KULIAH MODUL KULIAH MODUL 20152015Dr.HOLY AMETATI, SpKKDr.HOLY
AMETATI, SpKKBAGIAN ILMU KESEHATAN KULIT & KELAMINBAGIAN ILMU
KESEHATAN KULIT & KELAMINFAKULTAS KEDOKTERAN UNDIPFAKULTAS
KEDOKTERAN UNDIPPENYAKIT MENULAR PENYAKIT MENULAR SEKSUALSEKSUALPMS
MINORPMS MINOR1.HERPESGENITALIS1.HERPESGENITALISDefinisi : Definisi
:
infe!si "!#$ p"%" &eni$"'i" !"ren" infe!si "!#$ p"%"
&eni$"'i" !"ren" (ir#s )erpes si*p'e!s(ir#s )erpes si*p'e!s
&e+"'" !)"s &e+"'" !)"s (esi!e' (esi!e' ,er!e'-*p-!
%en&"n %"s"r eri$e* ,er!e'-*p-! %en&"n %"s"r eri$e* %"n
re!#ren%"n re!#renE$i-'-&i :E$i-'-&i :
.ir#s )erpes )-*inis $ipe I "$"# .ir#s )erpes )-*inis $ipe I
"$"# $ipe II$ipe IIEpi%e*i-'-&i :Epi%e*i-'-&i
:K-s*-p-'i$"nK-s*-p-'i$"n Insi%ens : '"!i'"!i / 0"ni$"Insi%ens :
'"!i'"!i / 0"ni$"Ge+"'" !'inis :.Infe!si pri*er.Infe!si
'"$en.Infe!si re!#renAd. 1. Infeksi PrimerAd. 1. Infeksi
PrimerLe,i) '"*" 1Le,i) '"*" 1 2 *in& 3 2 *in& 3Le,i) ,er"$
Le,i) ,er"$Bis" "si*$-*"$i! 1 45 6 75 8 3 Bis" "si*$-*"$i! 1 45 6
75 8 3Bi"s"n9" "%" &e+"'" sis$e*i! Bi"s"n9" "%" &e+"'"
sis$e*i!M"s" in!#,"si 2 6 7 )"ri M"s" in!#,"si 2 6 7 )"riGe+"'"
!'inis : r"s" $er,"!"r, 'esi "0"'Ge+"'" !'inis : r"s" $er,"!"r,
'esi "0"' *#!-!#$"n, n9eri *#!-!#$"n, n9eriLesi !#'i$ : (esi!e'
,er!e'-*p-!, %"s"rLesi !#'i$ : (esi!e' ,er!e'-*p-!, %"s"r eri$e*,
(esi!e' *#%") pe:")eri$e*, (esi!e' *#%") pe:") er-sier-si *#'$ipe'
*#'$ipe'Pe*,es"r"n !e'en+"r &e$") ,enin& 1 ; 3Pe*,es"r"n
!e'en+"r &e$") ,enin& 1 ; 3 Lesi p"%" #re$r"Lesi p"%"
#re$r" %is#ri"%is#ri" re$ensire$ensi #rine #rineAd. 2. Infeksi
L!enAd. 2. Infeksi L!en" " Ge#$ k$inis % " &Ge#$ k$inis % "
& P"%" &"n&'i-n %-rs"'is P"%" &"n&'i-n
%-rs"'isAd. '. Infeksi Rek(renAd. '. Infeksi Rek(ren" " ) * 10 +ri)
* 10 +ri Ge+"'" 'e,i) rin&"n Ge+"'" 'e,i) rin&"n Ge+"'"
!'inis ,is" 1 ; 3 < 13 Ge+"'" !'inis ,is" 1 ; 3 < 13L,ksi
$esi -L,ksi $esi -
Pri" : prep#$i#*, &'"ns penis,Pri" : prep#$i#*, &'"ns
penis, ,"$"n& penis, #re$r", "n"',,"$"n& penis, #re$r",
"n"', s!r-$#* s!r-$#*
="ni$" : '",i" *"9-r, *in-r,="ni$" : '",i" *"9-r, *in-r,
!'i$-ris, in$r-i$#s ("&in", ser(i!s !'i$-ris, in$r-i$#s
