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Keloid yang diterapi dengan kombinasi bedah eksisi dan injeksi kortikosteroid intralesi: sebuah laporan kasus

  • Ketut Wida Komalasari ,
  • Ketut Kwartantaya Winaya ,
  • Putu Gde Hari Wangsa ,
  • I Dewa Made Rendy Sanjaya ,


Abstract

Background: Keloids are soft solid tumors with a smooth surface that extend beyond the wound margins and invade adjacent normal tissue. Appears at the age of 10-30 years, occurs as a result of an imbalance between increased collagen synthesis and extracellular matrix. There are several types of therapeutic modalities such as intralesional or topical corticosteroids, surgical excision, electrosurgery, frozen surgery, radiotherapy and laser therapy. Combination therapy of surgical excision and intralesional corticosteroids used for this case.

Case Description: A woman, 43 years old, complained since 3 years ago, in the lower left abdomen there is a lump, which has been getting bigger over the past 1 year, sometimes feels pain and itching. In the left inferior abdominal region, multiple tumors were found to be erythematous to hyperpigmented, with firm boundaries, oval in shape, 0.2 cm to 0.5 cm in diameter, with a length and width of 0.3 cm and 0.5 cm, respectively. 1 cm and 1.5 cm, the surface feels smooth and shiny. On palpation, the tumor was fixed and firm in consistency. Surgical excision was performed and continued with intralesional injection of triamcinolone acetonide once a week on keloid and post-excision lesions. There was clinical improvement of keloids, on the 21st day of observation.

Conclusion: Surgical excision is minimally invasive and can be combined with weekly intrakeloid triamcinolone acetonide injection therapy for keloid lesions and post-excision area to reduce the risk of new keloids appearing. On follow-up observation of keloids in the left inferior abdominal region, the lesion was getting smaller and softened and there was no new keloid growth in the post-excision area.

 

Latar belakang: Keloid adalah tumor yang padat lunak, dengan permukaan licin berkembang melebihi batas luka dan menginvasi jaringan normal yang berdekatan. Muncul pada usia 10-30 tahun, terjadi akibat dari ketidakseimbangan antara peningkatan sintesis kolagen dan matriks ekstraseluler. Terdapat beberapa macam modalitas terapi seperti kortikosteroid intralesi atau topikal, bedah eksisi, bedah listrik, bedah beku, radioterapi dan terapi laser. Kasus ini membahas terapi kombinasi bedah eksisi dan kortikosteroid intralesi.

Kasus: Seorang wanita, berusia 43 tahun, mengeluh sejak 3 tahun yang lalu, pada perut kiri bawah terdapat benjolan, yang semakin lama semakin membesar selama 1 tahun terakhir, rasa nyeri dan gatal terkadang dirasakan. Pada regio abdominalis inferior sinistra ditemukan tumor multipel berwarna eritema sampai hiperpigmentasi, dengan batas yang tegas, berbentul bulat oval, berdiameter 0,2 cm sampai 0,5 cm, dengan panjang dan lebar masing-masing 0,3 cm dan 0,5 cm serta 1 cm dan 1,5 cm, permukaan teraba licin dan mengkilat. Pemeriksaan palpasi ditemukan tumor terfiksir dan konsistensinya keras. Dilakukan tindakan bedah eksisi dan dilanjutkan dengan injeksi triamsinolon asetonid intralesi seminggu sekali pada lesi keloid dan lesi paska eksisi. Terdapat perbaikan klinis keloid, pada pengamatan hari ke-21.

Simpulan: Tindakan invasif minimal seperti bedah eksisi dapat dikombinasi dengan injeksi triamsinolon asetonid intrakeloid seminggu sekali pada lesi keloid dan daerah paska eksisi untuk mengurangi risiko munculnya keloid baru. Pada pengamatan lanjutan keloid pada regio abdominalis inferior sinistra, didapatkan lesi semakin mengecil dan melunak dan tidak terdapat pertumbuhan keloid baru pada daerah paska tindakan eksisi.

Keywords: Keloid Bedah eksisi Kortikosteroid intralesi

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How to Cite

Komalasari, K. W., Ketut Kwartantaya Winaya, Putu Gde Hari Wangsa, & I Dewa Made Rendy Sanjaya. (2022). Keloid yang diterapi dengan kombinasi bedah eksisi dan injeksi kortikosteroid intralesi: sebuah laporan kasus. Intisari Sains Medis, 13(3), 561–565. https://doi.org/10.15562/ism.v13i3.1504
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Ketut Wida Komalasari
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Ketut Kwartantaya Winaya
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Putu Gde Hari Wangsa
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I Dewa Made Rendy Sanjaya
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