pemicu 4 rizky

7/26/2019 pemicu 4 rizky

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Pemicu 4

Rizky Lumalessil

4051300171


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LO 1

Tumor di Otot dan Jaringan

Lunak


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Lipoma


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Lipoma

gro!t" o# #at cells in a t"in$ %&rouscapsule usually #ound 'ust &elo! t"e skin

re #ound most o#ten on t"e torso$ neck$

upper t"ig"s$ upper arms$ and armpits$ &utt"ey can occur almost any!"ere in t"e&ody(

One or more lipomas may &e present at t"esame time(

Lipomas are t"e most commonnoncancerous so#t tissue gro!t"(


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)pidemiology

Lipomas occur in all age groups &utmost o#ten appear in middle age(

*ingle lipomas occur !it" e+ual#re+uency in men and !omen(

,ultiple lipomas occur more#re+uently in men(


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)tiology

T"e cause o# lipomas is notcompletely understood$ &ut t"etendency to de-elop t"em is

in"erited(

minor in'ury may trigger t"egro!t"(

.eing o-er!eig"t does not causelipomas(


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Risk /actors

Being between 40 and 60 years old.lt"oug" lipomas can occur at any age$t"eyre most common in t"is age group(

Lipomas are rare in c"ildren( Having certain other disorders.People

!it" ot"er disorders$ including adiposisdolorosa$ ,adelung disease$ o!den

syndrome and 2ardners syndrome$ "a-ean increased risk o# multiple lipomas(


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*ign and *ymptoms

small 0(4 in( 1 cm to 1(6 in( 3 cm and#elt 'ust under t"e skin(

mo-a&le and "a-e a so#t$ ru&&ery

consistency( 8o not cause pain(

Remain t"e same size o-er years or gro!-ery slo!ly(

O#ten t"e most &ot"ersome symptom is t"elocation or increased size t"at makes t"elipoma noticea&le &y ot"ers(


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8iagnosis

9sually &e diagnosed &y itsappearance alone


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Treatment

Lipomas do not generally re+uire treatment(

T"ere is no kno!n treatment to pre-ent lipomas or a:ect t"eirgro!t"(

lipoma may &e surgically remo-ed i# symptoms de-elop$

suc" as i# t"e lipoma; .ecomes pain#ul or tender(

.ecomes in#ected or ince oroutpatient surgery center( T"e doctor in'ects a local anest"eticaround t"e lipoma$ makes an incision in t"e skin$ remo-es t"egro!t"$ and closes t"e incision !it" stitc"es sutures


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R"a&domiosarkoma


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R"a&domyosarcoma

cancerous malignant tumor o# t"emuscles t"at are attac"ed to t"e &ones(

=t can occur in many places in t"e &ody(

T"e most common sites are t"estructures o# t"e "ead and neck$ t"eurogenital tract$ and t"e arms or legs(

T"e most common so#t tissue tumor inc"ildren(


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)tiology

T"e cause o# r"a&domyosarcoma isunkno!n(

=t is a rare tumor !it" only se-eral"undred ne! cases per yeart"roug"out t"e 9nited *tates(

*ome c"ildren !it" certain &irt"

de#ects are at an increased risk$ andsome #amilies "a-e a gene mutationt"at ele-ates risk(


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Types

Embryonal rhabdomyosarcoma

Alveolar rhabdomyosarcoma

Anaplastic rhabdomyosarcomaand undiferentiated sarcoma


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Types

Embryonal rhabdomyosarcoma(E!"# most common type( =t usually a:ects

c"ildren in t"eir %rst 5 years o# li#e(T"e cells o# )R,* look like t"e de-eloping

muscle cells o# a ?@ to A@!eek@old em&ryo(

)R,* tends to occur in t"e "ead and neck

area$ &ladder$ -agina$ or in or around t"eprostate and testicles(


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Types

Alveolar rhabdomyosarcoma (A!"#Typically a:ects all age groups e+ually$ &ut it is

t"e type most o#ten seen in older c"ildren andteens(

T"is type o# r"a&domyosarcoma most o#tenoccurs in large muscles o# t"e trunk$ arms$ andlegs(

R,* cells look like t"e normal muscle cellsseen in a 10@!eek@old #etus(

R,* tends to gro! #aster t"an )R,* andusually re+uires more intensi-e treatment(


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Types

Anaplastic rhabdomyosarcoma andundiferentiated sarcoma naplastic r"a&domyosarcoma #ormerly called

pleomorphic rhabdomyosarcoma is anuncommon type t"at occurs in adults &ut is-ery rare in c"ildren(

