Keberhasilan Terapi Kombinasi Menggunakan Metotreksat Injeksi dan Siklosporin pada Psoriasis Pustulosa Generalisata

Oki Suwarsa, Nadilla Carissa Devi Nursjamsi, Miranti Pangastuti, Endang Sutedja, Hartati Purbo Dharmadji

Abstract


Psoriasis pustulosa generalisata (PPG) adalah bentuk khusus dari psoriasis yang bersifat akut dan berat. Etiologi yang belum diketahui secara pasti menyebabkan pengobatan PPG masih menjadi suatu tantangan. Terapi kombinasi dapat diberikan pada PPG yang berat maupun yang tidak memberikan respons terhadap terapi sistemik tunggal, selain itu terapi kombinasi juga dapat meningkatkan efektivitas dari obat tunggal. Dilaporkan satu kasus PPG pada seorang wanita yang diterapi dengan menggunakan kombinasi metotreksat (MTX)  injeksi dan siklosporin. Dari anamnesis dan pemeriksaan fisis didapatkan pustula berkelompok pada dasar makula eritem yang bergabung membentuk lake of pus, disertai gejala sistemik demam dan leukositosis. Keluhan tersebut sudah berulang sejak 13 tahun yang lalu. Pasien diberikan terapi kombinasi injeksi MTX dan siklosporin. Pustula pada pasien menghilang setelah tujuh hari pemberian obat. Terapi kombinasi dengan MTX injeksi dan siklosporin ini baru pertama kali dilakukan 19 Mei–26 Mei 2017 di Departemen Ilmu Kesehatan Kulit dan Kelamin Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung dan memberikan hasil yang baik. [MKB. 2017;49(3):208–12]

Kata kunci: Metotreksat, metotreksat injeksi, psoriasis pustulosa generalisata, siklosporin

 

Succesful Treatment of Generalized Pustular Psoriasis with a Combination of Methotrexate Injection and Cyclosporine

Generalized pustular psoriasis (GPP) is a special form of acute and severe psoriasis. The definite etiology of GPP remains a challenge. Combination therapy may be given to severe GPP or GPP that does not respond to a single systemic therapy sincecombination therapy may also improve the effectiveness of a monotherapy drug. A GPP case was reported in a woman treated with a combination of methotrexate (MTX) and cyclosporine. From anamnesis and physical examination it was revealed that there were clustered  pustules on the base of erythematous macules that form a lake of pus accompanied by systemic symptoms of fever and leukocytosis. This was a recurrent complaint since 13 years ago. Patients were given combination therapy of MTX injection and cyclosporine. Pustules disappeared after seven days of drug administration. This case was the first combination therapy with MTX injection and cyclosporine used during the period of 19 May to 26 May 2017 at the Department of Dermatology and Venereology Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung, resulting in good results. [MKB. 2017;49(3):208–12]

Key words: Cyclosporine, generalized pustular psoriasis, methotrexate, methotrexate injection


Keywords


Metotreksat, metotreksat injeksi, psoriasis pustulosa generalisata, siklosporin

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DOI: http://dx.doi.org/10.15395/mkb.v49n3.1123

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