HIPERSENSITIVITAS & PRURITUS Ns. Zaqqi ubaidillah, M. Kep., Sp, Kep, MB

Hipersensitivitas

Definisi Allergic dysfunction adanya gangguan respon yang dilakukan oleh pertahanan natural tubuh dalam mempertahankan serangan dari virus, bakteri atau substansi asing Disorders caused by immune responses are collectively referred to as hypersensitivity reactions. The term arose from the clinical definition of immunity as “sensitivity” to an antigen

antigens, substansi yang mampu menstimulasi respon imun, dimana zat tersebut dapat diidentifikasi oleh sistem imun Sistem imun dapat mengenali protein asing dan diri Sistem imun dapat mengenali antigen pada saat pertama kali terpapar, kemudian pada saat terpapar yang kedua akan bisa langsung menyerang

Atopy is a personal or familial tendency to become sensitized and produce immunoglobulin E (IgE) antibodies in response to ordinary exposure to allergens Atopy adalah keadaan klinis dimana antibody IgE high responder. Genetic predisposition to produce a prolonged IgE antibody response to allergens that are found in the general environment, such as serbuk sari, dust mites, dan jamur

Patofisiologi

Respon imun terhadap allergen

Any one confuse?

Tipe hipersensitivitas Pada umumnya di bagi menjadi 4 yakni, hipersesitivtas tipe 1, 2, 3 dan 4

Tipe 1 The type 1 hypersensitive reaction is an immediate type of hypersensitivity reaction The contact, inhalation, ingestion, or injection of the allergen creates an allergic reaction mediated by specific IgE antibodies, the cellular release of histamine, and other vasoactive mediators, resulting in an immediate local or systemic reaction (anaphylaxis)

Tipe 2 Type 2 hypersensitivity reactions are cytotoxic reactions where the antibody (IgG or IgM) is directed against antigen on an individual’s own cells or against foreign antibody, such as that acquired after blood transfusion This may lead to cytotoxic action by killer cells or to lysis mediated by the complement system

Tipe 3 Type 3 hypersensitivity reactions are immune complex reactions where immune complexes (antigen and usually IgG or IgM) are deposited in the tissue. The complement is activated, causing local tissue damage and inflammation

Tipe 4 Type 4 hypersensitivity reactions are cell-mediated reactions, which are also called delayed hypersensitivity contact dermatitis after exposure to ointments containing active drugs is the most frequent form of drug-mediated delayed hypersensitivity contact hypersensitivity, tuberculintype hypersensitivity, and granulomatous hypersensitivity

Beberapa zat allergen

Diagnostik Diagnosis begins with a detailed medical history and physical examination skin allergy test will be done, and blood testing may be done to determine the allergen causing the reaction When the triggers are identified, a treatment program can be established The first step in treatment is to minimize exposure to the identified allergen. Medications may be prescribed to reduce allergic symptoms and inflammation.

Nursing problem Ineffective breathing pattern Ineffective coping related to anxiety, lower activity level, and the inability to perform normal activities of daily living Activity intolerance related to fatigue Fear and anxiety related to actual or potential lifestyle changes

Pruritus

Definisi Pruritus (itching) is one of the most common symptoms of patients with dermatologic disorders. Itch receptors are unmyelinated, ujung saraf (brushlike) yang dapat ditemukan pada skin, mucous membranes, and cornea

Some common oral medications such as aspirin, antibiotics, hormones (ie, estrogens, testosterone, or oral contraceptives), and opioids (ie, morphine or cocaine) may cause pruritus directly or by increasing sensitivity to ultraviolet light. Certain soaps and chemicals, radiation therapy, prickly heat (miliaria), and contact with woolen garments are also associated with pruritus Bahkan juga faktor psikologis dapat memicu pruritus

Patofisiologi Scratching the pruritic area causes the inflamed cells and nerve endings to release histamine, which produces more pruritus, generating a vicious itch–scratch cycle. Pasien menggaruk area yang gatal  the integrity of the skin may be altered, and excoriation, redness, raised areas (ie, wheals), infection, or changes in pigmentation may result. Pruritus pada umumnya sering terjadi pada malam hari dari pada siang  pada siang hari dapat terdistraksi oleh kegiatan At night, when there are fewer distractions, the slightest pruritus cannot be easily ignored.

Terapi farmakologis Topical corticosteroids may be beneficial as anti- inflammatory agents to decrease itching ntihistamine, such as diphenhydramine (Benadryl) or hydroxyzine (Atarax), prescribed in a sedative dose at bedtime is often effective in producing a restful and comfortable sleep

Any question ???

Terima kasih Gamsha Hammidah Arigato gozaimaze