9sing la& tests$ doctors can tell t"at t"esecancers are sarcomas$ &ut t"e cells donBt "a-eany #eatures t"at "elp classi#y t"em #urt"er(

.ot" o# t"ese uncommon cancers tend to gro!+uickly and usually re+uire intensi-e treatment(


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*ymptoms

T"e most common symptom is a mass t"at may or may not &epain#ul(

Ot"er symptoms -ary depending on location o# t"e tumor(

Tumors in t"e nose or t"roat may cause &leeding$ congestion$s!allo!ing pro&lems$ or neurological pro&lems i# t"ey eCtendinto t"e &rain(

Tumors around t"e eyes may cause &ulging o# t"e eye$pro&lems !it" -ision$ s!elling around t"e eye$ or pain(

Tumors in t"e ears$ may cause pain$ "earing loss$ or s!elling(

.ladder and -aginal tumors may cause lead to trou&le startingto urinate or "a-ing a &o!el mo-ement$ or poor control o#urine(

,uscle tumors may lead to a pain#ul lump and are o#tent"oug"t to &e an in'ury(


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)Cam and Tests

8iagnosis o# r"a&domyosarcoma is o#ten delayed &ecause o#lack o# symptoms$ and &ecause t"e tumor may appear at t"esame time as a recent in'ury( )arly diagnosis is important&ecause r"a&domyosarcoma spreads +uickly(

complete p"ysical eCam s"ould &e done( Tests mayinclude; .iopsy o# t"e tumor

"est C@ray

T scan o# t"e c"est to look #or spread o# t"e tumor

T scan o# t"e tumor site

.one marro! &iopsy may s"o! t"e cancer "as spread

.one scan to look #or spread o# t"e tumor

,R= scan o# t"e tumor site

*pinal tap lum&ar puncture


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Treatment

T"e precise treatment depends on t"e site and type o#r"a&domyosarcoma(

)it"er radiation or c"emot"erapy$ or &ot"$ !ill &e used &e#ore ora#ter surgery( =n general$ surgery and radiation t"erapy are usedto treat t"e primary site o# t"e tumor( "emot"erapy is used to

treat disease at all sites in t"e &ody( "emot"erapy is an essential part o# treatment to pre-ent #urt"er

spread o# t"e cancer( ,any di:erent c"emot"erapy drugs areacti-e against r"a&domyosarcoma( *ome o# t"ese drugs include; 8acar&azine

8oCoru&icin )piru&icin

2emcita&ine

=#os#amide


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omplication

omplications #rom c"emot"erapy

Location in !"ic" surgery is notpossi&le

,etastasis


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Prognosis

E"ile aggressi-e treatment is usuallynecessary$ most c"ildren !it"r"a&domyosarcoma !ill ac"ie-e

long@term sur-i-al( ure depends ont"e speci%c type o# tumor$ itslocation$ and t"e amount t"at "as

spread(


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/i&rosarkoma


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/i&rosarcoma

/i&rosarcoma is a tumor o#mesenc"ymal cell origin t"at iscomposed o# malignant %&ro&lasts in

a collagen &ackground(

=t can occur as a so#t@tissue mass oras a primary or secondary &one

tumor(


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)pidemiology

/i&rosarcoma represents only a&out 10F o# musculoskeletal sarcomas andless t"an 5F o# all primary tumors o# &one( Go kno!n racial predilection

eCists(

/i&rosarcoma o# &one occurs slig"tly more commonly in men t"an in!omen(

/i&rosarcoma o# &one can &e diagnosed in patients o# any age$ &ut it is

diagnosed more commonly in patients in t"e #ourt" decade o# li#e( =t isusually located in t"e lo!er eCtremities$ especially t"e #emur and ti&ia(

/i&rosarcoma o# t"e so#t tissues usually a:ects a !ider age spectrum o#patients t"an %&rosarcoma o# t"e &one does$ !it" an age range o# 35@55years( =t o#ten arises in t"e so#t tissues o# t"e t"ig" and t"e posterior knee(=t is generally a large$ painless mass deep to #ascia and "as an ill@de%ned

margin( n in#antile #orm in c"ildren H 10 y o# %&rosarcoma eCists( 9nlike

%&rosarcoma in adults$ it "as an eCcellent prognosisIe-en in t"e #ace o#

metastatic disease at presentationI!"en treated !it" a com&ination o#neoad'u-ant and ad'u-ant c"emot"erapy and resection


