 6 3-erbeaan ??3 6 3
Histopatologi *uberke Lini tenan
(Subepidermal clear zone)(Subepidermal clear zone)'e busa
(Foam cell/ Virchow cell)(Foam cell/ Virchow cell)
Tes Lepromin Positif
munitasseuer
)eatif
munitas seuer
Perbedaan Tuberkuloid(TT)
Lepromatosa (LL)
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
14/49
SimtomatologiSimtomatologi
1.1. Eoresensi KulitEoresensi Kulit
Ma/ula, *a*ula, n.ulaMa/ula, *a*ula, n.ulaInltratInltrat ul/usul/us
Ma/ula hi*.*i$entasi %an$ /has @Ma/ula hi*.*i$entasi %an$ /has @ 5A5A%aitu %aitu
Ahr.iaAhr.ia # tia/ aa *i$en# tia/ aa *i$en
AnestesiaAnestesia# baal# baal
Atr.Atr.# /ulit a$a/ ene/un$# /ulit a$a/ ene/un$ Al.*esiaAl.*esia# tan*a rabut# tan*a rabut
Anhir.sisAnhir.sis# tia/ ber/erin$at# tia/ ber/erin$at
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
15/49
2.2. Kelainan SaraKelainan Sara
a3 -enebalan sara0 *eri0er, a3la3 -enebalan sara0 *eri0er, a3l).fa6iais7 raba baian peipis).fa6iais7 raba baian peipis
).auri6.manus7 raba sisi4 atera e#er).auri6.manus7 raba sisi4 atera e#er
). radiais7 raba atera enan atas). radiais7 raba atera enan atas).unaris7 raba dorsa epi6ondius).unaris7 raba dorsa epi6ondiusmediamedia
).peroneus atera7 raba dorsa).peroneus atera7 raba dorsa
6apituum fibuae6apituum fibuae).tibiais posterior7 raba dorsa).tibiais posterior7 raba dorsamaeous mediaismaeous mediais
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
16/49
b3b3 'an$$uan sensibilitas'an$$uan sensibilitas
(@(@tabun$ rea/si,tabun$ rea/si, jaru 6jaru 6/a*as/a*as))
a/u/an *eeri/saana/u/an *eeri/saan
rasa suhu (*anas 6 in$in)rasa suhu (*anas 6 in$in)rasa sa/it (taja 6 tu*ul)rasa sa/it (taja 6 tu*ul)
rasa raba (sentuhan /a*as)rasa raba (sentuhan /a*as)
rasa n%eri alarasa n%eri ala
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
17/49
1313 'an$$uan Sara0 Aut.n.'an$$uan Sara0 Aut.n. Al.*esia (alis ataCAl.*esia (alis ataC madarosismadarosis, bulu ata), bulu ata)
Anhir.sis (tes *.tl.tAnhir.sis (tes *.tl.t GunaanGunaan, tes, teshistain)histain)
4343 'an$$uan Sara0 M.t.ri/'an$$uan Sara0 M.t.ri/ Atr. .t.t thenar, hi*.thenar 6Atr. .t.t thenar, hi*.thenar 6
inter*hinter*halan$ealalan$eal
1law Han 6 4r.* rist1law Han 6 4r.* rist
4r.* +..t 6 1law ?.es4r.* +..t 6 1law ?.es
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
18/49
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
19/49
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
20/49
Kelainan .r$an lainKelainan .r$an lain
-enebalan u*in$ telin$a-enebalan u*in$ telin$a
+aies le.nina+aies le.nina Sale n.seSale n.se
OrhitisOrhitis
1law han, r.* han, r.* 0..t,1law han, r.* han, r.* 0..t,utilasiutilasi
llll
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
21/49
4ia$n.sa4ia$n.sa
4iasar/an *aa *eneuan tana /arinal %i4iasar/an *aa *eneuan tana /arinal %i Bera/ /ulit ati rasa (ati rasa t.tal atauBera/ /ulit ati rasa (ati rasa t.tal atau
seba$ian)seba$ian) -enebalan s%ara0 te*i-enebalan s%ara0 te*i
4a*at isertai n%eri an $an$$uan 0un$si4a*at isertai n%eri an $an$$uan 0un$sis%ara0 %an$ ter/enas%ara0 %an$ ter/ena
5 $an$$uan 0un$si sens.risati rasa5 $an$$uan 0un$si sens.risati rasa
5 $an$$uan 0un$si .t.ris *aresa atau *aralisa5 $an$$uan 0un$si .t.ris *aresa atau *aralisa
