Koinfeksi Sifilis Sekunder, Condyloma Acuminata dan Human Immundeficiency Virus (HIV) pada Pria Homoseksual
DOI:
https://doi.org/10.56951/medicinus.v35i2.94Kata Kunci:
HIV, homoseksual, kutil kelamin, condyloma acuminata, sifilis sekunderAbstrak
Pendahuluan: Pria homoseksual merupakan kelompok yang berisiko tinggi terkena infeksi menular seksual (IMS). Sifilis merupakan salah satu jenis IMS yang bersifat kronis dan sistemik. Infeksi virus human immunodeficiency virus (HIV) dan atau human papillomavirus (HPV) merupakan faktor risiko terjangkitnya infeksi sifilis, dan infeksi HIV serta koinfeksi sifilis dapat saling meningkatkan risiko IMS lainnya. Kasus: Seorang laki-laki 22 tahun, orientasi seksual sesama jenis, mengeluh bercak merah bersisik di kedua telapak tangan dan kaki, tidak gatal, rambut rontok dan benjolan di daerah genital. Pemeriksaan regio oksipital tampak adanya alopesia tanpa disertai jaringan parut, regio palmar dan plantar pedis bilateral tampak patch, plak eritem multipel sebagian hiperpigmentasi konfluens dengan skuama di atasnya, dan pada regio perineal tampak papul nodul multipel dengan permukaan licin merah pucat. Pemeriksaan acetowhite positif pada lesi papul verukosa. Hasil pemeriksaan CD4 112 sel/µl, VDRL/RPR reaktif 1:256 dan TPHA reaktif >1:5.120. Gambaran histopatologi kulit sesuai dengan gambaran sifilis kulit dan condyloma acuminata. Pada pemeriksaan imunohistokimia didapatkan gambaran Spirochaeta berwarna kecoklatan. Pasien didiagnosis dengan koinfeksi sifilis sekunder, condyloma acuminata, dan HIV. Kesimpulan: Pada kasus ini didapatkan seorang pasien homoseksual dengan koinfeksi sifilis sekunder, condyloma acuminata dan HIV. Infeksi HPV dan HIV sering ditemukan bersamaan, dan keduanya saling meningkatkan risiko infeksi menular seksual.
Unduhan
Referensi
UN Joint Programme on HIV/AIDS (UNAIDS). HIV and Sex Between Men. 2012. pp.1-2.
Werner RN, Gaskins M, Nast A, Dressler C. Incidence of sexually transmitted infections in men who have sex with men and who are at substantial risk of HIV infection – A metaanalysis of data from trials and observational studies of HIV preexposure prophylaxis. PLoS ONE 2019; 13(12):e0208107. DOI: https://doi.org/10.1371/journal.pone.0208107
Centers for Disease Control and Prevention. 2018 STD Surveillance Report. Available from: https://www.cdc.gov/nchhstp/newsroom/2019/2018-STD-surveillance-report.html#:~:text=According%20to%20the%20annual%20Sexually,chlamydia%2C%20gonorrhea%2C%20and%20syphilis.
UN Joint Programme on HIV/AIDS (UNAIDS). Global HIV & AIDS statistics — 2018 fact sheet. pp.3.
World Health Organization. WHO Guidelines for theTreatment of Treponema pallidum (syphilis). 2016. pp.10-29.
Sparling PF. Clinical Manifestations of Syphilis. In: Holmes KK, et al., 4th ed. Sexually Transmitted Diseases. New York: McGraw Hill; 2008. p.661-82.
Daili SF, et al. Infeksi Menular Seksual Pedoman Praktis Diagnosis & Tata laksana, Jakarta: Kementrian Kesehatan Republik Indonesia. 2015. pp.27-30.
Peeling RW, Hook EW. The Pathogenesis of Syphilis: the Great Mimicker, Revisited. J Pathol. 2006;208:224-32. DOI: https://doi.org/10.1002/path.1903
Weedon D. Infections and Infestations. In: Weeddon’s Skin Pathology 3rd ed. Elsevier; 2010. p.574-8.
Karp G, Schlaeffer F, Jotkowitz A, Reisenberg K. Syphilis and HIV Co-Infection. Eur J Intern Med 2009;20(1):9-13. DOI: https://doi.org/10.1016/j.ejim.2008.04.002
Androphy EJ, Kirnbauer R. Human papilloma virus infections. In: Goldsmith LA, Katz SI, Cilchrest BA, Paller AS, Leffel DJ, Wolff K, editor. Fitzpatrick’s dermatology in general medicine. 8th ed. New York: Mc-Graw Hill;2012. p.3440-56.