("&in", ser(i!sK,m.$iksi -K,m.$iksi - Infe!si se!#n%er Infe!si
se!#n%er Re$ensi #rin Re$ensi #rin Infe!si sis$e*i! : p"%"
ne-n"$#s, Infe!si sis$e*i! : p"%" ne-n"$#s, *enin&i$is,
ensef"'i$is *enin&i$is, ensef"'i$is Ge'is"), %epresi Ge'is"),
%epresi >" ser(i!s >" ser(i!sPemeriksn Pem/n!( Pemeriksn
Pem/n!( :: T?"n! $es T?"n! $es Bi"!"n +"rin&"n Bi"!"n
+"rin&"n De$e!si A& : E'is", i*#n-per-!si%"se De$e!si
A& : E'is", i*#n-per-!si%"se De$e!si A, : E'is" De$e!si A, :
E'is" Penen$#"n DNA (ir#s : P>RPenen$#"n DNA (ir#s : P>R
1P-'9*er"se >)"in Re":$i-n3 1P-'9*er"se >)"in Re":$i-n3
Pe*eri!s""n A, *-n-!'-n"' %"riPe*eri!s""n A, *-n-!'-n"' %"ri
!er-!"n 'esi 1*i!r-s!-p e'e!$r-n in%ire!3 !er-!"n 'esi 1*i!r-s!-p
e'e!$r-n in%ire!3Pen0,/!n -Pen0,/!n [email protected]&-,"$"n
[email protected]&-,"$"n spesifi!
". Lesi pri*er". Lesi pri*er Infe!si ,er"$ Infe!si ,er"$ r"0"$
r"0"$ "si!'-(ir 4 *& < !& BB < !"'i I."si!'-(ir 4
*& < !& BB < !"'i I.1 4@5 )"ri 3 1 4@5 )"ri 3 Infe!si
se%"n& Infe!si se%"n& "si!'-(ir 4 A"si!'-(ir 4 AB55 *&
$",'e$ 1 @5 )"ri 3B55 *& $",'e$ 1 @5 )"ri 3,. Infe!si re!#ren
,. Infe!si re!#ren
Bi'" $i*,#' +"r"n& & rin&"n : "si!'-(irBi'" $i*,#'
+"r"n& & rin&"n : "si!'-(ir 4 8:re"* 1 4 A< )"ri 3 4
8:re"* 1 4 A< )"ri 3
Lesi se%"n& 6 ,er"$,$i*,#' +"r"n&Lesi se%"n& 6
,er"$,$i*,#' +"r"n& "si!'-(ir 4 A B55 *&1 4 )"ri 3"si!'-(ir
4 A B55 *&1 4 )"ri 3
Ti*,#' serin&Ti*,#' serin& s#presi !r-ni! :s#presi
!r-ni! : "si!'-(ir -r"' B 6 4 A B55 *& "$"# "si!'-(ir -r"' B 6
4 A B55 *& "$"#B A C D55 6 E55 *&3 s"*p"i @ $")#n B A C D55
6 E55 *&3 s"*p"i @ $")#nB. Pen&-,"$"n n-n spesifi!B.
Pen&-,"$"n n-n spesifi!
R"s" n9eri R"s" n9eri "n"'&e$i!"n"'&e$i!
Hin%"ri p"!"i"n !e$"$Hin%"ri p"!"i"n !e$"$
Psi!-$er"piPsi!-$er"pi
Men&erin&!"n 'esi, Men&erin&!"n 'esi,
*en:e&") infe!si se!#n%er : *en:e&") infe!si se!#n%er :
p-(i%-n i-%in $-pi!"', p-(i%-n i-%in $-pi!"', !-$ri*-!s"?-'
-r"'!-$ri*-!s"?-' -r"'2. Pen:e&")"n2. Pen:e&")"n
K-n%-*K-n%-*
Hin%"ri f"!$-r pen:e$#sHin%"ri f"!$-r pen:e$#s
A,s$inensi"A,s$inensi"Pr,0n,sis -Pr,0n,sis -
Infe!si pri*er %ini 9"n& Infe!si pri*er %ini 9"n&
se&er" %i-,"$i se&er" %i-,"$i pr-&n-sis pr-&n-sis
,"i!,"i!
