Case Report

Kondiloma akuminata perianal pada seorang laki-laki biseksual disertai infeksi HIV stadium III yang diterapi dengan kombinasi asam trikloroasetat 80% dan seng oral

Rahel Lisana Debora Hutagalung , Anak Agung Gde Putra Wiraguna

Rahel Lisana Debora Hutagalung
Departemen/KSM Kulit dan Kelamin, Fakultas Kedokteran, Universitas Udayana-RSUP Sanglah Denpasar, Bali-Indonesia. Email: debzhuga15@gmail.com

Anak Agung Gde Putra Wiraguna
Departemen/KSM Kulit dan Kelamin, Fakultas Kedokteran, Universitas Udayana-RSUP Sanglah Denpasar, Bali-Indonesia
Online First: April 01, 2021 | Cite this Article
Hutagalung, R., Wiraguna, A. 2021. Kondiloma akuminata perianal pada seorang laki-laki biseksual disertai infeksi HIV stadium III yang diterapi dengan kombinasi asam trikloroasetat 80% dan seng oral. Intisari Sains Medis 12(1): 76-82. DOI:10.15562/ism.v12i1.869


Background: Condyloma acuminata in the homosexual population caused by anogenital sexual behavior causes more microabrasion to occur which increases the risk of infection with human papilloma virus (HPV) and HIV. This case report aims to provide an overview of the clinical outcome of condyloma acuminata in homosexual patients with HIV grade III.

Case: Male, 26 years old with an itchy and painless lump around the genitals and anal canal since two months ago. The new patient was diagnosed with HIV since two weeks before the visit to the Sanglah Hospital polyclinic. It was found that the patient was a homosexual with a history of multiple partners and had been going on for five years. Physical examination of the perianal region revealed multiple skin-colored tumors, geographic shape, 3x5cm - 3x5.5cm in size, with a verrucous surface, and solid consistency with a positive acetowhite test that concluded as perianal condyloma acuminata. It was decided to give tricolor acetate (TCA) 80% spotted therapy and oral zinc sulfate 100mg/day. Up to 2 TCA session therapy and oral zinc administration in approximately three weeks, the lesion was getting better with efflorescence in the form of multiple papules, color of the mucosa that confluent to form a tumor, geographic shape, size 3x2cm - 3x3cm, smooth surface, solid consistency.

Conclusion: The response to treatment with TCA 80% for 2 times and oral zinc for 3 weeks was quite good, the number of lesions was reduced and the size of the lesions was reduced. The prognosis of the patient is dubious because even if the condyloma acuminata lesion has been repaired, the presence of HIV infection can lead to the risk of recurrence and the risk of progression to malignancy.

 

Latar belakang: Kondiloma akuminata pada populasi homoseksual diakibatkan oleh perilaku seksual secara anogenital menyebabkan lebih banyak mikroabrasi yang terjadi yang menyebabkan peningkatan risiko infeksi human papilloma virus (HPV) dan HIV. Laporan kasus ini bertujuan untuk memberikan suatu gambaran luaran klinis dari kondiloma akuminata pada pasien homoseksual dengan HIV derajat III.

Kasus: Laki-laki, 26 tahun dengan benjolan risakan gatal dan tidak nyeri pada sekitar kelamin dan lubang anus sejak dua bulan yang lalu. Pasien baru terdiagnosa HIV sejak dua minggu sebelum kunjungan poliklinik RSUP Sanglah. Diketahui pasien merupakan seorang homoseksual dengan riwayat berganti-ganti pasangan dan sudah berlangsung selama lima tahun. Pemeriksaan fisik region perianal menunjukkan tumor sewarna kulit multipel, bentuk geografika, ukuran 3x5cm – 3x5,5cm, dengan permukaan verukosa, dan konsistensi padat dengan hasil tes acetowhite positif yang disimpulkan sebagai suatu kondiloma akuminata perianal. Diputuskan untuk memberikan terapi tutul tricolor acetat 80% dan seng sulfat oral 100mg/hari. Hingga terapi 2 kali tutul dan pemeberian seng oral dalam jangka waktu kurang lebih tiga minggu terjadi perbaikan lesi dengan efloresensi berupa papul multipel sewarna mukosa yang berkonfluen membentuk tumor, bentuk geografika, ukuran 3x2cm – 3x3cm, permukaan licin, konsistensi padat.

Simpulan: Respon pengobatan dengan TCA 80% selama 2 kali dan seng oral selama 3 minggu cukup baik, jumlah lesi berkurang dan ukuran lesi mengecil. Prognosis dari pasien adalah dubius karena walaupun telah terjadi perbaikan lesi kondiloma akuminata, adanya infeksi HIV dapat menyebabkan risiko terjadinya rekurensi dan risiko perkembangan ke arah keganasan.

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