Diagnosis Dyshidrotic Eczema

Oleh :

dr. Felicia

Diagnosis dyshidrotic eczema bisa ditegakkan secara klinis. Manifestasi klinis khas adalah vesikel atau bula, dengan atau tanpa gambaran hiperkeratotik dan deskuamasi pada area palmoplantar. Lesi terasa gatal dan nyeri, dengan onset akut berulang atau kronis. Beberapa pasien dapat mengalami serangan 6–12 kali per tahun.[5,8,32]

Diagnosis pasti dengan biopsi kulit akan menunjukkan gambaran histopatologi berupa parakeratosis, hiperplasia epidermal irregular, rete ridges tipis, dan vesikel spongiotik. Pemeriksaan penunjang lain seperti patch test, tes mikrobiologi, dan tes mikologi bisa dilakukan untuk menyingkirkan diagnosis banding bila perlu atau mengetahui faktor yang memperberat penyakit.[6,33]

Anamnesis

Referensi

2. Nishizawa A. Dyshidrotic Eczema and Its Relationship to Metal Allergy. Yokozeki H, Murota H, Katayama I, editors. Curr Probl Dermatol. 2016;51:80–5.
5. Gk W, et al. Dupilumab in the Treatment of Dyshidrosis: A Report of Two Cases. J Drugs Dermatol JDD. 2018 Mar 1;17(3):355–6.
6. Agarwal US, Besarwal RK, Gupta R, et al. Hand eczema. Indian J Dermatol. 2014 May 1;59(3):213.
8. Reich D, Psomadakis CE, Buka B. Pompholyx. In: Top 50 Dermatology Case Studies for Primary Care. Cham: Springer International Publishing; 2017. p. 79–84. http://link.springer.com/10.1007/978-3-319-18627-6_13
11. Silvestre Salvador J, Romero-Pérez D, Encabo-Durán B. Atopic Dermatitis in Adults: A Diagnostic Challenge. J Investig Allergol Clin Immunol. 2017 Apr 10;27(2):78–88.
12. Shah I, Sengupta K. Pompholyx-Case Reports. Pediatr Oncall J. 2009;6(1):17.
14. Soler D, Bai X, Ortega L, et al. The key role of Aquaporin 3 and Aquaporin 10 in the pathogenesis of pompholyx (P6372). J Immunol. 2013 May 1;190(1 Supplement):201.1-201.1.
17. Guillet M, Wierzbicka E, Guillet S, et al. A 3-Year Causative Study of Pompholyx in 120 Patients. Arch Dermatol. 2008 Jan 1;143:1504–8.
32. Bershow A. Dyshidrotic dermatitis - Symptoms, diagnosis and treatment. BMJ Best Practice US. 2019. https://bestpractice.bmj.com/topics/en-us/91
33. Wang X, Shi XD, Li LF, et al. Classification and possible bacterial infection in outpatients with eczema and dermatitis in China. Medicine (Baltimore). 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5585520/
34. Wollina U. Pompholyx or dyshidrosis. Expert Rev Dermatol. 2014 Jan 10;4(4):403–11.
35. Ikumi K, Kio T, Torii K, et al. PRIME PubMed | Successful treatment of dyshidrotic palmoplantar eczema with ultraviolet A1 light-emitting diodes. J Dermatol. 2020. https://www.unboundmedicine.com/medline/citation/32441347/Successful_treatment_of_dyshidrotic_palmoplantar_eczema_with_ultraviolet_A1_light-emitting_diodes.
36. Christoffers WA, Coenraads P-J, Svensson Å, et al. Interventions for hand eczema. Cochrane Database Syst Rev. 2019;(4). https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004055.pub2/references
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39. Vocks E, Plötz SG, Ring J. The Dyshidrotic Eczema Area and Severity Index – A Score Developed for the Assessment of Dyshidrotic Eczema. Dermatology. 1999;198(3):265–9.
40. Chopra R, Vakharia PP, Sacotte R, et al. Severity strata for Eczema Area and Severity Index (EASI), modified EASI, Scoring Atopic Dermatitis (SCORAD), objective SCORAD, Atopic Dermatitis Severity Index and body surface area in adolescents and adults with atopic dermatitis. Br J Dermatol. 2017;177(5):1316–21.
41. Fonacier L, Chong M. Contact Dermatitis: Synopsis | World Allergy Organization. www.worldallergy.org. 2015. https://www.worldallergy.org/education-and-programs/education/allergic-disease-resource-center/professionals/contact-dermatitis-synopsis
42. Masuda-Kuroki K, Murakami M, Kishibe M, et al. PRIME PubMed | Diagnostic histopathological features distinguishing palmoplantar pustulosis from pompholyx. J Dermatol. 2019 May;46(5):399–408.
43. Spongiosis - an overview | ScienceDirect Topics. 2015. https://www.sciencedirect.com/topics/medicine-and-dentistry/spongiosis
44. Agner T, Elsner P. Hand eczema: epidemiology, prognosis and prevention. J Eur Acad Dermatol Venereol. 2020;34(S1):4–12.
45. Sitepu EH, Muis K, Putra IB. Dermatophytes and bacterial superinfections in tinea pedis patients at Haji Adam Malik Central Hospital, Medan-Indonesia. Bali Med J. 2018 Aug 8;7(2). https://www.balimedicaljournal.org/index.php/bmj/article/view/778
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47. Levitt JO, Levitt BH, Akhavan A, et al. The Sensitivity and Specificity of Potassium Hydroxide Smear and Fungal Culture Relative to Clinical Assessment in the Evaluation of Tinea Pedis: A Pooled Analysis. Dermatol Res Pract. 2010. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2905901/

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