Sindrom Stevens-Johnson dan Nekrolisis Epidermal Toksis di RSUP MH Palembang Periode 2006 - 2008

M. Athuf Thaha


Abstract


Steven-Johnson syndrome and toxic epidermal necrolysis in RSUP MH Palembang in year 2006-2008

Background: Stevens-Johnson syndrome (SSJ) and toxic epidermal necrolysis (TEN) are rare, life-threatening, drug-induced cutaneous reactions.
Methods: We conducted a retrospective study by gathering 43 SJS, SJS/TEN, and TEN patients data from RSUP MH General Hospital Palembang from 2006-2008. Variable that were evaluated covered the age, gender, incidence, drug causes, and results of medical treatment.

Results: The number of SSJ cases was higher than SJS/TEN and TEN cases, most of SSJ patients were in 26-36 year age group (11 patients or 25.5%), with male/female ratio of: 55.8%:44.2%. The use of paracetamol, amoxycilline, tetracycline, cotrimoxsazole, methampirone, ciprofloxacine, and carbamazepine was associated with large increases in the risk of SSJ or TEN. Hospital stays for SSJ was 8.91 ± 5.52 days, and 13.2 ± 3.89 days for SJS/TEN. This retrospective study expressed the high incidence of the SJS in
RSUP MH in 2006-2008 period, compared with the incidence reported in the bibliography.

Conclusions: Although there were still controvercies in systemic corticosteroid use, this study showed the use of steroid gave satisfactory results.

Keywords: Stevens-Johnson syndrome, toxic epidermal necrolysis, drug-induced cutaneous reactions

 

ABSTRAK

Latar belakang: Sindrom Stevens-Johnson (SSJ) dan nekrolisis epidermal toksis (NET) ialah reaksi kulit terutama akibat obat yang jarang ditemui dan dapat menyebabkan kematian.

Metode: Penelitian dilakukan secara retrospektif dengan mengumpulkan data rekam medik RSUP MH Palembang periode 2006–2008, sebanyak 43 pasien rawat inap yang didiagnosis sebagai SSJ, SSJ/NET, dan NET. Variabel yang dievaluasi meliputi usia, jenis kelamin, angka kejadian penyakit, obat yang menyebabkan penyakit, lama perawatan, dan hasil pengobatan.

Hasil: Hasil evaluasi menunjukkan jumlah kasus SSJ merupakan yang terbanyak dibandingkan NE lainnya, usia terbanyak SSJ terdapat pada kelompok usia 26-36 orang (11 orang atau 25,5%), rasio laki-laki/perempuan sebesar: 55,8%:44,2%. Obat yang terbanyak berturut-turut ialah parasetamol, amoksisilin, tetrasiklin, kotrimoksasol, metampiron, siprofloksasin dan karbamazepin. Lama perawatan pasien SSJ ialah 8,9 ± 5,5 dan SSJ/NET 13,2 ± 3,9 hari, dan semua pasien (kecuali yang pulang paksa) sembuh pada evaluasi paska rawat. Penelitian retrospektif ini mengungkap tingginya angka kejadian SSJ di RSUP MH periode 2006-2008, dibandingkan angka kejadian yang dilaporkan dalam kepustakaan. Terdapat perbedaan jenis obat penyebab SSJ di RSUP Palembang dari obat penyebab risiko tinggi yang dilaporkan dalam literatur.

Simpulan: Walaupun masih terdapat silang pendapat penggunaan steroid sistemik pada SSJ, penelitian ini menunjukkan pemakaian steroid memberikan hasil yang  memuaskan.


Keywords


Stevens-Johnson syndrome, toxic epidermal necrolysis, drug-induced cutaneous reactions

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