Eritroderma Diduga Akibat Hipersensitivitas Cefadroxil pada Perempuan Pasca Sectio Caesarea: Laporan Kasus

Yuni Mahrunisa, Dian Kusumadewi, Shirly Gunawan

Sari


Eritroderma merupakan kegawatdaruratan dermatologi yang jarang terjadi, ditandai dengan eritema difus dan deskuamasi yang melibatkan ≥90% luas permukaan tubuh, sering disertai komplikasi sistemik. Seorang perempuan usia 31 tahun datang dengan keluhan lesi kulit eritematosa, berskuama, nyeri, dan gatal yang menyeluruh setelah menjalani operasi caesar. Pemeriksaan fisik menunjukkan plak eritematosa luas, skuama kasar, dan fisura pada seluruh regio tubuh. Pemeriksaan penunjang (darah lengkap dan kimia darah) dalam batas normal, tanpa eosinofilia maupun gangguan fungsi organ internal. Karena tidak dilakukan uji provokasi obat maupun re-challenge, penilaian kausalitas formal dilakukan menggunakan Naranjo Algorithm dengan skor 6 (probable relationship). Hal ini menguatkan dugaan reaksi hipersensitivitas obat berdasarkan hubungan temporal anamnesis dan riwayat pajanan cefadroxil sebelumnya. Pasien menunjukkan perbaikan klinis yang signifikan setelah penghentian segera obat pencetus dan pemberian terapi kortikosteroid sistemik. Kasus ini menunjukkan bahwa alat penilaian kausalitas objektif seperti Naranjo Algorithm penting dalam menegakkan dugaan reaksi hipersensitivitas obat pascaoperasi pada eritroderma, sehingga memungkinkan intervensi dini dan pencegahan komplikasi yang dapat mengancam jiwa. 


Kata Kunci


Cefadroxil; Eritroderma; Dermatitis eksfoliatif; Reaksi obat

Teks Lengkap:

PDF

Referensi


Akhyani, M., Ghodsi, Z.S., Toosi, S. and Dabbaghian, H. (2005) ‘Erythroderma: a clinical study of 97 cases’, BMC Dermatology, 5, p. 5.

Bedouelle, E., Said, B. B., Tetart, F., Milpied, B., Welfringer-Morin, A., Maruani, A., Catteau, B., Dezoteux, F., Staumont-Sallé, D., Mazereeuw-Hautier, J., & Abasq, C. (2021). Drug reaction with eosinophilia and systemic symptoms (DRESS): Series of 49 French pediatric cases. The Journal of Allergy and Clinical Immunology: In Practice, 9(10), 3852–3858. https://doi.org/10.1016/j.jaip.2021.07.029

Calle, A. M., Aguirre, N., Ardila, J. C., & Cardona Villa, R. (2023). DRESS syndrome: A literature review and treatment algorithm. World Allergy Organization Journal, 16(1), 100673. https://doi.org/10.1016/j.waojou.2022.100673

Choudhary, S., McLeod, M., Torchia, D., & Romanelli, P. (2013). Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. Journal of Clinical and Aesthetic Dermatology, 6(6), 31–37.

Criado, P. R., Ianhez, M., Miot, H. A., Criado, R. F., Talhari, C., & Müller Ramos, P. (2025). DRESS syndrome: An interaction between drugs, latent viruses, and the immune system. Anais Brasileiros de Dermatologia, 100(1), 104–120.

https://doi.org/10.1016/j.abd.2023.12.010

Dogra, S. and Mahajan, R. (2010) ‘Erythroderma: Etiological and prognostic aspects’, Indian Journal of Dermatology, Venereology and Leprology, 76(6), pp. 528–533.

Habif, T.P. (2016) Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 6th edn. Elsevier.

Han, X. D., Koh, M. J., & Wong, S. M. (2019). Drug reaction with eosinophilia and systemic symptoms in a cohort of Asian children. Pediatric Dermatology, 36(3), 324–329. https://doi.org/10.1111/pde.13795

Harper-Kirksey, K. et al. (2018) ‘Erythroderma’, PMID/PMC article [Review].

Litt, J. Z., & Shear, N. H. (2016). Litt’s drug eruption and reaction manual (22nd ed.). CRC Press.

Martínez-Cabriales, S. A., Rodríguez-Bolaños, F., & Shear, N. H. (2019). Drug reaction with eosinophilia and systemic symptoms (DReSS): How far have we come? American Journal of Clinical Dermatology, 20(2), 217–236. https://doi.org/10.1007/s40257-018-00402-9

Metterle, L., Hatch, L., & Seminario-Vidal, L. (2020). Pediatric drug reaction with eosinophilia and systemic symptoms: A systematic review of the literature. Pediatric Dermatology, 37(1), 124–129. https://doi.org/10.1111/pde.14015

Miyashiro, D. et al. (2020) ‘Erythroderma: a prospective study of 309 patients followed’, Scientific Reports.

Nguyen, E., Gabel, C. K., & Yu, J. (2020). Pediatric drug eruptions. Clinics in Dermatology, 38(6), 629–640. https://doi.org/10.1016/j.clindermatol.2020.06.012

Pramono, D., Handoko, R. and Budianto, A. (2009) ‘Profil klinis penderita eritroderma di RSUD Dr. Soetomo Surabaya tahun 2005–2007’, Berkala Ilmu Kesehatan Kulit & Kelamin, 21(3), pp. 202–210.

Reed, J.L., George, T. and Tobin, A.M. (2021) ‘Management of erythroderma in adults’, American Journal of Clinical Dermatology, 22(6), pp. 769–781.

Romano, A., Gaeta, F., Arribas Poves, M.F. and Valluzzi, R.L. (2016) ‘Cross-reactivity among beta-lactams’, Current Allergy and Asthma Reports, 16(3), p. 24.

Sehgal, V.N. and Srivastava, G. (2018) ‘Exfoliative dermatitis: A prospective study of 80 patients’, Dermatology, 193(2), pp. 113–117.

Sehgal, V.N., Srivastava, G. and Dogra, S. (2004)

‘Erythroderma/exfoliative dermatitis: A synopsis’, International Journal of Dermatology, 43(1), pp. 39–47.

Setyowatie, L. (2018). Drug reaction with eosinophilia and systemic symptoms. In L. Setyowatie, A. P. Yuniaswan, S. Prawitasari, D. P. Ekasari, & T. Sugiman (Eds.), Adverse cutaneous drug reaction: Caveats & essential practices (pp. 44–55).




DOI: https://doi.org/10.33024/jikk.v13i5.23473

Refbacks

  • Saat ini tidak ada refbacks.


##submission.copyrightStatement##

##submission.license.cc.by-nc4.footer##

Pendidikan Dokter Universitas Malahayati Lampung


Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.