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)tiology

/i&rosarcoma$ like ot"er so#t@tissuesarcomas$ "as no de%nite cause(urrent researc" indicates t"at many

sarcomas are associated !it" geneticmutations(


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*ign and *ymptoms

*arcomas in-ol-ing &one; pain and s!elling a#ter a long duration o# symptoms(

T"ey may e-en gro! large enoug" to t"reaten t"e structural integrityo# t"e &one and cause pat"ologic #racture as t"e initial presentation(

*o#t@tissue sarcomas; painless masses(

.ecause t"ese lesions #re+uently arise deep to t"e muscular #ascia$t"ey may &ecome eCtremely large tumors prior to diagnosis(

,ost lesions occur around t"e knee$ in t"e proCimal #emur and"ip region$ or in t"e proCimal arm( /indings are nonspeci%c and

can -ary #rom a %Ced$ %rm mass to a localized area o#tenderness(

Geurologic or -ascular c"anges are late %ndings and indicateeCtensi-e disease in-ol-ement


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88

/i&rous dysplasia

/i&rous "istiocytoma

Osteosarcoma Paget sarcoma

,alignant %&rous "istiocytoma

,alignant neurosarcoma


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Treatment

,edical T"erapy Radiation treatment and c"emot"erapy$ can

impro-e local control and may make t"eappearance o# clinically e-ident metastaticdisease less likely( T"e use o# c"emot"erapy iscontro-ersial$ &ut c"emot"erapy is generallyused in &one lesions( Radiation t"erapy is usedin con'unction !it" surgery #or so#t@tissue

%&rosarcomas$ !it" or !it"out c"emot"erapy *urgical T"erapy

*urgical resection !it" a cu: o# normal tissue!ide margins


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omplication

Local recurrence may occur in up to?0F o# cases and is t"e reason t"atpostoperati-e radiation$ preoperati-e

radiation$ or &ot" are o#tenrecommended( Local recurrence isreduced to a&out 65F !"en

postoperati-e irradiation is used(


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Prognosis

/or congenital %&rosarcoma o# &one inc"ildren$ t"e prognosis !"ic" is relatedto age and to time to diagnosis is muc"

&etter$ !it" t"e disease "a-ing long@term sur-i-al rates o# "ig"er t"an 50F(

*o#t@tissue %&rosarcoma is associated

!it" a 40@?0F sur-i-al rate at 5 years(T"e in#antile #orm "as an e-en &etter 5@year sur-i-al rate$ in eCcess o# A0F(


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/i&romatosis


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8e%nition

/i&romatosis is a condition !"ere%&rous o-ergro!t"s o# dermal andsu&cutaneous connecti-e tissue

de-elop tumors called %&romas(T"ese %&romas are usually &enignnon@cancerous(


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lassi%cation

Ju-enile

dult *uper%cial #acial %&romatoses

8eep musculoaponeurotic%&romatoses


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lassi%cation

Ju-enile ongenital generalised %&romatosis

in#antile myo%&romatosis

poneurotic %&roma =n#antile digital %&romatosis

ggressi-e in#antile %&romatosis

/i&romatosis colli 8ermato%&rosis lenticularis .usc"ke@

Ollendor# syndrome


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lassi%cation

dult *uper%cial #acial %&romatoses

Palmar 8upuytren contracture and plantar Ledder"osedisease %&romatosis

Penile %&romatosis Peyronie disease nuckle pads

8ermato%&roma

Godular #asciitis

)lasto%&roma

/i&rous papule o# t"e #ace 8eep musculoaponeurotic %&romatoses

8esmoid tumours aggressi-e %&romatoses )Ctraa&dominal %&romatosis

&dominal %&romatosis

=ntraa&dominal %&romatosis e(g( pel-ic %&romatosis


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/eature o# /i&romatosis

*uper%cial %&romatoses

*lo! gro!ing tumour

*mall size

rise #rom #ascia or aponeurosis

Less aggressi-e

8eep %&romatoses

Rapidly gro!ing tumour

9sually reac" large size

O#ten in-ol-e deeper structures muscles o#t"e trunk and eCtremities


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=n#antile digital%&roma

nuckle pads8ermato%&roma

/i&rous papulePeriungual%&roma


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)tiology

T"e cause o# %&romatosis remains unclear(

=n some types o# %&romatosis suc" asdesmoid tumours it is t"oug"t t"at t"e

condition may &e related to trauma$ "ormonal#actors$ or "a-e a genetic association(

