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STATUS RESPONSI LIKEN SIMPLEKS KRONIS Oleh : Deliza Ardela Pravintsari G99121011 Pembimbing : dr. Endra Yustin ES, Sp. KK, M.Sc KEPANITERAAN KLINIK ILMU KESEHATAN KULIT DAN KELAMIN FAKULTAS KEDOKTERAN UNS / RSUD DR. MOEWARDI SURAKARTA 2014 1 STATUS RESPONSI ILMU KESEHATAN KULIT DAN KELAMIN Penguji : dr. Endra Yustin ES, Sp. KK, M.Sc Nama Mahasiswa : Deliza Ardela Pravintasari NIM : G99121011 LIKEN SIMPLEKS KRONIS A. SINONIM  Neurodermat
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  STATUS RESPONSI LIKEN SIMPLEKS KRONIS Oleh : Deliza Ardela Pravintsari G99121011 Pembimbing : dr. Endra Yustin ES, Sp. KK, M.Sc KEPANITERAAN KLINIK ILMU KESEHATAN KULIT DAN KELAMIN FAKULTAS KEDOKTERAN UNS / RSUD DR. MOEWARDI SURAKARTA 2014  1   STATUS RESPONSI ILMU KESEHATAN KULIT DAN KELAMIN Penguji : dr. Endra Yustin ES, Sp. KK, M.Sc  Nama Mahasiswa : Deliza Ardela Pravintasari  NIM : G99121011 LIKEN SIMPLEKS KRONIS A.   SINONIM     Neurodermatitis sirkumskripta      liken vidal 2   B.   DEFINISI Liken simplek kronik dikenal juga dengan neurodermatitis sirkumskripta, atau Liken Vidal. Liken simplek kronik adalah peradangan kulit kronis, disertai rasa gatal, sirkumskrip, yang khas ditandai dengan kulit yang tebal dan likenifikasi. Likenifikasi pada kasus ini terjadi akubat garukan atau gosokan yang berulang-ulang, karena berbagai rangsangan pruritogenik. Keluhan dan gejala dapat muncul dalam waktu hitungan minggu hingga bertahun-tahun. Liken simplek kronik merupakan penyakit yang sering ditemui pada masyarakat umum terutama pada usia dewasa, dan puncak insidennya antara 30-50 tahun. Keluhan utama yang dirasakan pasien dapat berupa gatal yang  bersifat paroksismal, dan dirasakan pasien terutama jika tidak beraktivitas. Lesi yang timbul dapat muncul hanya pada satu tempat, tetapi dapat juga dijumpai pada beberapa tempat.  2  Lichen simplex chronicus (LSC) is thickening of the skin with variable scaling that arises secondary to repetitive scratching or rubbing. Lichen simplex chronicus is not a primary process. Rather, a person senses pruritus in a specific area of skin (with or without underlying pathology) and causes mechanical trauma to the point of lichenification. (5) Neurodermatitis circumscripta also commonly called as lichen simplex chronicus (LSC) is a chronic skin disease characterized by lichenified plaques, which occur as result of constant scratching or rubbing of skin. Itch sensation that provokes an intense desire to scratch or rub a localized accessible area of skin is secondary to a psychological stress. Common sites are nape of neck, ankles, anogenital region and scalp. (6)   C.   EPIDEMIOLOGI Dikatakan bahwa 12% dari populasi orang dewasa dengan keluhan kulit gatal menderita liken simplek kronik. Tidak ada kematian akibat liken simplek kronik. Liken simplek kronik tidak memandang ras dalam penyebarannya. Diketahui bahwa insiden terjadi lebih sering pada wanita daripada pria. Penyakit ini sering muncul pada usia dewasa, terutama usia 30 hingga 50 tahun. Pasien dengan koeksistensi dermatitis atopi cenderung memiliki onset umur yang lebih muda (rata-rata 19 tahun) dibandingkan dengan pasien tanpa atopi (rata-rata 48 tahun). Lichen simplex chronicus affects adults, predominantly from ages 30 to 50. Females are affected more commonly than males. Prurigo nodularis may occur at any age, but most patients are between 20 and 60 years. 14 Men and women are equally affected.  3   Patients with coexistent atopic dermatitis have been found to have any earlier age of onset (mean: 19 years) as compared to the nonatopic group (mean: 48 years). (3) Exact frequency in the general population is unknown. In one study, 12% of aging  patients with pruritic skin had lichen simplex chronicus.  No mortality occurs as a result of lichen simplex chronicus. Overall, pruritus of lichen simplex chronicus is mild to moderate, but paroxysms may occur that are relieved by moderate-to-severe rubbing and scratching. Pruritus is usually described as much worse during periods of inactivity, usually at bedtime and during the night. Touch and emotional stress also may provoke pruritus, which is relieved by moderate-to-severe rubbing and scratching.    Lesions cause little direct morbidity; however, occasionally patients report decreased or interrupted sleep, which affects motor and mental functioning.    Lichen simplex chronicus SC may become secondarily infected after excoriation.    Lichen simplex chronicus is often visible enough to cause patients to seek treatment.  No differences are reported in frequency among races, although prior authors claimed lichen simplex chronicus was more common in Asians and African Americans. The appearance of lesions on darker skin sometimes shows follicular prominence. Secondary pigmentary alterations are also more severe in individuals with darker skin. Lichen simplex chronicus is observed more commonly in females than in males. Lichen nuchae is a form of lichen simplex that occurs on the midposterior neck and is observed almost exclusively in women. Lichen simplex chronicus occurs mostly in mid-to-late adulthood, with highest  prevalence in persons aged 30-50 years.(5) D.   ETIOPATOGENESIS Etiologi pasti liken simplek kronik belum diketahui, namun pruritus memainkan peran sentral dalam timbulnya pola reaksi kulit berupa likenifikasi
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