miliaria pustulosa poster minggu i

8/11/2019 Miliaria Pustulosa Poster Minggu i

1/29

MILIARIA PUSTULOSA


2/29

SEKAR TIARIN SIHADARU (C111 09 807)

MOHD FAREZ BIN AZIZUL (C111 10 873) ANDI YUSMAWATI (C111 10 306)

HARITH SHAHIRAN BIN MOHAMAD FADHIL

(C111 10 879)

BASO AGUSOFYANG (C111 10 012)

IMAN TAUFIK (C111 09 148)

IRENE PATANDUNGAN (C111 06 041)


3/29


4/29

HISTORY TAKING

Chief complainNeedle like tip pimple appearance with pus at the

neck.

Further anamnesis

Admitted to the hospital on 18 February 2014.

Complaint of pimple and itchness on 25 February

2014 starting on the neck and spreads to both armand trunk area.


5/29

HISTORY TAKING (Cont.)

Systematical anamnesis

Fever (-), history of fever (-)

- History of similiar symptom since twoweek ago (-)

- Family history of similiar symptom (-)

- Allergy of food and drugs (denied)

- Smoking (-), Alcoholic (-)


6/29

PHYSICAL EXAMINATIONdate of examination : February 25th

General condition : Moderate

Consciousness : compos mentis

Vital sign

Blood pressure : 110/80 mmHg

Heart rate : 84 x/min regular

Respiratory rate : 23 x/min

Temperature : 36,5C


7/29

PHYSICAL EXAMINATION (cont.)

Dermatology Status:

Location: Regio facialis, Regio colli, RegioExtremitas Superior et. Inferior

Dextra and Sinistra

Efflorescence: papule, pustule, erythema


8/29

DIFFERENTIAL DIAGNOSIS

MILIARIA PUSTULOSA

FOLICULITIS


9/29


10/29


11/29


12/29

ASSESMENT

MILIARIA PUSTULOSA


13/29

Therapy

The best treatment is to avoid heat and high humidity, tryto maintain good temperature regulation and clothes thatare thin.

MBS : (Menthol 0.15%)

Boric acid 3%

Talk venet add 10%

Zinc Oxide 10%

Aqua add 100ml

Spiritus dilututs 10% M.f.mix da in bottle

Cetrizine 1 x 1 10mg


14/29

History

Further anamnesis

Admitted to the hospital on 18 February 2014.

Complaint of redness on 25 February 2014

starting on the neck and spreads to both the

hand and trunk area.


15/29

LABORATORIUM EXAMINATION

Elektrolit Hasil Nilai Rujukan

Kalium 3,0 3,5-5,1

Hgb 8,6 L g/dl 14.0-18.0

Plt 444x 103 150-400

RBC 3.84x 106

4.50-6.50x106

WBC 5,6 x 103 4.0-10.0 x 103

MCV 70 um3 80-100

MCH 22,5 pg 27,0- 32,0

GDS 100mg


16/29

THERAPHY FROM NEUROLOGIST

Dexamethasone amp/12 hours/IV

IVFP RL 20 drops per minute

Piracetam 3gr / 8hours/ IV

Omeprazole 1 amp/ 12 hours/ IV

Ceftriaxone 1gr/ 12 hours/ IV

SF 2 x 1

Haloperidol 0,5 mg 2 x 1

Sohotaom amp / 24 hours/ IV


17/29

Status Neurologi

GCS: E4M6VX

FKL: Sdn-

RM: KK+, KS-/- Nn.Cr.= pupil bounder

Nn.Cr.lain: pupil bounder o 3mmOPS

RLL +/+, RCTL +/+


18/29

Status Neurologi (Cont.)

Nn .Cr.lain: Sulit dinilai

SSO: BAB: Sudah

BAB: perkateter A: suspek meningoencephalitis

infarc cerebri


19/29

disscusion


20/29

definisi

Miliaria is a group of eccrine disorders

having in common obstruction of the

eccrine sweat duct. Three types, eachreflecting obstruction of sweat ducts at

different levels, from the stratum

corneum to the dermal

epidermaljunction, are recognized


21/29

Klasifikasi miliaria

Miliaria crystallina (superficial ductalocclusion)clear vesicles

Miliaria rubra (intermediate ductalocclusion)erythematous papules orpustules

Miliaria profunda (deeper ductalocclusion)white papules


22/29

etiologi

Sweat retention can be caused byobstruction of the eccrine duct at variouslevels

Common in neonates (whose eccrine sweatducts are not fully developed) and adultsliving in hot, humid conditions

Resolves with relocation to a coolenvironment


23/29

Pathogenesis

Excessive sweating, particularly under

occlusive clothing, can lead to

maceration of the stratum corneum

which is sufficient to cause blockage of

the eccrine duct[Keratinous plugs form,

causing obstruction.


24/29

Clinical finding

Miliaria Crystallina : non pruritic, clear,

fragile, I mm vesicles; location face and trunk

Miliaria rubra : Pruritic, erythematous, 13

mm papules; may have pustules ; location

Neck and upper trunk

Miliaria profunda : Non-pruritic, white, 13

mm papules; location Trunk and proximal

extremities


25/29

Differential diagnosis

Each type of miliaria presents such a classic

clinical picture that diagnosis is usually readily

apparent. A simple diagnostic test involves the

puncture of a miliaria vesicle with a fineneedle, resulting in release of the clear sweat

trapped (and, in the case of miliaria

crystallina, disappearance of the lesion). Inneonates, miliaria rubra must be


26/29

Cont..

distinguished from erythema toxicum

neonatorum, neonatal cephalic pustulosis

(which can involve the upper trunk as well as

the face), candidiasis, and (in atypical cases)

other vesiculopustular diseases of the

newborn (s). In adults, the differential

diagnosis for miliaria rubra includes otherconditions with a predilection for sites of


27/29

Cont..

occlusion and excessive sweating, such as

folliculitis (with normal flora or Staphylococcus

aureus), candidiasis and Grover's disease. The

regression of miliaria profunda within hours ofceasing physical exertion and/or exposure to

high temperatures distinguishes it from other

papular


28/29

Pemeriksaan penunjang

Punch biopsy


29/29

PROGNOSIS

Most patient become well after they have

been transfer to a better environment.

miliaria pustulosa poster minggu i

Documents