dr.

Farida Oesman SpPK

dr. Elly Santosa SpPK
dr. Ninik Sukartini SpPK
Department of Clinical Pathology
Medical Faculty, University of Indonesia
 SKIN DISEASES

• INFECTION
• INFLAMMATION
• AUTOIMMUNE

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 DIAGNOSIS

• ANAMNESIS
•CLINICAL FEATURES
• LABORATORY ASSAY

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 MICROORGANISM DISEASES

• FUNGAL • CANDIDIASIS
• TINEA
• VIRAL • HERPES SIMPLEX
• VARICELLA ZOSTER
• BACTERIAL • IMPETIGO
• FOLLICULITIS

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 METHODE

BACTERIAL/FUNGAL
DETECTION
• DIRECT • KOH : Candida, Trichophyton sp
(MICROSCOPIC) GRAM : S. aureus, S.epidermidis
• ISOLATION • CULTURE: blood agar, Sabouraud
• NUCLEIC ACID • PCR
SEROLOGY
• ANTIBODY DETECTION • IgM, IgG
• ANTIGEN DETECTION
OTHER
• HEMATOLOGY • LEUCOCYTE, DIFF, PLATELET
COUNT
• ACUTE PHASE PROTEIN • CRP
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 ASSAY SPECIMEN

• MICROSCOPIC • SKIN SCRAPING, HAIR, NAIL

• ISOLATION • SKIN SCRAPING, HAIR, NAIL
• NUCLEIC ACID • BLOOD
• SEROLOGY • BLOOD
• HEMATOLOGY • BLOOD
• ACUTE PHASE PROTEIN • BLOOD

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• CULTURE
• PCR
• ANTIGEN

POSITIVE

CONFIRM
DIAGNOSIS

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 ANTIBODY
DETECTION

PRIMARY SECONDARY
INFECTION INFECTION

• IgM (+), IgG (-) • IgM (-) , IgG (+)

• IgM (+), IgG (+) • IgM (+), IgG (+)

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 ASSAY BACTERIAL VIRAL
INFECTION INFECTION

• LEUCOCYTE INCREASED DECREASED

COUNT
• DIFFERENTIAL NEUTROPHILIA LYMPHOCYTOSIS
COUNT SHIFT LEFT
• PLATELET INCREASED DECREASED
COUNT

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 INFLAMMATION

HYPERSENSITIVITY REACTION

HYPERSENSITIVITY DISEASES

• TYPE I • ATOPIC ECZEMA

• ACUTE URTICARIA

• TYPE IV • ALLERGIC CONTACT

DERMATITIS

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 ASSAY RESULT

TYPE I
• IgE LEVEL • INCREASED
• IgE SPECIFIC • POSITIVE
• EOSINOPHIL COUNT • INCREASED
INFLAMATION REACTION
• INFLAMMATORY • IL-4, IL-5, IL-10 ↑
CYTOKINE
• ACUTE PHASE PROTEIN • CRP ↑

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 AUTOIMMUNE
SKIN DISEASE

SKIN DAMAGE
TRIGGERED BY

• AUTOANTIBODIES TO
SKIN ANTIGEN
 BULLOUS SKIN DISEASES
• DEPOSITION OF
IMMUNE COMPLEXES
 VASCULITIS, SLE

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 AUTOANTIBODIES DISEASES

SKIN ANTIGEN
• EPIDERMAL INTER • PEMPHIGUS VULGARIS
CELLULAR CEMENT
• BASEMENT MEMBRANE • BULLOUS PEMPHIGOID

SYSTEMIC ANTIGEN
• NUCLEAR • SUBACUTE CUTANEOUS LE
• DISCOID LE

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 ASSAY RESULT

• AUTOANTIBODIES • POSITIVE
• COMPLEMENT • DECREASED
LEVEL

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 DISEASES ASSAY

• LE • RENAL FUNCTION:
• STAPHYLCOCCAL CREATININE ↑
SCALDED SKIN • LIVER FUNCTION :
SYNDROME (SSSS) SGOT ↑
• TOXIC SHOCK SGPT ↑
SYNDROME (TSS)

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