Research Article

Profil onikomikosis pada pasien lanjut usia di Rumah Sakit Umum Pusat Sanglah, Bali, Indonesia: studi retrospektif

I Gusti Ayu Agung Dwi Karmila , Made Swastika Adiguna, Luh Made Mas Rusyati

I Gusti Ayu Agung Dwi Karmila
Department of Dermatology and Venereology, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia. Email: d.karmila@yahoo.com

Made Swastika Adiguna
Department of Dermatology and Venereology, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia

Luh Made Mas Rusyati
Department of Dermatology and Venereology, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia
Online First: April 01, 2020 | Cite this Article
Karmila, I., Adiguna, M., Rusyati, L. 2020. Profil onikomikosis pada pasien lanjut usia di Rumah Sakit Umum Pusat Sanglah, Bali, Indonesia: studi retrospektif. Intisari Sains Medis 11(1): 364-368. DOI:10.15562/ism.v11i1.653


Background: Fungal infections are one of the most common dermatologic conditions affecting elderly population. Elderly population is susceptible to all of the superficial mycoses such as tinea pedis, candidiasis, and onychomycosis in geriatric populations compared to other age groups.

Objective:  To determine the profile of onychomycosis among elderly patients over a period of 1 years (January 2018–August 2019) at Dermatology and Venereology outpatient clinic, Sanglah General Hospital

Methods:  Retrospective study was performed at Department of Dermatology and Venereology, Sanglah General Hospital, Denpasar, Bali. The data collected from patient’s register data of outpatient clinic.

Result:  A total of 11 patients were diagnosed with onychomycosis, consist of 5 women and 6 men. From these, 4 (36,3%) was reported with chronic systemic diseases and 7 (63,6%) reported with no concomitant diseases. The most common clinical sign were onychodystrophy, hyperkeratotic subungual and dyschromia (6 patients, 54,54%). Potassium hydroxide examination reveal positive results in all patient. From 5 patients, on culture examination, Candida (2 patients, 40%), Trichophyton rubrum (2 patients, 40%), and Trychophyton mentagrophytes (1 patient, 20%) were found. For therapy, there were 7 patients got combination therapy (fluconazole 150 mg and ciclopirox lacquer 8%) and 4 patients with single therapy (ciclopirox lacquer 8%).

Conclusion: Onychomycosis is more common in the elderly or geriatric patients, this occurs because old age can change the body's immune function, including decreased immune response to fight infections against viruses, bacteria, and fungi.

 

Pendahuluan: Infeksi jamur adalah salah satu kondisi dermatologis paling umum yang mempengaruhi populasi lansia. Populasi lansia rentan terhadap semua mikosis superfisial seperti tinea pedis, kandidiasis, dan onikomikosis pada populasi geriatri dibandingkan dengan kelompok usia lainnya.

Tujuan:  Untuk menentukan profil onikomikosis pada pasien usia lanjut selama 1 tahun (Januari 2018 - Agustus 2019) di poliklinik rawat jalan Dermatologi dan Venereologi, Rumah Sakit Umum Pusat Sanglah.

Metode:  Studi retrospektif dilakukan di Departemen Dermatologi dan Venereologi, Rumah Sakit Umum Pusat Sanglah, Denpasar, Bali. Data dikumpulkan dari data pendaftaran pasien di klinik rawat jalan.

Hasil:  Sebanyak 11 pasien didiagnosis menderita onikomikosis, terdiri dari 5 wanita dan 6 pria. Dari hasil ini, sebanyak 4 orang (36,3%) dilaporkan dengan penyakit sistemik kronis dan 7 orang (63,6%) dilaporkan tanpa penyakit bersamaan. Tanda klinis yang paling umum adalah onikodistrofi, hiperkeratotik subungual dan dischromia (6 pasien, 54,54%). Pemeriksaan kalium hidroksida mengungkapkan hasil positif pada semua pasien. Dari 5 pasien pada hasil pemeriksaan kultur ditemukan adanya infeksi Candida (2 pasien, 40%), Trichophyton rubrum (2 pasien, 40%), dan Trychophyton mentagrophytes (1 pasien, 20%). Untuk penatalaksanaan, terdapat sejumlah 7 orang pasien mendapatkan terapi kombinasi (fluconazol 150 mg dan ciclopirox lacquer 8%) dan 4 orang pasien dengan terapi tunggal (ciclopirox lacquer 8%).

Simpulan: Onikomikosis lebih sering terjadi pada pasien usia lanjut atau usia lanjut dimana hal ini terjadi karena usia tua dapat mengubah fungsi kekebalan tubuh, termasuk penurunan respons imun untuk melawan infeksi terhadap virus, bakteri, dan jamur.

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