DERMATITIS EKSIM

&
LESI ERITROSQUAMA

Riyan Fauzan : 12100116239

Preceptor : Diana Wijayanti,
dr.Sp.KK
1.Dermatitis Kontak iritan
 Management
The definitive treatment of irritant contact dermatitis is the
identification and removal of any potential causal agents
-barier cream : ceramide or dimethicone gunakan sehari 2 kali
-Cleanser : The best antimicrobial efficacy can be achieved with
ethanol (60-85%), isopropanol (60-80%), andN-propanol (60-
80%). The antimicrobial efficacy of chlorhexidine (2-4%) and
triclosan (1-2%) .
-Kortikosteroid :
hydrocortison/betmetason/clobetasol/triamcinolone/prednisone
dalam waktu 1-2 minggu
-immunomodulator : tacrolimus 2x1/hari
2.Dermatitis Atopic(Kec recalcitrant)
Management
-Topical
- identification and elimination of flare factors
-Sistemik
Topical
1.Cutaneous hydration :
-rendam air hangat 20 menit dan diolesi emolient
-penggunaan wet dressing
-Moisturized : Petrolatum, Aquaphor, or newer agents such as Atopiclair and
Mimyx
-Kortikosteroid topikal : Hydrocortisone, triamcinolone, or betamethasone :
ointment
-Immunomodulator topical : Tacrolimus and pimecrolimus (calcineurin
inhibitors; generally considered second-line therapy) 2 x 1/hari
-Antipruritus Topical : Preparat TAR
-fototerapi : Ultraviolet (UV)-A, UV-B, a combination of both, psoralen plus
UV-A (PUVA), or UV-B1 (narrow-band UV-B) therapy
 identification and elimination of flare factors
- identify and eliminate aggravating factors that trigger the itch-
scratch cycle.
include soaps or detergents, contact with chemicals, smoke,
abrasive clothing,
and exposure to extremes of temperature and humidity.
- Foods and aeroallergens such as dust mites, animal danders,
molds, and pollens have been demonstrated to exacerbate
atopik dermatitis
- Emotional stressor : frustration, embarrassment, or other
stressful events with increased pruritus and scratching.
- Agen infeksi : e.c staphylococcus aureus (erithromycin and the
newer macrolide
antibiotics (azithromycin and clarithromycin).

Systemik
-Kortikosteroid oral : prednison 1- 2 minggu
-Allergen therapi : cyclosporine, Mycophenolate mofetil (MMF)
4. Dermatitis Numularis
 Management
The skin should be hydrated by baths containing oil additives
and the application of emollients.
-Topical anti-inflammatory agents include tar preparations.
-
Kortikosteroid:hydrocortison,betmetason,clobetasol,triamcinolon
e,prednisone 1-2 minggu
-Immunomodulator topical : Tacrolimus 2 x 1 /hari
5.Napkin eczema/napkin dermatitis
 Management
first-line therapy for individuals with Napkin (diaper dermatitis) is
zinc oxide ointment or various products containing zinc oxide. Zinc
oxide is an inexpensive treatment with the following properties:
Antiseptic and astringent
Significant role in wound healing
Low risk for allergic or contact dermatitis

-Ganti popok bayi lebih sering, gunakan pelembab sebelum

memakaikan popok bayi.
-Dianjurkan pemakaian popok sekali pakai jenishighly absorbent.
-farmakoterapi : untuk menekan inflamasi dan mengatasi infeksi
kandida.
Derajat ringan: krim/ salep bersifat protektif (zinc oxide/pantenol)
dipakai 2 kali sehari selama 1 minggu atau kortikosteroid potensi
lemah (salep hidrokortison 1-2.5%) dipakai 2 kali sehari selama 3-7
hari.
terinfeksi kandida: berikan antifungal nistatin sistemik 1 kali
sehari selama 7 hari atau derivat azol topikal dikombinasi
denganzinc oxidediberikan 2 kali sehari selama 7 hari
LESI ERITROSQUAMA
Dermatitis Seboroik
 Management
In general, therapy is directed toward loosening and removal of
scales and crusts, inhibition of yeast colonization, control of secondary

SCALP
-Shampoos containing 1 to 2.5% selenium sulfide, imidazoles (e.g., 2%
ketoconazole) zinc pyrithione, benzoyl peroxide, salicylic acid, coal or
juniper tar twice on a week.

FACE AND TRUNK

-Corticosteroid :
hydrocortison,betmetason,clobetasol,triamcinolone,prednisone dalam 1-
2 minggu

-anti-inflammatory supportive : Vitamin D3 analogues (calcipotriol cream

or lotion, calcitriol ointment, or tacalcitol ointment) oles 2 kali sehari
dalam 1 minggu

-Phototherapy : Narrow-band UVB phototherapy appears to be an

effective and safe treatment option for patients with severe and
refractory seborrheic dermatitis.
Pitiriasis Rosea
 Management
Self limited disease
Supportive treatment
-Topical zinc oxide and calamine lotion
-Oral antihistamines :dipenhydramin 25 mg 2x1
-topical corticosteroids
:hydrocortison,betmetason,clobetasol,triamcinolone,prednisone
dalam 1-2 minggu
-For patients in whom superficial tinea infection is a concern or
possibility, topical antifungal therapy can be used.
-PR in patients with evidence of group A streptococcal infection :
Erithromysin 2 x 1 selama 2 minggu
-Acyclovir may hasten resolution, especially if given within 1 week
of rash, but the data are not conclusive.