Nevus Unius Lateris with Hemophilia: A rare case report

Ammarilis Murastami, Siti Efrida Fiqnasyani, Zilpa Widyastuti, Nugrohoaji Dharmawan

Abstract


Latar Belakang: Nevus Unius Lateris (NUL) adalah kelainan bawaan jaringan kulit langka, ditandai distribusi lesi unilateral mengikuti garis Blaschko. Lesi ditemukan pada tahun pertama kehidupan dengan bercak coklat kekuningan, batas yang jelas, dan permukaan verukosa. Pemeriksaan multidisiplin dianjurkan untuk menegakkan diagnosis dan memberikan penatalaksanaan yang tepat. Terapi bertujuan untuk mengangkat dan menghancurkan lesi hiperkeratosis dengan pembedahan/non-pembedahan. Elektrokauter dapat menjadi pilihan untuk membantu mencegah perdarahan setelah operasi dermatologis, terutama hemofilia. Kasus: Tn. A, 24 tahun, pekerjaan wiraswasta, datang dengan keluhan utama beberapa plak yang meninggi di belakang lehernya. Keluhan pertama muncul sebagai bintik pada usia 6 tahun dan naik perlahan, dan menyebar luas. Pasien memiliki riwayat hemofilia A. Pemeriksaan dermatologis, beberapa nodul verukosa hiperpigmentasi bertangkai dengan batas teratur, garis yang jelas tersusun secara linier mengikuti garis Blaschko di daerah coli posterior. Hasil pemeriksaan dermoskopi menunjukkan pola sirkular hiperpigmentasi dengan struktur epidermis eksofitik dan pola serebriform. Pemeriksaan histopatologi menunjukkan hiperkeratosis, akantosis, papilomatosis minimal, dan deposit melanin dengan kepadatan ringan-sedang. Pasien didiagnosis dengan nevus unius lateris dan diterapi bedah listrik. Pasien diberikan antibiotik sistemik oral dan analgesik selama lima hari setelah prosedur dan disarankan untuk kontrol pada hari ketiga, dan pengangkatan jahitan dilakukan pada hari ketujuh. Kesimpulan: Beberapa perawatan medis dan bedah telah dicoba, tetapi tidak ada pengobatan yang ideal atau dapat diterima secara universal. Namun, kekambuhan dapat terjadi berbulan-bulan atau bertahun-tahun setelah pengangkatan lesi dengan metode apa pun. Terapi dengan bedah listrik dapat dipilih untuk membantu mencegah perdarahan yang mungkin terjadi setelah prosedur melalui target hemostasis dan untuk kerusakan jaringan superfisial.


Keywords


Nevus unius lateris, Hemofilia A, Bedah Listrik, Garis Blaschko

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References


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DOI: https://doi.org/10.33854/heme.v5i3.1314

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