*uper%cial %&romatoses suc" as palmar$plantar and penile %&romatosis "a-e

sometimes &een linked to certain diseasessuc" as dia&etes$ li-er disease and"ypertension(


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Treatment

,anagement o# %&romatosisdepends on t"e indi-idual disease(


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Liposarkoma


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Liposarcoma

cancerous malignant tumor t"atde-elops #rom #at cells(

an de-elop any!"ere$ &ut typicallyappear in t"e deep #at tissues o# t"elim&s or a&domen in people ages 50to ?5(


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)pidemiology

Liposarcomas are slig"tly more commonin males t"an in #emales

T"e mean patient age at onset is 50

years( lt"oug" liposarcomas account #ora&out 17F o# all so#t tissue sarcomas$t"ey are in-ol-ed in only 4F o# c"ild"oodso#t tissue sarcomas( ases o# liposarcoma

are reported in young adults andteenagers$ &ut cases in c"ildren are rare


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$athophysiology

Liposarcoma is a lipogenic tumor o# largedeep@seated connecti-e tissue spaces( /usionproteins created &y c"romosomala&normalities are key components o#mesenc"ymal cancer de-elopment( na&normality o# &and 16+13 "as &eenassociated !it" t"e de-elopment o#liposarcomas( T"e most commonc"romosomal translocation is t"e FUS-CHOP#usion gene$ !"ic" encodes a transcription#actor necessary #or adipocyte di:erentiation(


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)tiology

Go !ell@esta&lis"ed causati-e #actor"as &een identi%ed$ alt"oug" trauma"as &een implicated(


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*ymptoms

,ost people !it" liposarcoma do not#eel sick( T"ey mig"t notice a lump!"ic" can &e so#t or %rm to t"e

touc" t"at is usually painless andslo! gro!ing( 9n#ortunately$ tumorsin t"e a&domen can gro! to &e +uite

large &e#ore t"ey are #ound(


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8iagnosis

p"ysical eCam Lumps t"at are 5cm or larger and deep@

seated$ %rm and %Ced to underlying

structures are usually consideredsuspicious(

=maging tests and o#ten include an K@

ray and an ,R=( needle or a surgical &iopsy(


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88

Lipomas

Geuro%&romatosis


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Treatment

"urgeryis t"e treatment #or primary liposarcomast"at "a-e not yet spread to ot"er organs

T"e com&ination o# surgery and radiationtherapy"as &een s"o!n to pre-ent recurrence at

t"e surgical site in a&out A5@0F o# liposarcomacases

T"e role o# c"emot"erapy in t"e treatment o#liposarcoma is not clearly de%ned$ &ut it may &e

recommended in certain situations !"ere patientsare at "ig" risk o# recurrence or already "a-e!idespread disease(


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LO 6

9lkus pada Tungkai


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9lkus Tropicum


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8e%nisi

suatu ulkus dengan ciri@ciri k"assering terdapat didaera" tropik$&er&entuk k"as$ &er&au &usuk dan

dise&a&kan ole" mikroorganisme


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Penye&a&

penye&a& yg paling pasti &elumdiketa"ui$ diduga dise&a&kansim&iosis dua macam

mikroorganisme .orrelia -incenti dan.acillus #usi#ormis


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)pidemiologi

umur ; ?@10 ta"un

'enis kelamin ; le&i" &anyak padapria

/ k # k "i


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/aktor@#aktor yg mempengaru"itim&ulnya penyakit

daera" ; tropis

musim ; "u'an

ke&ersi"an ; "igiene yg &uruk dangizi yg kurang( terkadang dpt tim&ulaki&at gigitan serangga


