Ulkus Marjolin yang Berkembang dari Ulkus Trofik Kronis pada Pasien Kusta

Adniana Nareswari; Harijono Kariosentono; Nugrohoaji Dharmawan; Muhammad Eko Irawanto; Nurrachmat Mulianto

doi:10.56951/medicinus.v34i2.67

Ulkus Marjolin yang Berkembang dari Ulkus Trofik Kronis pada Pasien Kusta

Penulis

Adniana Nareswari Bagian Ilmu Kesehatan Kulit dan Kelamin, Fakultas Kedokteran, Universitas Sebelas Maret Surakarta/RSUD Dr. Moewardi, Surakarta
Harijono Kariosentono Bagian Ilmu Kesehatan Kulit dan Kelamin, Fakultas Kedokteran, Universitas Sebelas Maret Surakarta/RSUD Dr. Moewardi, Surakarta
Nugrohoaji Dharmawan Bagian Ilmu Kesehatan Kulit dan Kelamin, Fakultas Kedokteran, Universitas Sebelas Maret Surakarta/RSUD Dr. Moewardi, Surakarta
Muhammad Eko Irawanto Bagian Ilmu Kesehatan Kulit dan Kelamin, Fakultas Kedokteran, Universitas Sebelas Maret Surakarta/RSUD Dr. Moewardi, Surakarta
Nurrachmat Mulianto Bagian Ilmu Kesehatan Kulit dan Kelamin, Fakultas Kedokteran, Universitas Sebelas Maret Surakarta/RSUD Dr. Moewardi, Surakarta

DOI:

https://doi.org/10.56951/medicinus.v34i2.67

Kata Kunci:

karsinoma sel skuamosa, kusta, ulkus marjolin

Abstrak

Ulkus Marjolin merupakan komplikasi dari ulkus kronis yang bersifat ganas. Perubahan lesi ulkus menjadi keganasan dapat disebabkan oleh iritasi kronis, infeksi, penurunan vaskularisasi, dan peningkatan ekspresi protoonkogen. Bentuk histopatologi tersering dari ulkus Marjolin adalah karsinoma sel skuamosa. Seorang laki-laki berusia 55 tahun, dengan keluhan adanya luka menonjol pada telapak tangan kiri yang tak kunjung sembuh sejak tiga tahun yang lalu. Pasien memiliki riwayat terdiagnosis dengan penyakit kusta sejak 30 tahun lalu, dengan riwayat pengobatan yang tidak tuntas. Pada pemeriksaan fisik, regio palmar sinistra tampak ulkus soliter, berukuran ±10x8x1,5 cm, permukaan noduler, berwarna kemerahan, konsistensi keras, tepi meninggi dan tidak rata. Pemeriksaan laboratorium slit-skin smear (SSS) dengan pewarnaan Ziehl-Neelsen ditemukan banyak basil tahan asam. Pemeriksaan histopatologi dari tepi ulkus memberikan gambaran tumor epitelial, tampak sel-sel epidermis yang berdiferensiasi dan menginvasi lapisan dermis, sel-sel tumor tersusun secara fokal dan konsentris disertai masa keratin yang tampak sebagai sel mutiara tanduk (horn pearl). pengecatan Fite-Faraco ditemukan banyak sekali basil tahan asam M. leprae. Berdasarkan anamnesis, pemeriksaan fisik, dan penunjang pasien didiagnosis dengan ulkus Marjolin pada kusta multibasiler (MB). Pasien diterapi dengan multidrug therapy MB selama 12 bulan dan below-wrist amputation.

Unduhan

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