CHRISTYA LORENA G (C111 07 263)

Case Report
Name Address Age Sex RM no. #ate

: Muh. Agung : Jln. Rajawali : 2 tahun : laki-laki : 22 !!" : Jun$% 2&th 2"''

(istor$ )aking
Major sign: injuries around the upper lip and nasal*s

+a,ities
-rie. anamnesis:

)he injur$ has /een /eginning sin+e 0 1 months ago. 2nniall$ with just one ,esi+le on the upper lip%then erupt% ex+essi,e% and spread around the upper lip and nasal*s +a,ities in 2 da$s.

(istor$ )aking
)he patient*s parent +omplain that her son /e+ome .uss$ /e+ause the injuries soreness% so she +an*t tou+h to +lean and gi,e /etadine to +ure injuries. )here are s+a/ on the right pointer .inger and le.t leg patient. 2t+h$ 3-4. (istor$ o. .lu 354% 6 da$s ago% nasal mu+us 354. (istor$ o. +ough 354. (istor$ o. .e,er 354% 7 da$s ago.

Status 8resent
9eneral +ondition: mild illness% +omposmentis Nutrition: normal weight% ($giene: /ad :ital sign:
): ''" ; 6" mm(g N: 7" x ; mnt 8: 2" x ; mnt S: 1<.! =C

#ermatolog$ > :enereolog$ Status

?o+ation

Si@e A..loresention

: around the upper lip and nasal*s +a,ities% on the right pointer .inger and on the dorsum pedis. : lenti+ular. : ,esi+le% pustule% and +rust.

#iagnose
Impetigo

krustosa

#i..erential #iagnose

ECTHYM A

#i..erential #iagnose

SELULI

#i..erential #iagnoses
NO .
1.

DIFFEREN CES Distributio

IMPETIGO KRUSTOSA !or" #o!!o i #$i%&r"

EKTIMA

Selulitis

#$i%&r" ' ' (&u%t

)or" #o!!o i *ou + #$i%&r" (, - 11 *"(rs. r(r" i (&u%ts I 0"rior "1tr"!iti"s

2.

/r"&i%"#tio

)or" #o!!o o 0(#". /"rior(%. ( t"rior (s(% R(r" o %i!b "rosio

O i 0"rior "1tr"!iti"s

3.

b(sis

u%#"r

Erosi 2 "1#ori(tio

)herap$
)opi+al:

- .uson +ream 3morning 5 e,ening4

S$stemi+:

- Compress: Na+l ".!B 5 sterile gau@e - +e.adrox$l s$rp. 2 x ' - 8ara+etamol ';1 ta/. 5 metilprednisolon ' mg 5 C8M ';1 ta/. m... 1 x '

Resume
A /o$% 2 $ears old% +ame to the hospital with eritematous ,esi+le% pustules% and +rusts around the upper lip and nasal*s +a,ities. )hese ha,e /een /eginning sin+e 0 1 months ago. 2nniall$% there is just one ,esi+le on the upper lip% /ut then it erupted ex+essi,ed% and spreaded around the upper lip and nasal*s +a,ities in 2 da$s.

Resume
)he patient*s mother +omplaint that her son /e+ame .uss$ /e+ause the injuries soreness% and re.used to /e tou+hed when she tried to +ure wounds with /etadine . )here are s+a/ on the right pointer .inger and le.t dorsum pedis patient. 2t+h$ 3-4. (istor$ o. .lu 354% 6 da$s ago% nasal mu+us 354. (istor$ o. +ough 354. (istor$ o. .e,er 354% 7 da$s ago.

Resume
C%i i#(% /r"s" t 3" 0ou & /(ti" t i !i%& i%% "ss. #o!/os!" tis. +oo& utritio (% st(tus. ( & b(& $*+i" ". 4it(% si+ (r" T5 110 6 70 !!H+. N5 70 1 6 ! t. 85 20 1 6 ! t. S5 36 9C. T$" D"r!(to%o+* st(tus o0 i :uri"s (r" %o#(tio (rou & u//"r %i/ ( & (s(%;s #(<iti"s. ri+$t /oi t"r 0i +"r. ( & %"0t &orsu! /"&is. T$"r" (r" %" ti#u%(r si=". ( & t$" "00%or"s#" #" (r" <"si#%". /ustu%". ( & #rust.

#is+ussion
#e.inition:

Crust impetigo is in+luded in pioderm .orm o. skin diseases% a super.i+ial skin in.e+tion. 2t*s +ommon +aused /$ Strepto+o++us -- (emolith$+us.

#is+ussion
Apidemiolog$.

Most patient are +hildren 3pres+hool and $oung s+hool age4. 2n adults% males predominate. 2n.e+tion usuall$ in late summer and .all% more +ommon under poor h$gieni+ +onditions.

#is+ussion
#iagnose.

'. S$mptoms: - patient +ome into the hospital with .lu s$ndrom 3+ough% nasal mu+us 3544 - s$stemi+s s$mptom 3-4% ex+ept in se,ere +ase ma$/e those will appear. - pruritus - soreness

#is+ussion
2. Clini+al .eatures: - lesion +ommonl$ on the anterior nares and the adja+ent lip area. 2t also +an spread to the lim/. - initiall$ with ,esi+le or pustule that Dui+kl$ e,ol,es into hone$-+olored +rusted plaDue that +an enlarge to greater than 2 +m in diameter. - regional l$mphadenophat$ ma$ /e present in prolonged untreated in.e+tion.

#iagnose
3. L(b Stu&i"s5 2 >%oo& t"st 5 %"u#o#*tosis 2 Erin routi " 2 #u%tur" usu(%%* r"<"(%s !i1"& i 0"#tio 2 ( tistr"/to%*si ( & ( tistr"/to&or (s"2> tit"rs "%"<(t"&.

)herap$
)opi+al:

- anti/iotik : mupiro+in ointment or +ream

S$stemi+:

- anti/iotik: di+loxa+$lin 3& x 2 " >

"" mg ;hr4%

er$throm$+in 3& x 2 " > "" mg;hr4 gi,en .or '" da$s. - or we +an gi,e a@ithrom$+in 3in adults "" mg in the .irst da$% then 2 " mg on the next & da$s4.

)herap$
For +hildren we +an gi,e:

- amox$+illin 5 +la,ulani+ a+id 32 mg;Gg--;hr4 1 x ' '" da$s - +ephalexin 3&" > " mg;Gg--;hr4 .or '" da$s - +e.phro@il 32" mg;Gg--;hr4 ' x ' .or '" da$s - +lindam$+in 3' mg;Gg--;hr4 .or '" da$s
Cthers:

- remo,al +rusts - ha,e good h$giene

Complication
? tr"(t"& %"sio s o0 i!/"ti+o /ro+r"ss 0or s"<"r(% 3""@s.

? tr"(t"& or "+%"#t"& i!/"ti+o #( /ro+r"ss to "#t$*!(. L"sio s #( /ro+r"ss to i <(si<" s"%%u%itis i 0"#tio or 3it$ %*!/$( +itis. su//ur(ti<". "r*si/"%(s.

%*!/$(&" itis. b(#t"r"!i(. s"/ti#"!i(.

Prognosis
Ait$ (&"Bu(t" tr"(t!" t. /ro!/t r"so%utio .