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2e'ala

dimulai dg luka kecil MMN ter&entukpapula yg dg cepat meluas men'adi-esikel MMN -esikel peca" dan

men'adi ulkus kecil$ setela" diin#eksiole" mikroorganisme$ ulkus meluaske samping dan ke dalam dan

mem&eri &entuk k"as ulkus tropikum


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Pemeriksaan ulit

lokalisasi ; tungkai &a!a" dan lengan

e


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2am&ar istopatologi

ulkus dg se&ukan sel radang akutP,G serta sel dara" mera"

pada dermis$ ditemukan pele&aran

u'ung6 pem&ulu" dara" disertaise&ukan sel plasma


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Pemeriksaan pem&antula&

pemeriksaan rutin ; leukositosis$ L)8meningkat

pemeriksaan k"usus ; mikroskop

lapangan gelap mencari .orrelia-incenti atau .acillus #usi#ormis

pe!arnaan .urry ; utk meli"at

.orrelia -incenti


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8iagnosis .anding

ulkus &anal

ulkus -arikosus

ulkus karena 'amur$ tu&erkulosis


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Penatalaksanaan

umum ; istira"at$ diet tinggi kaloritinggi protein$ meng"indar gigitanserangga

k"usus ; sistemik ; in'eksi penisilin 00(000 =9

selama 7 "ari atau amoksisilin 4C500

mg selama 5@10 "ari topikal ;

kompres ,nO4 15000@110(000

'ika lesi &ersi" di&eri salep salisil 6F


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Prognosis

&aik


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9lkus Tro%k


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8e%nisi

suatu ulkus kronik yg dise&a&kangangguan tro%k$ &iasanya di'umpaipada penderita lepra$ 8,$ dan ta&es

dorsalis gangguan tro%k ; aki&at neuropati

peri#er

ulkus tim&ul didaera" kulit yg seringmendapat tekanan anestetik


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Penye&a& dan )pidemiologi

Penye&a& ; gangguan tro%k setempat

)pid umur ; pada usia de!asa

'enis kelamin ; #rekuensinya sama padapria dan !anita


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2e'ala

mula@mula terdapat koreng pdtelapak kaki'ari tangan$ namunkarena pada penderita lepra ter'adi

anestesi$ aki&atnya tidak lagimerasakan tekanan saat &eker'a s"gkoreng makin mem&esar dg atro%

'aringan sekitarnya serta an"idrosis


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Pemeriksaan ulit

Lokalisasi ;telapak kaki$ u'ung 'aridan sela pangkal 'ari kaki

e


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2am&aran istopatologi

ulkus dg se&ukan sel radang kronikdisertai sel epiteloid

terkadang ditemuka sel datia

Lang"arns


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Pemeriksaan La&

pemeriksaan &akteriologik dr sekretulkus

pemeriksaan dara" rutin$ gula

dara"$.T

&iakan sekret ulkus dan u'i resistensi


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8iagnosis .anding

9lkus piogenik ; &tk o-al$ pinggirmeninggi$ dasar &er&en'ol6$ sekretprodukti#$ daera" sekitar reda$

pera&aan nyeri$ indurasi positi#


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Penatalaksanaan

umum ; istira"at

k"usus ; terapi ter"adap etiologiprimernya sistemik ; penisilin 00(000 =9 selama 7

"ari Q anti&iotik lain yg sensiti#

topikal ; kompres ,nO4 110(000


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Prognosis

&aik$ sepan'ang pengo&atanpenye&a&nya &aik


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9lkus Piogenik


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8e%nisi

in#eksi kulit yg menim&ulkan ulkustidak k"as$ dise&a&kan ole"streptokok atau sta%lokok


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Penye&a& ; streptokok dan sta%lokok

)pidemiologi umur ; le&i" sering pd anak6

'enis kelamin ; #rekuensinya samadengan pria dan !anita


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2e'ala

tim&ul korengulkus dg tanda6radang di sekitarnya$ scr lam&atmengalami nekrosis dan menye&ar

scr serpiginosa


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Pemeriksaan ulit

lokalisasi ; ekstremitas

e


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tampak reaksi sel di 'aringan dengansel plasma$ dan sel lim#oid

ik &


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Pemeriksaan La&

kultur sekret ulkus dan tes resistensi

8i i . di


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8iagnosis .anding

9lkus tropikum dan ulkus karenapenye&a& lain spt antraks$tu&erkulosis atau #ram&usia

P t l k


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Penatalaksanaan

umum ; &ersi"kan de&ridementulkus

k"usus sistemik ; penisilin ?00(000@1$6 'uta =9

intramuskular selama 5@7 "ari eritromisin 4C500 mg selama 7 "ari

topikal ; salep salisil 6FQ 'ika &erat dgkompres P 110(000 atau gGO3 1@6F

P i


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Prognosis

&aik


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9lkus 8eku&itus

8 % i i


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8e%nisi

ulkus yg tim&ul karena tekanan &erat&adan pada tempat tidur

P & & d ) id i l i


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Penye&a& ; tekanan &erat &adan pdtempat tidur