Infe!si re!#ren Infe!si re!#ren )"n9" )"n9" %"p"$ %i,"$"si
fre!#ensi %"p"$ %i,"$"si fre!#ensi !e!"*,#)"nn9"!e!"*,#)"nn9"2. NSU
- 2. NSU - NON SPESI1IK URETRITISNON SPESI1IK URETRITISDefinisi :
Definisi : infe!si #re$r" 9"n& pen9e,",n9"infe!si #re$r"
9"n& pen9e,",n9" $i%"!%"p"$ %i$e*#!"n p"%"$i%"!%"p"$ %i$e*#!"n
p"%" pe*eri!s""n '",-r"$-ri#*pe*eri!s""n '",-r"$-ri#*
se%er)"n",%"p"$ %i$e*#!"n p"%"se%er)"n",%"p"$ %i$e*#!"n p"%" pri"
%"n 0"ni$" 1 p"%" 0"ni$" %ise,#$pri" %"n 0"ni$" 1 p"%" 0"ni$"
%ise,#$ NSGI :N-n Spesifi! Geni$"' Infe:$i-n NSGI :N-n Spesifi!
Geni$"' Infe:$i-n3 3E$i-'-&i :E$i-'-&i :
>)'"*9%i" $r":)-*"$is>)'"*9%i" $r":)-*"$is: 25 6 45 8 : 25
6 45 8
Ure"p'"s*" #re"'9$i:#*Ure"p'"s*" #re"'9$i:#*: 25 6 45 8 : 25 6
45 8
Ti%"! %i!e$")#iTi%"! %i!e$")#i: B5: B5 88Ge#$ k$inis -Ge#$
k$inis -
M"s" in!#,"si @ 6 4 *in& M"s" in!#,"si @ 6 4 *in&
Se!re$ p"%" #re$r" : +erni)Se!re$ p"%" #re$r" : +erni)
se%i!i$se%i!i$ !er#), serin& p"&i )"ri !er#), serin&
p"&i )"ri
Dis#ri" : p"%" p"n&!"' *#"r" #re$r" Dis#ri" : p"%"
p"n&!"' *#"r" #re$r"
G"$"' : sep"n+"n& s"'#r"n #re$r"G"$"' : sep"n+"n&
s"'#r"n #re$r"
P-'"!is#ri" P-'"!is#ri"
Ge+"'" sis$e*i! : %e*"*, n9eriGe+"'" sis$e*i! : %e*"*, n9eri
!e'en+"r inin"' !e'en+"r inin"'K,m.$iksi - K,m.$iksi - @.
Epi%i%i*i$is@. Epi%i%i*i$is B. Pr-s$"$i$isB. Pr-s$"$i$is 2.
Pr-!$i$is2. Pr-!$i$is D. S$ri!$#r #re$r"D. S$ri!$#r #re$r" 4.
Infer$i'i$"s4. Infer$i'i$"sL/,r!,ri(m -L/,r!,ri(m -
T"! %i$e*#!"n T. ("&in"'is & >.T"! %i$e*#!"n T.
("&in"'is & >. "',i:"ns 1p"%" prep"r"$ ,"s")3 "',i:"ns
1p"%" prep"r"$ ,"s")3
T"! %i$e*#!"n %ip'-:-::#sT"! %i$e*#!"n %ip'-:-::#s &-n-re
1p"%" pe*eri!s""n &r"*3 &-n-re 1p"%" pe*eri!s""n
&r"*3
K#'$#r GO, T. ("&in"'is, >.K#'$#r GO, T. ("&in"'is,
>. "',i:"ns : 13 "',i:"ns : 13Kri!eri (re!ri!is -Kri!eri
(re!ri!is -". Se!re$ #re$r" 1pen&e:"$"n &r"*3". Se!re$
#re$r" 1pen&e:"$"n &r"*3 F'e#!-si$ PMN G 4 %&'e#!-si$
PMN G 4 %& pe*,es"r"n @555A pe*,es"r"n @555A,. Se%i*en #rin ,.
