Profil Sindrom Stevens Johnson pada Pasien Rawat Inap di RSUP Dr. M. Djamil Padang Periode Januari 2010 sampai Desember 2011

Abstract

AbstrakSindrom Stevens Johnson (SSJ) merupakan reaksi mukokutaneus akut yang mengancam jiwa berupa nekrosis yang ekstensif dan lepasnya epidermis. Sindrom ini mengenai kulit, selaput lendir orifisium, dan mata dengan keadaan umum bervariasi dari ringan sampai berat. Meskipun kasusnya jarang terjadi, SSJ memiliki dampak yang signifikan terhadap kesehatan masyarakat karena angka morbiditas dan mortalitas yang tinggi. Tujuan penelitian ini adalah untuk mengetahui beberapa aspek kasus SSJ pasien rawat inap di RSUP Dr. M. Djamil Padang periode Januari 2010 sampai Desember 2011. Penelitian ini dilakukan secara retrospektif dengan menganalisis data rekam medik seluruh pasien SSJ yang dirawat inap. Variabel yang diteliti meliputi jenis kelamin, umur, penyebab SSJ, gejala SSJ, lama rawatan, tingkat keparahan, angka kesembuhan, dan angka mortalitas. Data diolah, dihitung persentasenya, dan disajikan dalam bentuk tabel. Hasil penelitian menunjukkan terdapat 22 kasus SSJ (0,05%) dengan perbandingan insiden pada pria dan wanita adalah 3:1. SSJ banyak terjadi pada umur >19 tahun sampai ≤59 tahun (31,81%) dengan penyebab terbanyak adalah obat (81,82%) terutama obat golongan antikonvulsan (33,33%). Semua pasien mengalami gejala prodromal dan trias kelainan SSJ. Lama rawatan pasien SSJ ≤10 hari. Sebagian besar pasien memiliki tingkat keparahan SSJ yang ringan berdasarkan nilai SCORTEN, yaitu 3,2% dan hampir semua pasien sembuh (95,46%). AbstractStevens-JohnsonSyndrome (SJS) is acute life-threatening mucocutaneous reactions characterized by extensive necrosis and detachment of the epidermis. SSJ comes to the skin, mucous membrane, and the eyes with varies of general state from mild to severe. Although this case is rare, it has a significant public health impact because of high mortality and morbidity. The aim of this study is to know some aspects of SJS cases toward hospitalized patients in Dr. M. Djamil Padang Hospital during January 2010 until December 2011.This study is conducted a retrospective study by analyze the medical record of hospitalized patients with SJS. Variables that were evaluated covered gender, age, causes of SJS, clinical manifestation of SJS, treatment time, the severity, cure rate, and mortality rate. The data were processed, counted the percentage, and presented in tabular form.The result showed there were 22 SJS cases (0,05%) with incidence ratio between male and female was 3:1. SJS most happened in >19 and ≤59 years age group (31,81%) with the most causes was drugs (81,82%) especially anticonvulsant group of drugs (33,33%). All of the patients showed prodromal symptoms and triage abnormalities of SJS. Treatment time for the patients was ≤10 days. A total of 81,82% patients had mild severity based on SCORTEN values, i.e. 3,2% and almost all the patients recovered from SJS (95,46%).

Risk Factors for Stevens Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) in Dr. Soetomo General Hospital Surabaya

“…Another research showed that the incidence rate of SJS is 5 cases per million person per year and TEN is 2 cases per million person per year [3]. A similar study conducted in Indonesia reported that there are 35 SJS cases and 3 TEN cases in Dr. Mohammad Hoesin Central General Hospital Palembang from 2006-2008 and 22 SJS cases in Dr. M. Djamil Central General Hospital Padang from 2010-2011 [4,5]. SJS and TEN are rare cases, but the mortality rate is high, ranging from 25-70% and found higher in older age (>50 years) due to several factors such as comorbidity.…”