)pidemiologi umur ; semua umur terutama orang tua

'enis kelamin ; #rekuensinya sama pdpria dan !anita

/ kt P di i i


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/aktor Predisposisi

penderita penyakit kronik spt 8,$malnutrisi$ keganasan$ dan orang@orang yg tidak dapat &ergerak le&i"

muda" terkena ulkus deku&itus

2 ' l


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2e'ala

dimulai dg eritema pd daera" ygtertekan

ulkus mengeluarkan 'aringan

nekrosis &er!arna kecoklatan se&agian ulkus ditutupi ole" 'aringan

nekrosis &er!arna "itam yg

menyerupai mem&ran

P ik lit


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Pemeriksaan ulit

lokalisasi ; pinggang$ &okong dantempat6 yg &anyak mengalamitekanan

e


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ulkus dg dinding rata atau &ergaung

pada dasarnya ditemukan se&ukansel6 radang akut

pd su&kutis didapatkan pele&aran P8dan se&ukan sel6 radang

Pemeriksaan La&


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Pemeriksaan La&

kultur dara" dan tes resistensi

8iagnosis .anding


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8iagnosis .anding

ulkus gangrenosa ole" karena 8,$&iasanya &er&au &usuk dg 'arnekrosis yg produkti#

ulkus &anal; sering &er&entuk tidakteratur dan &ersi#at akut

Penatalaksanaan


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Penatalaksanaan

"ilangkan tekanan pd daera"6 yg terkenadg mengu&a"@u&a" posisi

mengusa"akan agar -entilasi antara&adan dan tempat tidur &er'alan lancar

sistemik ; anti&iotik spektrum luas sptamoksisilin 4C500 mg selama 15@30 "ari(*iklosporin 1@6 g"ari selama 3@10 "ariatau golongan kuinolon 4C500 mg"ari

selama 14 "ari topikal ; salep anti&iotik spt salep

kloram#enikol 6F

Prognosis


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Prognosis

&aik selama pengo&atan penyakitdasar &er"asil &aik


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9lkus 2angrenosum

8e%nisi


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8e%nisi

ulkus yg tim&ul pd penderita6 dgkeadaan umum &uruk atau penderitapenyakit kronik



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Penye&a& ; streptokok danmikroorganisme lain

)pidemiologi umur ; le&i" &anyak pd orang tua'enis kelamin ; #rekuensi yg sama pd pria

dan !anita

/aktor Predisposisi


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/aktor Predisposisi

&iasanya tim&ul pd penderitapenyakit6 yg menye&a&kan keadaantu&u" lema"$ spt 8,$ keganasan$

kusta dan malnutrisi

2e'ala


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2e'ala

mula6 tim&ul papula6 kecil di kulit$dalam !aktu cepat tim&ul a&ses danselan'utnya ter&entuk ulkus dg si#at6

MMN tak teratur$ sekret ulkus$ 'arnekrosis yg "itam$ dg &er&au &usuk

penderita mengelu" panas dan nyeri

Pemeriksaan ulit


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Pemeriksaan ulit

lokalisasi ; ekstremitas in#erior danu'g6 'ari

e


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9lkus tidak k"as$ ditutupi ole" 'arnekrosis dan sel6 polinuklear$ selplasma dan lim#osit

pada dermissu&kutis terdptpele&aran P8

Pemeriksaan La&


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Pemeriksaan La&

pemeriksaan dara" utk gula dara"$kultur dan tes resistensi

8iagnosis .anding


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8iagnosis .anding

ulkus &anal ; &iasanya tidak &er&au$keadaan umum penderita takterpengaru"

ulkus tro%k ; &iasanya ter'adigangguan sensi&ilitas$ tak produkti#dg dasar yg le&i" &ersi"

Penatalaksanaan


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Penatalaksanaan

kom&inasi pengo&atan dgpengo&atan penyakit dasarnya

sistemik ; anti&iotik spektrum luas

spt amoksisilin 4C500 mg"ariselama 10@14 "ari( *iklosporin 1@6g"ari selama 10@14 "ari( Preparatkuinolon 6C650 mg"ari selama 10@

14 "ari topikal ; kompres ,nO4 15(000

atau larutan po-idon yodium 5@10F

Prognosis


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Prognosis

&iasanya &aik &ila penyakit dasarnyadapat diatasi

pemicu 4 rizky

Documents

Transcript of pemicu 4 rizky