Se%i*en #rinFLe#!-si$ PMN G@4 %&Le#!-si$ PMN G@4 %&
pe*,es"r"n D55A pe*,es"r"n D55ADi0n,sis - Di0n,sis - #re$ri$is ;
*en9in&!ir!"n pen9e,",#re$ri$is ; *en9in&!ir!"n pen9e,",
,er#p" N. GO, T. ("&in"'is & >. "',i:"ns ,er#p" N. GO,
T. ("&in"'is & >. "',i:"nsPen0,/!n -Pen0,/!n -
Te$r"si!'in : D A 455 *&. "',i:"ns >. "',i:"ns :E@8:E@8
S$-:!is$. G'",r"$" S$-:!is$. G'",r"$" : @I8: @I8 R"&i '"in
R"&i '"in :28:281k!,r .redis.,sisi -1k!,r .redis.,sisi -@.
@.MeMe!"%"r!"r,-)i%r"$1pe!"%"r!"r,-)i%r"$1pe"n "n &'i!-&en
("&in"3 p"%" !e)"*i'"n & &'i!-&en ("&in"3 p"%"
!e)"*i'"n & pe*"!"i pi' KBpe*"!"i pi' KBB. B.PePe pHpH2.
2.Lin&!#n&"n 9"n& )"n&"$ &
'e*,",Lin&!#n&"n 9"n& )"n&"$ & 'e*,",D.
D.D.M.D.M.4. 4.Pe*"!"i AB < !e*-$er"pi Pe*"!"i AB <
!e*-$er"pi Ge#. K$inis Ge#. K$inis : *"s" $#n"s 4 6 B@ )"ri : *"s"
$#n"s 4 6 B@ )"ri:ni! - :ni! -&"$"' p"%" (#'(", %#) $#,#) :
,"n9"!, p#$i)&"$"' p"%" (#'(", %#) $#,#) : ,"n9"!, p#$i)
sp$s#s#pe:"),,is"se%i!i$,:"ir,s"n&"$sp$s#s#pe:"),,is"se%i!i$,:"ir,s"n&"$
&"$"',n9eri,p"n"sse'"*"sen&&"*",&"$"',n9eri,p"n"sse'"*"sen&&"*",
%is#ri".
%is#ri".Pemeriksnk$inis-Pemeriksnk$inis-(#'(""s*"n:"&"r
>"s*"n Kr-*"$-'-&r"fi : Kr-*"$-'-&r"fi :
s#::in"$ "s"* "se$"$ s#::in"$ "s"* "se$"$ KK
'"!$"$'"!$"$Pen0,/!n - Pen0,/!n - @. T-pi!"'@. T-pi!"'
". Kri* s#'f-n"*i% $ripe' :". Kri* s#'f-n"*i% $ripe' :
pen9e*,#)"n @D 6 EI8pen9e*,#)"n @D 6 EI8
,. S#p-si$-ri $e$r"si!'in ("&in"' ,. S#p-si$-ri $e$r"si!'in
("&in"'
pen9e*,#)"n CE8pen9e*,#)"n CE8 :. K'in%"*isin >R B8
in$r"("&, 7 )r, :. K'in%"*isin >R B8 in$r"("&, 7 )r,
se,e'#* $i%#r.se,e'#* $i%#r.B. Sis$e*i!B. Sis$e*i!
". Me$r-ni%"?-' : B A 455 *& 17 )"ri3 -r"'B &r )r I
& III 1-r"' @3,. A*pisi'in < A*-!si'in :D A 455 *& 17
)"ri3 -r"':. K'in%"*isin B A 255 *&, 7 )r;.KONDILOMA
AKUMINATA;.KONDILOMA AKUMINATAE.idemi,$,0i - E.idemi,$,0i -
Se,"&. ,es"r p% #si" @7 6 22 $")#n Se,"&. ,es"r p% #si"
@7 6 22 $")#n p"%" p"s"n&"n se!s#"' 9"n& p"%" p"s"n&"n
se!s#"' 9"n&
,er&"n$i&"n$i.,er&"n$i&"n$i.E!i,$,0i - E!i,$,0i
-
..ir#s p"pi''-*" )#*"n#sir#s p"pi''-*" )#*"n#sPen($rn - Pen($rn
- K-n$"! '"n&s#n& : K-n$"! '"n&s#n& : A#$-in-!#'"si
1!-n$"! se!s#"'3,!issin&A#$-in-!#'"si 1!-n$"!
