Patofisiologi dan Manajemen Terapi (SSJ) dan Nekrolisis Epidermal Toksik (NET)
DOI:
https://doi.org/10.56951/medicinus.v33i2.53Kata Kunci:
Nekrolisis epidermis (NE), Stevens-JohnsonAbstrak
Nekrolisis epidermis (NE) adalah sindrom reaksi mukokutan akut yang ditandai dengan nekrosis dan pengelupasan epidermis yang luas serta dapat menyebabkan kematian. Lesi awal berupa makula eritematosa, kemudian berkembang secara progresif menjadi lesi lepuh kendur dan selanjutnya terjadi pengelupasan epidermis. Berdasarkan luas permukaan tubuh yang terlibat, NE diklasifikasikan menjadi tiga kategori, yaitu sindrom Stevens-Johnson (SSJ) jika luas lesi <10%, overlap SSJ-nekrolisis epidermal toksik (SSJ-NET) jika luas lesi 10-30% dan nekrolisis epidermal toksik (NET) jika luas lesi >30%. Patofisiologi NE belum diketahui dengan jelas hingga saat ini. Sindrom Stevens-Johnson (SSJ) dan nekrolisis epidermal toksik (NET) merupakan kondisi yang dapat menyebabkan kematian, oleh karena itu memerlukan penanganan yang cepat dan tepat. Mengidentifikasi kemungkinan penyebab dan memberikan perawatan yang diperlukan di rumah sakit diharapkan mampu meminimalisasi kejadian fatal akibat kondisi ini. Penanganan utama pada SSJ-NET adalah dengan menghentikan penggunaan substansi yang dicurigai sebagai penyebab. Terapi lain yang dapat diberikan masih cukup kontroversial, seperti pemberian corticosteroid, IVIG, plasmapheeresis, dan cyclosporine.
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