Post on 12-Apr-2018
7/21/2019 Case Report Oral medicine
1/46
Recurrent
AphthousStomatitis e.c.
Keturunan
Kasma Ernida HaidaOral Medicine Clinic
Rumah Sakit Gigi Mulut Pendidikan
Gt. Hasan Aman Banjarmasin
7/21/2019 Case Report Oral medicine
2/46
I. Data Pribadiama ! Mrs. RAlamat ! "alan Abdul Rahman#
Pangkalanbun$mur ! %& tahun
'elamin ! Perem(uan
Pekerjaan ! Pelajar
Status ! Belum Menikah
Suku Bangsa ! Banjar# Ind)nesia
'unjungan (erta*+ "anuari *,%-
7/21/2019 Case Report Oral medicine
3/46
II. Ria/at 'asus'eluhan $tama! Pasien datang ke RSGM Gt. Hasan Aman 'linik
Pen/akit Mulut dengan keluhan sariaan dibibir baah sebelah kiri. Pasien mengeluh
sariaann/a sakit. Sariaan muncul tiba0tibatan(a tergigit sejak - hari /ang lalu. Pernahdi)bati alb)t/l % 1 saat hari ke + muncul# ta(itidak sembuh.
Ria/at $mum! Pasien mengaku sering mengalami sariaan
dan ber(indah0(indah. 2erakhir kali sariaan 3% bulan /ang lalu muncul 4 buah sariaan kecildi bibir baah tan(a tergigit dan tidak di)bati.
'unjungan (erta*+ "anuari *,%-
7/21/2019 Case Report Oral medicine
4/46
Ria/at 'esehatan
a. 'elainan Darah ! 2A'
b. 'elainan 5nd)krin ! 2A'
c. 'elainan utrisi ! 2A'
d. Gangguan Res(irat)ri ! 2A'
e. 'elainan Imun)l)gi ! 2A'
6. Gangguan 2M" ! 2A'
g. 'elainan "antung ! 2A'
h. 'elainan 'ulit7'elamin ! 2A' i. 'elainan Pencernaan ! 2A'
j. 2ekanan Darah ! 2A'
k. Diabetes Melitus ! 2A'
l. 8ain0lain ! 2A'
'unjungan (erta*+ "anuari *,%-
7/21/2019 Case Report Oral medicine
5/46
Ria/at 'eluarga
a. 'elainan Darah ! 2A' b. 'elainan 5nd)krin ! 2A'
c. Diabetes Melitus ! 2A'
d. 'elainan "antung ! 2A'
e. 'elainan Sara6 ! 2A'
6. Alergi ! 2A'
g. 8ain0lain ! A/ah sering sariaan.
Obat0)batan /ang sedang dijalani!
.2idak Ada
'unjungan (erta*+ "anuari *,%-
7/21/2019 Case Report Oral medicine
6/46
III. Pemeriksaan 'linis%. 5kstra Oral
Muka ! Simetris
Pi(i kiri ! )rmal
Pi(i kanan ! )rmal
Bibir atas ! )rmal
Bibir baah ! )rmalSudut mulut ! )rmal
'unjungan (erta*+ "anuari *,%-
7/21/2019 Case Report Oral medicine
7/46
'elenjar Submandibularis kiri !)rmal
'elenjar Submandibularis kanan !)rmal
'elenjar Submentalis !)rmal
'elenjar 8eher !
)rmal'elenjar Sublingualis !
)rmal
'elenjar Par)tis 'iri !)rmal
'unjungan (erta*+ "anuari *,%-
7/21/2019 Case Report Oral medicine
8/46
*. Intra Oral
Muk)sa 8abial Atas ! )rmal
Muk)sa 8abial Baah ! $lser# sakit# single# d
9 3 & mm# ):al# (utihkekuningan# dikelilingikemerahan# batas jelas#
Muk)sa Pi(i 'iri ! )rmal
Muk)sa Pi(i 'anan ! )rmal
'unjungan (ertama*+ "anuari *,%-
7/21/2019 Case Report Oral medicine
9/46
Muk)sa Bukal ;)ld Atas ! ;)rd/ce s()t#cheek biting
7/21/2019 Case Report Oral medicine
10/46
Gingi:a RA ! )rmal
Gingi:a RB ! )rmal
8idah ! ;issured t)ngue
Dasar mulut ! )rmal Palatum ! )rmal
2)nsil ! )rmal
Phar/n1 ! )rmal
7/21/2019 Case Report Oral medicine
11/46
7/21/2019 Case Report Oral medicine
12/46
I?. Diagn)sa Sementara
Sus(ect Reccurent A(th)usSt)matitis e.c 'eturunan
7/21/2019 Case Report Oral medicine
13/46
?. Rencana Peraatan dan
PenalaksanaanPemberian All)clair t)(ikal
R7 All)clair Gel 2ube ). I
@ + dd %
Oles Mulut
Obat di)leskan +1 sehari (ada mulut
(asien untuk meng)bati dan mengurangirasa sakit.
7/21/2019 Case Report Oral medicine
14/46
Diagn)sa Banding2raumatic $lcer
Behcet s s/ndr)meMagic s/ndr)me
Seets s/ndr)me
P;APA s/ndr)meC/clic neutr)(enia
HI? disease
7/21/2019 Case Report Oral medicine
15/46
')ntr)l %
7/21/2019 Case Report Oral medicine
16/46
AnamnesaPasien datang untuk
meng)ntr)lkan sariaann/aseminggu /ang lalu. Pasienmeng)leskan )bat All)clair +1
sehari. Sariaan (ada bibir baahsebelah kiri sudah sembuh sekitar4 hari /ang lalu dan tidak sakit lagi.
