CASE REPORT

Name Age Address Add. Date Reg. No. : : : : : Mr. IF 49 Years Old Bontolaja Street, Gowa July 9th 2012 251942

HISTORY TAKING
Chief Complain : itchy in whole body Brief Anamnesis : the patient consuled from interna department with complaints of itching of the whole body on July 11th 2012. there is a lump in almost the entire body since 6 months ago. There are abscess in regio femoralis dextra et sinistra, pain (+). There is a mass on his scrotum like a cocks comb that arise from a year ago. History of fever 5 days before come to hospital. History of drug comsumption (+) since 1997.

PHYSICAL EXAMINATION
Anemic (-), icterus (-), cyanoses (-), candidiasis oral (+). Thorax : there is a mass in the left breast with rubbery consistency and flat surfaces Cor / Pulmonal : normal Abdomen : normal,peristaltik(+) Genitals : stemmed vegetation such as cauliflower.

CURRENT STATUS
General status : moderate sickness Conciousness : compos mentis Hygiene : moderate Nutritional status : inadequate Vital signs : BP : 120/80 mmHg HR : 78 x/minute RR : 20x/minute temp : 36,5 C

DERMATO-VENEOROLOGY STATUS
Regio pedis dextra et sinistra : nodule hyperpigmentation Regio genitalia : stemmed vegetation such as cauliflower

LABORATORY RESULT
WBC RBC HB HCT PLT LYM Creatine NEUT SGOT SGPT : : : : : : : : : : 12,4 (10 3 /uL) 5,126 /uL) 14,4 (g/dL) 42,3 (%) 621 (10 3 /uL) 7,2 (%) 0,73 mg/dl 79,8 % 47 U/I 41 U/I

RECOMMENDED EXAMINATION

RESUME

DIAGNOSIS
Condyloma Acuminata + Prurigo Nodularis Eruption ec. Immunodeficiency

TREATMENT & MANAGEMENT

TCA (Trichloroasetic Acid) Cetirizine

CONDYLOMA ACUMINATA
Condyloma acuminata is sexually transmitted HPV infection of genital and perianal transition mucosa.

PATHOGENESIS
Most commonly caused by HPV 6 and 11 which are not oncogenic. Important to exclude infection with HPV 16 and 18 which are oncogenic. In affected women, HPV analysis of pap smear may supplement cytology to assess risk.

CLINICAL MANIFESTATION
Incubation period 4 weeks 6 months. Tiny white papules which rapidly both spread and enlarge. Larger lesions often macerated. May be genital or perianal.

DIAGNOSIS
Always examine sexual partner and exclude other STDs. Painting with 5% acetic acid will unmask discrete lesions by turning them white. Be sure affected women have cervical examination. If lesions are recalcitrant, consider HPV typing.

DD
Verruca vulgaris Condyloma latu Squamous cell carsinoma

TREATMENT
1. Chemotherapy : Podofilin 25% Triclorasetat acid 5-fluorourasil 2. Electric surgical 3. Cryosurgical (N2, N2o 4. Scalpel surgical 5. Carbondioxide laser 6. Interferon 7. Immunotherapy

PROGNOSIS
Although even residif, but the prognosis is good.

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