Latar belakang: Sindrom Ramsay Hunt (SRH) merupakan komplikasi yang jarang terjadi pada herpes zoster. SRH dapat terjadi tanpa adanya ruam kulit (zoster sine herpete). Karena gejala-gejala ini tidak selalu muncul saat onset, sindrom ini sering salah didiagnosis. Insidensi 5/100.000 kasus pada populasi di Amerika Serikat dan meningkat pada kelompok umur di atas 60 tahun dan kondisi imunokompromais. Laporan Kasus: Laki-laki, 66 tahun, timbul plenting-plenting di daerah telinga kiri menyebar ke dada sebelah kiri sejak 8 hari sebelum dikonsulkan. Terdapat nyeri pada telinga, pendengaran berkurang, pusing berputar, wajah sebelah kiri sulit digerakkan dan sulit berbicara. Permeriksaan fisik ditemukan vesikel berkelompok dengan dasar kulit eritem dan edema, bula, erosi, krusta, konfigurasi herpetiformis, distribusi unilateral, segmental setinggi persarafan servikal 2-4. Temuan tzank test menunjukkan sel datia berinti banyak. Penatalaksanaan dengan sistemik asiklovir dan metilprednison. Pembahasan: SRH merupakan hasil reaktivasi virus varicella zoster laten diganglion genikulatum yang menyebabkan vesikel pada aurikula, otalgia dan paresis/paralisis fasialis. Mekanisme pencetus reaktivasi pada pasien ini diduga berhubungan dengan imunokompromais (keganasan). Pasien imunokompromais memiliki resiko 20-100 kali lebih besar. Pemeriksaan Tzank sesuai dengan gambaran herpes zoster. Terapi SRH yang paling disarankan adalah terapi kombinasi antivirus dan kortikosteroid. Kesimpulan: Telah dilaporkan kasus herpes zoster otikus dengan paresis nervus fasialis (Sindrom Ramsay Hunt) pada pasien imunokompromais. Hasil terapi memuaskan. Prognosis qua ad vitam ad bonam, ad sanam dubia ad malam, ad cosmeticam dubia ad bonam. Kata kunci: Sindrom Ramsay Hunt, Herpes Zoster Otikus, Paresis Nervus Fasialis, Immunokopromais. Background; Ramsay Hunt Syndrome (RHS) is a rare complication in shingles. RHS can occur without the presence of skin rash (zoster sine herpete). Because these symptoms do not always appear at onset, RHS is often misdiagnosed. The incidence of 5/100,000 cases in the US and increase in the age above 60 years and immunocompromised. Case: A 66-years-old male complaint of vesicle on the left ear spreading to left chest, since 8 days prior to the consultation. There was otalgia, dizziness, hearing impairment, difficulty in movement and speaking on the left side. Physical examination found clustered vesicle on an erythematosus and oedematous base, bullaes, erosions, crusts, in a herpetiformis configuration, unilateral distribution, in a level of 2-4 cervical nerve innervation. The Tzank test showed multinucleated giant cells. Management with systemic acyclovir and methylprednisolone. Discussion: RHS is the result of reactivation of latent varicella zoster virus in geniculate ganglion which causes vesicles in the auricle, otalgia and facial paresis / paralysis. The mechanism for triggering reactivation in these patients is immunocompromise (malignancy). Immunocompromised have a 20-100 times greater risk. Tzank results in accordance with diagnostic of herpes zoster. The most recommended therapy is combination of antiviral and corticosteroid. Conclusion: The case of herpes zoster oticus with facial nerve paresis (Ramsay Hunt Syndrome) in immunocompromised has been published. The result of therapy was satisfying. The prognosis qua ad vitam ad bonam, ad sanam dubia ad malam, ad cosmetics dubia ad bonam. Keywords: Ramsay Hunt Syndrome, Herpes Zoster Oticus, Facial Nerve Paresis, Immunokopromised.
Karsinoma sel basal (KSB) tercatat sebanyak 75% dari semua kanker kulit. Data epidemiologis dunia menunjukkan peningkatan insidensi KSB 3-10% dalam setahun, hal ini diduga berkaitan dengan penipisan lapisan ozon (2% dalam 20 tahun terakhir) dan perubahan gaya hidup. Karsinoma sel basal (KSB) dapat menyebabkan cacat kosmetik maupun cacat fungsional sehingga diperlukan diagnosis dini dan penatalaksanaan yang tepat. Seorang perempuan 72 tahun, dengan keluhan benjolan yang semakin membesar kemudian menjadi borok di pelipis kiri sejak satu tahun. Riwayat sering terpajan sinar matahari. Pada pemeriksaan fisik ditemukan ulkus dengan diameter 3 cm dan krusta. Temuan histopatologik menunjukkan sel ganas dengan inti hiperkromatik dan tepi palisade. Penatalaksanaan dengan bedah eksisi, flap rotasi dan skin graft. KSB jarang bermetastasis, namun dapat mendestruksi jaringan di dekatnya. Studi epidemiologi memberikan fakta bahwa patogenesis KSB dapat terjadi melalui efek imunologik dan karsinogenik. Gambaran histopatologik penting untuk menentukan varian KSB. Prognosis quo ad vitam bonam, ad sanam dubia ad bonam, ad kosmetikam dubia ad bonam.Kata kunci: Bedah eksisi, flap rotasi, karsinoma sel basal, skin graft
Trisomy 13 is a serious genetic anomaly in the fetus that is one of the causes of abortion as a result of the chromosomal aneuploidy. Trisomy 13 affects roughly 1 in 10,000 to 20,000 live births, and more than 95% of pregnancies end in prenatal death. Due to the higher prevalence of preeclampsia and the danger of maternal death associated with early birth, abnormalities in these infants also have an impact on the mother's health. According to Law No. 36 of 2009 concerning Health, women who eligble for abortions if there are medical reasons to do so. The problems in this paper are 1) What are the ethical problems found in pregnancies with a fetus diagnosed with a genetic disorder due to trisomy 13? 2) What is the procedure for implementing medical abortion provocation that fulfills ethical aspects and complies with applicable regulations. To answer these problems, a research using normative legal research, accompanied by reports of cases of abortion. This normative legal research focuses on ethical and legal aspects of the implementation of provocative medical abortion following statutory regulations. This normative legal research starts with articles and case reports of fetal pregnancies with genetic disorders from the Gatot Soebroto Army Hospital. The results of the study show that consent to termination of pregnancy with medical indications by the patient and approved by the husband/family. T
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