Hardyanto Soebono

Department of Dermato-Venereology
Faculty of Medicine Gadjah Mada University
Yogyakarta

Unique :

the largest
limits our body and environment
Express our psychological condition
Estimate age
Plays a role in homeostasis

Discomfort
Disfigurement
Disability

Quality of Life
/QoL
ASM2014

2/23/14

ASM2014

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ASM2014

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SKIN DISEASES IN THE COMMUNITY

3 % (Specialist)
17 % (GP)

80 % without
complaints

Sanitasi jelek ------> Infeksi/ infestasi

Panas & lembab ---> Infeksi bakteri/
jamur
Industri -------------> Dermatitis kontak
Radiasi UV
------> Kanker kulit

POLA PENYAKIT KULIT

DI NEGARA MAJU DAN NEGARA
BERKEMBANG

Negara Maju

Negara Berkembang

1. Non-Infeksi
2. Tumor
3. Infeksi/ infestasi

1. Infeksi / infestasi
2. Non-Infeksi
3. Tumor

Gol. Dermatitis/Ekzema :
dermatitis kontak, dermatitis atopik, dermatitis

seboroik, dishidrosis, likhen kronik

Gol. Penyakit Reaktif :

urtikaria, erupsi obat (sindrom Stevens Johnson dll.)

Gol. Eritroskuamosa:
Psoriasis, parapsoriasis dll

Gol. Penyakit Bulosa:

Pemfigus vulgaris, pemfogoid

Gol. Penyakit Kolagen:

Lupus eritematosus, skleroderma

Bakteri :
Pioderma : Impetigo, Ektima, Furunkel, Karbunkel,
Erisipelas,

Tuberkulosis Kulit, Lepra, Frambusia

Jamur :
Tinea, Kandidiasis, Pityriasis

Virus

Varisela, H. Zoster, H. simpleks, Veruka,

Moluskum

Parasit

Skabies, Pedikulosis, Creeping eruption

POLA PENYAKIT KULIT

DI RSUP DR. SARDJITO TH. 1985 DAN
1995
%

I. Direct infection of skin and adjacent

tissues
a.
b.
c.
d.
e.
f.

Impetigo
Ecthyma
Folliculitis
Furunculosis
Carbuncle
Sycosis barbae

II. Cutaneous disease due to effect of

bacterial toxin
a.
Staphylococcal scalded skin syndrome
b. Toxic shock syndrome

I. Direct infection of skin or

subcutaneous
a.
b.
c.
d.
e.

Impetigo (non bullous)

Ecthyma
Erysipelas
Cellulitis
Necrotizing fascitis

II. Secondary infection

Eczema infection

Impetigo is a superficial skin infection with

crusting or bullae caused by streptococci,
staphylococci, or both.
Ecthyma is an ulcerative form of impetigo.

Impetigo (Bullou
Impetigo (Non-Bullous)

Non-bullous impetigo is
a superficial skin
infection that manifests
as clusters of vesicles or
pustules that rupture
and develop a honeycolored crust.

Bullous impetigo is a
superficial skin infection that
manifests as clusters of
vesicles or pustules that
enlarge rapidly to form bullae.
The bullae burst and expose
larger bases, which become
covered with honey-colored

Ecthyma is a skin infection

similar to impetigo, but more
deeply invasive. Usually caused
by a streptococcus infection,
ecthyma goes through the outer
layer (epidermis) to the deeper
layer (dermis) of skin, possibly
causing scars.

Ecthyma gangrenosum is a
bacterial skin infection (caused
by Pseudomonas aeruginosa)
that usually occurs in people
witha compromisedimmune
system.

Folliculitis is a bacterial infection of

hair follicles.
Folliculitis is usually caused by
Staphylococcus aureus but
occasionally Pseudomonas aeruginosa
(hot-tub folliculitis) or other
organisms. Hot-tub folliculitis occurs
because of inadequate treatment of
water with chlorine or bromine.

Folliculitis manifests as
superficial pustules or

 Recurrent

red follicular papules or

pustules centered on a hair, usually

remain discrete over the beard or upper
lip, but may coalesce to produce raised
plaques studded with pustules.

Furuncles are skin abscesses caused by

staphylococcal infection, which involve a
hair follicle and surrounding tissue.
Carbuncles are clusters of furuncles
connected subcutaneously, causing deeper
suppuration and scarring. They are smaller
and more superficial than subcutaneous
abscesses

Furuncles (boils) are tender nodules or pustules caused by

staphylococcal infection. Carbuncles are clusters of
furuncles that are subcutaneously connected.

Hidradenitis suppurativa is a chronic,

scarring inflammation of apocrine glands
of the axillae, groin, and around the
nipples and anus.

Cellulitis is acute bacterial infection of the

skin and subcutaneous tissue most often
caused by streptococci or staphylococci.
Erysipelas is a type of superficial cellulitis
with dermal lymphatic involvement.
Other causes - Staphylococcus aureus
(including methicillin-resistant S. aureus
[MRSA]), Klebsiella pneumoniae,
Haemophilus influenzae, Escherichia coli.
It is commonly accompanied by high fever,
chills, and malaise. Erysipelas may be
recurrent and may result in chronic
lymphedema.

Typically caused by a
mixture of aerobic and
anaerobic organisms that
cause necrosis of
subcutaneous tissue,
usually including the
fascia.
This infection most
commonly affects the
extremities and perineum.
Affected tissues become
red, hot, and swollen,
resembling severe
cellulitis.