se!s#"'3,!issin&M"s" in!#,"si 2 *in& 6 E ,#'"n.M"s"
in!#,"si 2 *in& 6 E ,#'"n.Mnifes!si k$inis -Mnifes!si k$inis
[email protected]%i'-*" "!#*in"$" @.K-n%i'-*" "!#*in"$"". Pri" :". Pri" : P"%"
fren#'#*, s#'!#s !-r-n"ri#s : P"%" fren#'#*, s#'!#s !-r-n"ri#s
:p"p#' *#'$ipe', *er") *#%", 'e*,",, p"p#' *#'$ipe', *er") *#%",
'e*,",,,ers"$# *en+"%i *"ss" ,es"r. ,ers"$# *en+"%i *"ss" ,es"r.,.
="ni$" :,. ="ni$" : In$r-i$#s ("&in" p-s$eri-r, '",i" *in-r",
In$r-i$#s ("&in" p-s$eri-r, '",i" *in-r",!'i$-ris
!'i$-risMnifes!si k$inis -Mnifes!si k$inis -B. Gi"n$ K-n%i'-*"
B#s:)e B. Gi"n$ K-n%i'-*" B#s:)e L-#0ens$ein :L-#0ens$ein :
!-n%i'-*" ,es"r, '-!"' in("sif, !-n%i'-*" ,es"r, '-!"'
in("sif,
$i%"! *e$"s$"sis.$i%"! *e$"s$"sis.2. P"p#'-sis B-0eni%: 2.
P"p#'-sis B-0eni%:
p"p#' *#'$ipe',!e:i',*er") p"p#' *#'$ipe',!e:i',*er")
!e)i$"*"n. !e)i$"*"n.
Bi'" ,er&",#n& sp$ L :-,,'e s$-ne Bi'" ,er&",#n&
sp$ L :-,,'e s$-ne
s#rf":ep"p#'e L.s#rf":ep"p#'e L. Iden!ifiksi .r!ike$ OB
BE.I*#n-$er"pi E.I*#n-$er"pi
C.R"%i-$er"pi C.R"%i-$er"pi). MOLUSKUM ). MOLUSKUM
KONTAGIOSUMKONTAGIOSUMDefinisi -Definisi -
Pen9"!i$9"n&%ise,",!"n-'e) Pen9"!i$9"n&%ise,",!"n-'e)
p-!s(ir#s9"n&!'inisn9",er#p" p-!s(ir#s9"n&!'inisn9",er#p"
p"p#'p"p#'B B9"n&p"%"per*#!""nn9" 9"n&p"%"per*#!""nn9"
$er%"p"$'e!#!"n,,erisi*"ss"9& $er%"p"$'e!#!"n,,erisi*"ss"9&
*en&"n%#n& ,"%"n *-'#s!#**en&"n%#n& ,"%"n *-'#s!#*
E.idemi,$,0i - E.idemi,$,0i -
B"n9"! p% "n"!B"n9"! p% "n"!BB & -r"n& %e0"s".&
-r"n& %e0"s".Pen($rn -Pen($rn -
K-n$"! '"n&s#n&, "#$-in-!#'"si.K-n$"! '"n&s#n&,
"#$-in-!#'"si.
Ge#$ k$inis -Ge#$ k$inis - M"ss" in!#,"si : @I *in&M"ss"
in!#,"si : @I *in& P"p#' *i'ier, !"%"n&B 'en$i!#'er, p#$i)
sp$ P"p#' *i'ier, !"%"n&B 'en$i!#'er, p#$i) sp$ 'i'in, ,en$#!