Chang GJ, Welton ML. Human papillomavirus, condyloma acuminata and anal neoplasia. Clinics 2004;17(4): 221-30. DOI: https://doi.org/10.1055/s-2004-836942
Departemen Kesehatan RI. Pedoman Tata Laksana Sifilis untuk Pengendalian Sifilis di Layanan Kesehatan Dasar. Jakarta: Depkes RI;2013.p.3-8.
UN Joint Programme on HIV/AIDS (UNAIDS). Miles to go: global AIDS update 2018.
Bourne A. Drug use among men who have sex with men: Implications for harm reduction. London: Harm Reduction International;2012. p.148-59.
Hoang MP, High W, Molberg KH. Secondary syphilis: a histologic and immunohistochemical evaluation. Journal of Cutaneus Pathology. 2004; 31(9):595-9. DOI: https://doi.org/10.1111/j.0303-6987.2004.00236.x
Dylewski J, Duong M. The rash of secondary syphilis. CMAJ. 2007;176(1):33-5. DOI: https://doi.org/10.1503/cmaj.060665
Komeno Y, Ota Y, Koibuchi T, Imai Y, Iihara K, Ryu T. Secondary Syphilis with Tonsillar and Cervical Lymphadenopathy and a Pulmonary Lesion Mimicking Malignant Lymphoma. Am J Case Rep. 2018;19:238-43. DOI: https://doi.org/10.12659/AJCR.907127
Taylor G, Heilman E. Interface Dermatitis. In: Kels Jane MG, editors. Color Atlas of Dermatology, Clinical and Basic Science. New York: Informa Health Care; 2007. p.26. DOI: https://doi.org/10.3109/9781420005455.003
Katz KA. Syphilis. In: Goldsmith LA, Katz Stephen, Gilchrest Barbara, Paller Amy, Leffell David, Wolff Klaus, editors. Fitzpatrick’s Dermatology in General Medicine, 8th ed. New York: McGraw-Hill; 2012. p.2471-92
Gianfaldoni S, Tchernev G, Wollina U, Gianfaldoni R, Lotti T. Secondary Syphilis Presenting As Palmoplantar Psoriasis. Open Access Maced J Med Sci. 2017;5(4):445-7. DOI: https://doi.org/10.3889/oamjms.2017.087
Uribe-Herranz M, Lian LH, Hooper KM, Milora KA, Jensen LE. IL-1R1 signaling facilitates Munro’s microabscess formation in psoriasiform imiquimod-induced skin inflammation. J Invest Dermatol. 2013;133(6):1541-9. DOI: https://doi.org/10.1038/jid.2012.512
Deshpande DJ, Nayak CS, Mishra SN, Dhurat RS. Verrucous condyloma lata mimicking condyloma acuminata: An unusual presentation. Indian J Sex Transm Dis AIDS. 2009;30(2):100-2. DOI: https://doi.org/10.4103/0253-7184.62766
Rosa G, Bennett, Piliang M. Eosinophil-rich syphilis: a report of four cases. Journal of Cutaneus Pathology. 2015;42(8):554-8. DOI: https://doi.org/10.1111/cup.12540
Yanofsky VR, Patel RV, Goldenberg G. Genital warts: a comprehensive review. J Clin Aesthet Dermatol. 2012;5(6):25–36.
Vyas NS, Pierce Campbell CM, Mathew R, et al. Role of histological findings and pathologic diagnosis for detection of human papillomavirus infection in men. J Med Virol. 2015;87(10):1777-87. DOI: https://doi.org/10.1002/jmv.24238
Caussy D, Goedert JJ, Palefsky J, Gonzales J, Rabkin CS, Digioia RA, et al. Interaction of human immunodeficiency and papilloma viruses: association with anal epithelial abnormality in homosexual men. Intl J Cancer 1990; 46:214-9. DOI: https://doi.org/10.1002/ijc.2910460212
Nazli A, Chan O, Dobson-Belaire WN, Ouellet M, Tremblay MJ, Gray-Owen SD, et al. Exposure to HIV-1 directly impairs mucosal epithelial barrier integrity allowing microbial translocation. PLoS Pathog 2010; 6:1-20. DOI: https://doi.org/10.1371/journal.ppat.1000852
Ganesan A, Mesner O, Okulicz JF, O’Bryan T, Deiss RG, Lalani T, et al. A single dose of benzathine penicillin G is as effective as multiple doses of benzathine penicillin G for the treatment of HIV-infected persons with early syphilis. Clin Infect Dis. 2015; 60(4):653-60. DOI: https://doi.org/10.1093/cid/ciu888
Unduhan
Terbitan
Bagian
Diterbitkan
Unduhan
Lisensi
Hak Cipta (c) 2022 Ahmad Fiqri, Endra Yustin ES
Artikel ini berlisensi Creative Commons Attribution-NonCommercial 4.0 International License.
Cara Mengutip
