VARICELLA VARICELLA ZOSTERZOSTER

Coass Coass DermatovenereologyDermatovenereology

Citra RahayuCitra Rahayu

Munirah Binti HamidomMunirah Binti Hamidom

Akmal Hakim Akmal Hakim

Dewi ShintaDewi Shinta

Ahmad NurfakhriAhmad Nurfakhri

Jabar AljufriJabar Aljufri

Nurul Iska UlmarikaNurul Iska Ulmarika

Ruth Fauntin Ruth Fauntin

Trivirasakti JunusTrivirasakti Junus

Daud YusufDaud Yusuf

MukhraeniMukhraeni

Intan Permata Sari A.D.Intan Permata Sari A.D.

Fitri Ani AzisFitri Ani Azis

Sri Suci MardiyantiSri Suci Mardiyanti

Patient’s identityPatient’s identity NameName : Mr. A.S.: Mr. A.S. Sex Sex : Man: Man Age Age : 15 Years Old: 15 Years Old Job Job : Unemployed: Unemployed Address Address : Je’rutallasa St., Jeneponto : Je’rutallasa St., Jeneponto

CountyCounty Status Status : Unmarried: Unmarried Religion Religion : islam: islam

History takingHistory taking

Status presentStatus present

General condition General condition : : SevereSevereConsciousnessConsciousness : Compos mentis : Compos mentis Vital signVital sign ::

BPBP : 100/60 mmHg: 100/60 mmHgPulsePulse : 84x/m: 84x/mRRRR : 24x/m: 24x/mTempTemp : 36ᶿC: 36ᶿC

Cont…….Cont…….

Head Head : Anemic (+/+), Icterus (-), Cyanosis (-): Anemic (+/+), Icterus (-), Cyanosis (-) CorCor : S1/S2 pure reguler : S1/S2 pure reguler Thorax Thorax : vesiculer, Wheezing (-), Ronchi (-): vesiculer, Wheezing (-), Ronchi (-) Abdomen Abdomen : Normal: Normal Extremities Extremities : Normal, no sign of Pretibial : Normal, no sign of Pretibial

Oedema in lower extremities. Oedema in lower extremities. Limphe Limphe : No sign of limphoma, : No sign of limphoma,

palpable pain palpable pain (-) (-)

STATUS STATUS DERMATOLOGISTDERMATOLOGIST

Regio Regio : Regio : Regio GeneralisataGeneralisata

Effloresence : Papul Effloresence : Papul eritematous, eritematous, Vesicle, Vesicle, Pustul, Pustul, Crusta, and Crusta, and Hiperpigmented Hiperpigmented (polimorf lesion)(polimorf lesion)

•Regio : regio vetebralis, regio infrscapularis and regio scapularis•Effloresensi : vesicle, crusta

regioregio : Coli : Coli EffloresensiEffloresensi : (1) vesicel, (2) krusta: (1) vesicel, (2) krusta

•Regio : lower and upper extremities•Effloresensi : vesicle and

Diagnostic Diagnostic ExaminationExamination

Laboratory FindingsLaboratory FindingsWBCWBC : 7,5 x 10: 7,5 x 1033 /mm /mm3 3 RBCRBC : 4,8 x 10: 4,8 x 1066 /mm /mm33

HGBHGB : 13,8 g/dL: 13,8 g/dLHCTHCT : 41,7 %: 41,7 %PLT PLT : 406 x 10: 406 x 1033 / mm / mm33

SGOTSGOT : 24 U/L: 24 U/LSGPTSGPT : 17 U/L: 17 U/L

Diagnose Diagnose

Varicella Varicella

TherapyTherapyDermatology:Dermatology:

Antiviral : Aciclovyr 5 x 400mg ( 7 days )Antiviral : Aciclovyr 5 x 400mg ( 7 days ) Antihistamin : Interhistin 50 mg 3 x 1Antihistamin : Interhistin 50 mg 3 x 1 Elkana syr 2x 1 cthElkana syr 2x 1 cth Salisil talk Salisil talk Fuson creamFuson cream

Opthalmology Opthalmology departementdepartement

Discussion Discussion

Definition Definition Varicella, commonly known Varicella, commonly known

as chickenpox, is the as chickenpox, is the primary infection with the primary infection with the VZV.VZV.

Varicella is characterized by Varicella is characterized by a vesicular eruption a vesicular eruption consisting of delicate consisting of delicate “teardrop” vesicles on an “teardrop” vesicles on an erythematous base.erythematous base.

ETIOLOGI VARICELLA ZOOSTER VIRUS

Lipid envelope surrounding nucleocapsid with icosahedral symmetry

Total diameter of approximately 150–200 nm

Centrally located double-strand DNA with a molecular weight of 80 million

EpidemiologyEpidemiologyVaricella is distrubated Varicella is distrubated

worldwideworldwideSince introduction of Since introduction of

varicella vaccine in 1995, varicella vaccine in 1995, incidence of varicella has incidence of varicella has decreased as vaccination decreased as vaccination coverage has increased. coverage has increased.

Prior to 1995, 3–4 million Prior to 1995, 3–4 million cases in the United States cases in the United States annually. annually.

Patogenesis

EFFLORESENCE OF EFFLORESENCE OF VARICELLAVARICELLA

Polimorf Lesion in varicella patient

CLINICAL FINDINGCLINICAL FINDING

Mild febrisMild febris Effloresence : Vesicle Tears drop-like Effloresence : Vesicle Tears drop-like

spreading from body to upper and lower spreading from body to upper and lower extrimities centrifugallyextrimities centrifugally

Itchiness of the whole body.Itchiness of the whole body. May infect upper respiratory tract and May infect upper respiratory tract and

mucosa of the mouthmucosa of the mouth

DIAGNOSEDIAGNOSE

Clinical FeatureClinical FeatureTzanck Test (Datia Tzanck Test (Datia cell with multiple cell with multiple nucleus)nucleus)

TREATMENTTREATMENT

Antiviral : Aciclovyr 5 x 400mg ( 7 days )Antiviral : Aciclovyr 5 x 400mg ( 7 days ) Antihistamin : Interhistin 50mg 3 x 1Antihistamin : Interhistin 50mg 3 x 1 Salisil talk Salisil talk Fuson creamFuson cream

DIFFERENTIAL DIFFERENTIAL DIAGNOSE DIAGNOSE

VARIOLA HERPES ZOSTER

PREVENTIONPREVENTION

Vaccination at the age of 12 months and Vaccination at the age of 12 months and above and revaccination at the age of 4 to 6 above and revaccination at the age of 4 to 6 years old. via subcutaneous injection 0.5ml years old. via subcutaneous injection 0.5ml at the age 12 months till 12 years old.at the age 12 months till 12 years old.

If vaccination is given at the age above 12 If vaccination is given at the age above 12 years old with the same dosage, then years old with the same dosage, then revaccination 4 to 8 weeks. Then antibody revaccination 4 to 8 weeks. Then antibody will appear in 3 to 6 days laterwill appear in 3 to 6 days later

COMPLICATIONCOMPLICATION

EncephalitisEncephalitis PneumoniaPneumonia GlomerulonephritisGlomerulonephritis Keratitis Keratitis Conjunctivitis, etcConjunctivitis, etc

PROGNOSISPROGNOSIS

A better hygiene will result a better A better hygiene will result a better prognosis.prognosis.

Thank youThank you