!#,") 9"n& %i$en&")n9" "%"'i'in, ,en$#! !#,") 9"n&
%i$en&")n9" "%" 'e!#!"n 1%e''e3'e!#!"n 1%e''e3 Bi'" %ipi+"$
!e'#"r *"ss" p#$i) sp$ n"si Bi'" %ipi+"$ !e'#"r *"ss" p#$i) sp$
n"si 1e'e*en$"r9 ,-%ies3 1e'e*en$"r9 ,-%ies3 L-!"si : L-!"si :
0"+"), ,"%"n, e!s$re*i$"s 1"n"! 0"+"), ,"%"n, e!s$re*i$"s 1"n"!B
B3, p#,is,3, p#,is, &eni$"'is e!s$ern" 1%e0"s"3 &eni$"'is
e!s$ern" 1%e0"s"3K-e,ner p)en-*en 1;3 K-e,ner p)en-*en 1;3Pen0,/!n
.rinsi. - Pen0,/!n .rinsi. - Men&e'#"r!"n *"ss" 9&
*en&"n%#n& Men&e'#"r!"n *"ss" 9& *en&"n%#n&
,"%"n *-'#s!#* %en&"n e!s$r"!$-r ,"%"n *-'#s!#* %en&"n
e!s$r"!$-r !-*e%- %& +"r#* s#n$i! & !#re$!-*e%- %&
+"r#* s#n$i! & !#re$
@. E!spresi %en&"n f-rsep@. E!spresi %en&"n f-rsep
B. E!s!-!'e"siB. E!s!-!'e"si
2. E'e!$r- !"#$eris"si2. E'e!$r- !"#$eris"si
D. Be%") ,e!# %en&"n >OD. Be%") ,e!# %en&"n >OB B,
N, NB B=.=.SKA7IESSKA7IESE!i,$,0i- E!i,$,0i- S"r:-p$es s:",iei
S"r:-p$es s:",ieiE.idemi,$,0i-E.idemi,$,0i- S-se! ren%") &
)i&iene ,#r#! S-se! ren%") & )i&iene ,#r#! H#,#n&"n
se!s#"' 9"n& pr-*is!#i$"s H#,#n&"n se!s#"' 9"n&
pr-*is!#i$"sPen($rn -Pen($rn -
K-n$"! '"n&s#n&K-n$"! '"n&s#n&
K-n$"! $i%"! '"n&s#n& K-n$"! $i%"! '"n&s#n&
1*e'"'#i ,en%", p"!"i"n, )"n%#!, 1*e'"'#i ,en%", p"!"i"n,
)"n%#!, sprei, ,"n$"'3sprei, ,"n$"'3Ge#$ K$inis - Ge#$ K$inis - 8
!nd krdin$ -8 !nd krdin$ -@. G"$"' $er#$"*" p% *"'"* )"r@. G"$"'
$er#$"*" p% *"'"* )"rB. Dis$ri,#si &"$"' : B. Dis$ri,#si
&"$"' :
se'"se'"B B +"ri, 'ip"$"n si!#, !e$i"!, ,"0") +"ri, 'ip"$"n
si!#, !e$i"!, ,"0") p"9#%"r", se!i$"r p#s"$, se!i$"r p"9#%"r",
se!i$"r p#s"$, se!i$"r !e'"*in !e'"*in %"er") 'e*,",, *#%") %"er")
'e*,",, *#%") %i$e*,#s S"r:-p$es.%i$e*,#s S"r:-p$es.2. Infe!si
!e'#"r&"2. Infe!si !e'#"r&"D.D. K#ni!#'i.K#ni!#'i. 7en!(k
Sk/ies A!i.ik -7en!(k Sk/ies A!i.ik -@[email protected]. in " :'e"n : p"%"
-r"n& ,ersi)S. in " :'e"n : p"%" -r"n& ,ersi)B.B.S.
in:-&ni$- :-'e) !rn !-r$i!-s$er-i%S. in:-&ni$- :-'e) !rn
!-r$i!-s$er-i%2.2.S.n-%#'"ris:n-%#'p"%"$e*p"$S.n-%#'"ris:n-%#'p"%"$e*p"$B
B $er$#$#p$er$#$#pD. S. p"%" ,"9i :se'#r#) $#,#)D. S. p"%" ,"9i
:se'#r#) $#,#)4. S!",ies 9& %i$#'"r!"n *e'"'#i )e0"n 4. S!",ies
9& %i$#'"r!"n *e'"'#i )e0"n
1,",i,!"*,in&, !#:in&3.1,",i,!"*,in&,
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