Psoriasis pada pasien tumor payudara yang dicurigai sebagai sindrom paraneoplastik

Setyorini Mirawati, Eddy Karta, Sri Adi Sularsito, Untung Sidhi Pratomo

Abstract


ABSTRACT

Paraneoplastic syndrome is a broad group of clinical syndromes of coexistent cutaneous inflammatory reaction and internal malignancy. Until now there is no literature that includes psoriasis as part of the syndrome, even though there are several reports on patients with breast cancer who had generalized psoriasi form eruptions.
A 64-year old woman with a right breast tumor for more than 2 years came with generalized psoriasis which appeared since 4 days a go. For the last 2 months, the tumor was diagnosed as mammary ductal carcinoma grade T4bN3M1. Histopathological finding from the skin lesion confirmed psoriasis vulgaris. After having chemotherapy for the mammary ductal carcinoma and liquor carbonis detergens 3% with lanoline 10% ointment for the skin lesions, the tumor size was decreased accompanied by clinical improvement of the psoriasis lesions.
Suspicion of paraneoplastic psoriasis was based on psoriatic lesions that suddenly erupted on a patient with mammary ductal carcinoma, both followed a parallel course, and the psoriatic lesions improved after treatment of the tumor with chemotherapy. After one year there was no reccurency of the psoriatic lesions.  Integrative treatment which includes treatment of mammary ductal carcinoma and also psoriasis gave significant clinical improvement.

Key words: paraneoplastic syndrome, mammary ductal carcinoma, psoriasis

ABSTRAK
Sindrom paraneoplastik merupakan sekumpulan sindrom klinis berupa kelainan kulit akibat reaksi inflamasi yang
timbul bersamaan dengan keganasan internal. Sampai saat ini belum ada kepustakaan yang memasukkan psoriasis sebagai
sindrom tersebut, walaupun ada beberapa laporan menyatakan terdapat beberapa pasien kanker payudara yang mengalami
erupsi psoriasi formis generalisata.
Seorang perempuan berusia 64 tahun dengan tumor payudara kanan selama lebih dari 2 tahun datang dengan
psoriasis generalisata yang sudah berlangsung 4 hari. Sejak 2 bulan terakhir diagnosis tumor adalah karsinoma duktal mamae
stadium T4bN3M1. Pemeriksaan histopatologi lesi kulit sesuai dengan psoriasis vulgaris. Setelah pemberian kemoterapi untuk
karsinoma duktal mamae dan salap kombinasi likuor karbonis detergen 3% dengan lanolin 10% untuk lesi kulit, ukuran tumor
mengecil disertai dengan perbaikan lesi psoriasis.
Dugaan psoriasis paraneoplastik berdasarkan psoriasis yang timbul mendadak pada pasien karsinoma duktal
mamae, keduanya berjalan secara paralel, dan lesi psoriasis membaik setelah penanganan tumor dengan kemoterapi.
Pemantauan selama 1 tahun tidak ditemukan kekambuhan lesi psoriasis. Tatalaksana pasien secara integratif antara
penanganan karsinoma duktal mamae dengan psoriasis menghasilkan perbaikan klinis bermakna.
Kata kunci: sindrom paraneoplastik, karsinoma duktal mamae, psoriasis

References



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