5 $an$$uan 0un$si .t.n./ulit5 $an$$uan 0un$si .t.n./ulit/erin$,reta/,eea/erin$,reta/,eea 4iteu/an basil tahan asa(B?A)4iteu/an basil tahan asa(B?A)
Bahan *eeri/saan ari u*in$ telin$aClesi /ulitBahan *eeri/saan ari u*in$ telin$aClesi /ulit
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
22/49
-eeri/saan *enerita-eeri/saan *enerita
AnanesisAnanesis
5 /eluhan *enerita5 /eluhan *enerita
5 riwa%at /.nta/ en$an *enerita5 riwa%at /.nta/ en$an *enerita
5 latar bela/an$ s.si. e/.n.i5 latar bela/an$ s.si. e/.n.i Ins*e/siIns*e/si
en$an *eneran$an %an$ bai/en$an *eneran$an %an$ bai/
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
23/49
-al*asi-al*asi
5 /elainan /ulit,n.us,inltrat,ul/us5 /elainan /ulit,n.us,inltrat,ul/us
5 /elainan s%ara05 /elainan s%ara0
1ara1ara5 Banin$/an s%ara0 ba$ian /iri an /anan5 Banin$/an s%ara0 ba$ian /iri an /anan
5 ebesar atau tia/5 ebesar atau tia/
5 *erabaan /eras atau /en%al5 *erabaan /eras atau /en%al5 n%eri atau tia/5 n%eri atau tia/
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
24/49
?es 0un$si s%ara0?es 0un$si s%ara0
Men$$una/an /a*as,jaru,tesMen$$una/an /a*as,jaru,testabun$ han$at an in$in3tabun$ han$at an in$in3
-eeri/saan /.*li/asi-eeri/saan /.*li/asi
5 ata, hiun$,larin$,testis5 ata, hiun$,larin$,testis
5 /erusa/an s%ara0 sens.ris, .t.ris5 /erusa/an s%ara0 sens.ris, .t.ris
an .t.n.an .t.n. -eeri/saan ba/teri.s/.*i/-eeri/saan ba/teri.s/.*i/
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
25/49
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
26/49
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
27/49
-en$.batan-en$.batan
?ujuan ?ujuan
5 eutus rantai *enularan, insiens5 eutus rantai *enularan, insiens
*en%a/it*en%a/itJJ5 en$.bati an en%ebuh/an5 en$.bati an en%ebuh/an
*enerita*enerita
5 ene$ah tibuln%a aat5 ene$ah tibuln%a aat
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
28/49
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
29/49
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
30/49
KOM-IKASI
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
31/49
4a*at beru*a4a*at beru*a
K.*li/asi a/ibat rea/siK.*li/asi a/ibat rea/si
K.*li/asi a/ibat /erusa/an s%ara0K.*li/asi a/ibat /erusa/an s%ara0 4isebab/an /arena *en%ebaran4isebab/an /arena *en%ebaran
basil(inasi asi0 /uan)basil(inasi asi0 /uan)
A/ibat rela*sA/ibat rela*s K.*li/asi a/ibat iunitas enurunK.*li/asi a/ibat iunitas enurun
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
32/49
+a/t.r *enetus rea/si+a/t.r *enetus rea/si
Setelah *en$.batan anti/usta %an$Setelah *en$.batan anti/usta %an$
intensi0intensi0
In0e/si re/urenIn0e/si re/uren
-ebeahan-ebeahan
Stress si/Stress si/
IunisasiIunisasi KehailanKehailan
Saat setelah elahir/anSaat setelah elahir/an
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
33/49
-rinsi* *en$.batan rea/si-rinsi* *en$.batan rea/si
/usta/usta -eberian .bat anti rea/si-eberian .bat anti rea/si
Istirahat atau i.bilisasiIstirahat atau i.bilisasi
Anal$eti/,seati0 untu/ en$atasiAnal$eti/,seati0 untu/ en$atasin%erin%eri
Obat anti/usta iterus/an(bila tia/Obat anti/usta iterus/an(bila tia/
aa /.ntraini/asi)aa /.ntraini/asi)
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
