Laporan Kasus : EKSISI ELLIPS NEVUS MELANOSITIK INTRADERMAL PADA AREA WAJAH: SERIAL KASUS

Tri Pradesa Boco Pranowo, Arif Widiatmoko, Diah Prabawati Retnani

Abstract


Nevus melanositik intradermal merupakan varian nevus melanositik yang paling umum. Metode terbaik untuk terapinya adalah tindakan eksisi ellips. Bekas luka pasca operasi eksisi nevus memerlukan perhatian ekstra terutama pada area wajah karena pasien mengharapkan bekas luka yang minimal. Eksisi elips diorientasikan searah dengan relaxed skin tension line (RSTL) untuk mencapai hasil kosmetik yang optimal. Kasus pertama melaporkan seorang perempuan 23 tahun dengan tahi lalat di area dagu yang membesar mulai 15 tahun yang lalu. Keluhan gatal, nyeri, mudah berdarah pada tahi lalat disangkal. Pemeriksaan dermatologis pada regio mentalis didapatkan nodul hiperpigmentasi, soliter, oval, diameter ±6 mm, batas tegas, homogen, permukaan mengkilat dengan terdapat rambut, pada palpasi teraba keras dan solid. Kasus kedua melaporkan seorang perempuan 33 tahun dengan beberapa tahi lalat berwarna kehitaman di area hidung yang membesar sejak 27 tahun yang lalu. Keluhan gatal, nyeri, dan mudah berdarah pada tahi lalat disangkal. Pemeriksaan dermatologis pada regio nasal didapatkan papul hiperpigmentasi, multipel, solid, bulat, diameter ±2-4 mm, batas tegas, homogen, pada palpasi teraba kenyal. Histopatologis kedua kasus menunjukkan nevus intradermal. Pengangkatan nevus pada kedua kasus dengan bedah eksisi ellips pada  pasien diikuti sampai 1 tahun pertama pasca operasi, dan didapatkan bekas luka yang minimal. Dapat disimpulkan bahwa pengangkatan nevus melanositik intradermal dengan bedah eksisi ellips merupakan salah satu modalitas terapi terbaik dalam pemeriksaan histopatologis untuk penegakan diagnosis. Pencegahan pembentukan bekas luka pasca operasi dapat diminimalisir dengan memperhatikan teknik  eksisi, relaxed tension skin line, tehnik undermining, penjahitan, dan perawatan luka.

 


Keywords


eksisi ellips; eksisi intradermal; nevus melanositik wajah.

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