'unjungan kedua
7/21/2019 Case Report Oral medicine
17/46
Pemeriksaan 'linis%. 5kstra Oral
Muka ! Simetris
Pi(i 'iri ! )rmal
Pi(i 'anan ! )rmal
Sudut Mulut ! )rmal
Bibir Atas ! )rmal Bibir Baah ! )rmal
'unjungan kedua
7/21/2019 Case Report Oral medicine
18/46
'elenjar Submandibularis 'anan !)rmal
'elenjar Submandibularis 'iri !)rmal
'elenjar Submentalis !)rmal
'elenjar 8eher !
)rmal'elenjar Sublingualis !
)rmal
'elenjar Par)tis 'anan !)rmal
'unjungan kedua
7/21/2019 Case Report Oral medicine
19/46
*. Intra Oral
2erda(at lesi n)n tera(i ! ;)rd/ce s()t
7/21/2019 Case Report Oral medicine
20/46
7/21/2019 Case Report Oral medicine
21/46
Diagn)sa Akhir
Recurrent A(hth)usSt)matitis e.c. 'eturunan
7/21/2019 Case Report Oral medicine
22/46
;akt)r Predis()sisi RAS
7/21/2019 Case Report Oral medicine
23/46
2i(e RAS
Min)r a(hthae
7/21/2019 Case Report Oral medicine
24/46
7/21/2019 Case Report Oral medicine
25/46
Pat)genesis RASInitial
phase
M)n)sit dan lim6)sit
7/21/2019 Case Report Oral medicine
26/46
Pat)genesis RAS
Indi:idu /gat)(ik
Mani6estasin/a
tergantung durasidan ke(arahan
;akt)r(redis()si
si
Mudahtimbululser
$lser terusmembesar
7/21/2019 Case Report Oral medicine
27/46
*&
Mechanisms of the disrupted immunologicresponse in RAS
7/21/2019 Case Report Oral medicine
28/46
2he r)le )6 genetic (redis()siti)n in
ras rst time Miller et al. in %>&&and Shi( in %>- au t)s)malrecessi:e )r multigene m)de )6
inheritance ith the m)dulatinginuence )6 the en:ir)nment
0
'eturunan
7/21/2019 Case Report Oral medicine
29/46
4, (un/a family history
Biasan/a dimulai dari anak0anak
8ebih (arah dari )rang /ang tidak(un/a ria/at )rang tua RAS
8ebih sering (ada anak kembarm)n)Fig)t dari(ada kembar diFig)t
0
'eturunan
7/21/2019 Case Report Oral medicine
30/46
'eturunanMajor Histocompatibility Complex Human Leukocyte Antigen
7/21/2019 Case Report Oral medicine
31/46
H8A
Mehra# *,,%=
7/21/2019 Case Report Oral medicine
32/46
Mehra# *,,%=
7/21/2019 Case Report Oral medicine
33/46
Genetik
jumlah H8A
H8Amen/erang sel0sel muk)sar)ngga mulut mekanisme
sit)t)ksin
mengakti6kan selm)n)nukleus
7/21/2019 Case Report Oral medicine
34/46
7/21/2019 Case Report Oral medicine
35/46
7/21/2019 Case Report Oral medicine
36/46
Genetik DA polymorphism
metab)lisme interleukin !IL"#interferon !I$"%# tumor necrosisfactor !&$"%
0
'eturunan
7/21/2019 Case Report Oral medicine
37/46
7/21/2019 Case Report Oral medicine
38/46
7/21/2019 Case Report Oral medicine
39/46
7/21/2019 Case Report Oral medicine
40/46
7/21/2019 Case Report Oral medicine
41/46
7/21/2019 Case Report Oral medicine
42/46
7/21/2019 Case Report Oral medicine
43/46
7/21/2019 Case Report Oral medicine
44/46
Da6tar Pustaka%. Slebi)da J.# 5lSFbieta SF()nar# Anna ')alska.
Recurrent a(hth)us st)matitis! genetic as(ects )6eti)l)g/. P)ste( Derm Alerg)l. *,%+E+,0%,*.
*. 8. Preeti# '2. Magesh# '. Rajkumar# R. 'arthik.
Recurrent a(hth)us st)matitis. " Oral Ma1ill)6ac
Path)l. *,%%E %-
7/21/2019 Case Report Oral medicine
45/46
-. Sain .# "igna P.# 8eela S.P.# K)gita P.5ti)l)gical 6act)rs )6 recurrent a(hth)usst)matitis! a c)mm)n (er(le1it/. ")urnal )6
C)ntem()rar/ Dentistr/. *,%*E * 0%,,.. Mehra# arinder '. Hist)c)m(atibilit/
antigens. 5nc/cl)(edia O6 8i6e Sciences.ature Publishing Gr)u(. *,,%E %0.
&. "urge S.# R 'uer## C Scull/# SR P)rter. Muc)saldisease series. umber ?I recurrent a(hth)usst)matitis. Oral Disease. *,,E %*! %0*%.
7/21/2019 Case Report Oral medicine
46/46
25RIMA
'ASIH