34/49
1A1A? KUS?A1A1A? KUS?A
2enis aat /usta2enis aat /usta Kel.*./ aat *rierKel.*./ aat *rier
aat %an$ isebab/an lan$sun$ .leh a/tiitasaat %an$ isebab/an lan$sun$ .leh a/tiitas*en%a/it, terutaa a/ibat res*.ns terhaa* *en%a/it, terutaa a/ibat res*.ns terhaa* le*rae3le*rae3
5 aat *aa 0un$si s%ara0 sens.ri/(anastesi)5 aat *aa 0un$si s%ara0 sens.ri/(anastesi)
5 0un$si s%ara0 .t.ri/(law han, r.*0..t5 0un$si s%ara0 .t.ri/(law han, r.*0..t
la$.*htalusla$.*htalus
5 inltrasi /uan *aa /ulit,jarin$an sub/utan(0asies5 inltrasi /uan *aa /ulit,jarin$an sub/utan(0asies
le.nina,e/tr.*i.n)le.nina,e/tr.*i.n)5 aar.sis, al.*esia(a/ibat /erusa/an 0.li/el5 aar.sis, al.*esia(a/ibat /erusa/an 0.li/elrabut)rabut)
5 a/ibat inltrasi *aa ten.n, tulan$,testis ll5 a/ibat inltrasi *aa ten.n, tulan$,testis ll
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
35/49
Kel.*./ aat se/unerKel.*./ aat se/uner
terjai a/ibat aat *rier, terutaaterjai a/ibat aat *rier, terutaa
a/ibata/ibat
aan%a /erusa/an sara0 sens.ri/,aan%a /erusa/an sara0 sens.ri/,
.t.ri/, .t.n..t.ri/, .t.n.
5 /.ntra/tur, ul/us5 /.ntra/tur, ul/us
5 /eratitis5 /eratitis
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
36/49
-ene$ahan aat *aa-ene$ahan aat *aa
/usta/usta?ujuan ?ujuan
Mene$ah tibuln%a aat *aa saatMene$ah tibuln%a aat *aa saat
ia$n.sis /usta ite$a//an ania$n.sis /usta ite$a//an an
i.batii.bati
Mene$ah a$ar aat %an$ telahMene$ah a$ar aat %an$ telah
terjai jan$an enjai lebih beratterjai jan$an enjai lebih berat
Menja$a a$ar aat %an$ telah bai/Menja$a a$ar aat %an$ telah bai/
tia/ /abuh la$itia/ /abuh la$i
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
37/49
U*a%a *ene$ahan aatU*a%a *ene$ahan aat
1aat *rier1aat *rier
4ia$n.sis ini4ia$n.sis ini
-en$.batan seara teratur an-en$.batan seara teratur anae/uatae/uat
4ia$n.sis ini an *enatala/sanaan4ia$n.sis ini an *enatala/sanaan
neuritis, terasu/ silent neuritisneuritis, terasu/ silent neuritis 4ia$n.sis ini an *enatala/sanaan4ia$n.sis ini an *enatala/sanaan
rea/sirea/si
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
38/49
1aat se/uner1aat se/uner
-erawatan iri seniri untu/ lu/a-erawatan iri seniri untu/ lu/a
-erawatan ata, tan$an an /a/i %an$-erawatan ata, tan$an an /a/i %an$
anastesiC en$alai /elu*uhan .t.tanastesiC en$alai /elu*uhan .t.t
Beah re/.nstru/si untu/ /.re/si .t.tBeah re/.nstru/si untu/ /.re/si .t.t
%an$ en$alai /elu*uhan a$ar%an$ en$alai /elu*uhan a$ar
tia/ en$alai te/anan %an$tia/ en$alai te/anan %an$berlebihanberlebihan
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
39/49
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
40/49
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
41/49
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
42/49
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
43/49
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
44/49
bb
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
45/49
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
46/49
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
47/49
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
48/49
7/24/2019 kustaNew Microsoft PowerPoint Presentation.ppt
49/49
Recommended