Studi Retrospektif: Reaksi Kusta Tipe 1
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Latar Belakang: Reaksi kusta tipe 1 terjadi akibat perubahan keseimbangan antara cell mediated immunity (CMI) dan basil Mycobacterium leprae di saraf dan kulit pasien kusta dengan hasil akhir berupa upgrading atau reversal. Pasien kusta tipe subpolar memiliki imunitas yang tidak stabil sehingga sering mengalami reaksi tipe 1 yang berulang terutama tipe Borderline Borderline (BB). Gejala klinis reaksi tipe 1 berupa peradangan kulit maupun saraf dapat menimbulkan kecacatan bila tidak ditangani secara tepat. Tujuan: Mengevaluasi gambaran umum, diagnosis, dan terapi reaksi kusta tipe 1. Metode: Studi retrospektif terhadap rekam medis kunjungan baru pasien kusta selama 4 tahun (2014 – 2017) di Divisi Kusta Unit Rawat Jalan Kesehatan Kulit dan Kelamin RSUD Dr Soetomo Surabaya. Hasil: Total 68 pasien baru kusta dengan reaksi tipe 1 (13,2% dari seluruh pasien baru Divisi Kusta), 60,3% berjenis kelamin laki-laki, 41,2% berusia 15–34 tahun, dan tipe kusta terbanyak adalah tipe BB (72,1%). Gejala reaksi pada kulit berupa keluhan penebalan bercak merah lama (80,9%), reaksi terutama terjadi saat masih dalam pemberian multidrug therapy (66,2%). Gejala saraf tepi pada reaksi tipe 1 yang terbanyak adalah tanpa gejala (66,7%). Terapi terbanyak yang diberikan adalah obat antiinflamasi nonsteroid (45,6%) dan kortikosteroid (29,4%). Simpulan: Diagnosis reaksi tipe 1 perlu ditegakkan dengan benar melalui anamnesis dan pemeriksaan fisik untuk menentukan penatalaksanaan yang tepat. Penggalian riwayat tentang faktor pemicu sangat penting untuk mencegah reaksi tipe 1 berulang atau berkepanjangan.
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