Kimura Disease: Tantangan Diagnosis pada Massa Kepala dan Leher yang Menyerupai Keganasan
DOI:
https://doi.org/10.58344/jii.v5i8.8008Keywords:
Kimura’s Disease, Pemicu Infeksi Jamur, Kasus LangkaAbstract
Kimura's Disease (KD) adalah penyakit inflamasi kronis langka yang umumnya menyerang pria Asia usia 20–40 tahun, dengan sekitar 200 kasus dilaporkan secara global hingga 2019. Etiologi belum diketahui, namun infeksi jamur diduga berperan sebagai faktor pencetus melalui aktivasi sel Th1, Th2, dan Th17. Laporan kasus ini bertujuan mengeksplorasi gejala, pendekatan diagnosis, dan penatalaksanaan KD dengan infeksi dermatofita sebagai faktor pencetus. Data diperoleh melalui anamnesis, pemeriksaan fisik, laboratorium (eosinofil, IgE), radiologi (CT-scan kepala), histopatologi dan imunohistokimia, serta pemeriksaan mikologi (KOH 10%). Seorang pria 35 tahun dengan massa bukal bilateral (kanan 7x5 cm, kiri 10x9 cm) disertai plak eritematosa bersisik di wajah, tengkuk, dan ekstremitas. Laboratorium: eosinofil 663/mm³, IgE 26.917 IU/mL. Histopatologi: infiltrasi eosinofil difus dan folikulolisis. KOH 10%: hifa bersekat panjang (dermatofita). Pasien diterapi metilprednisolon 16 mg/12 jam, siklosporin 100 mg/hari, ketokonazol oral 200 mg/12 jam, dan antijamur topikal. Setelah 3 bulan, massa bukal kiri menghilang dan massa kanan mengecil. Diagnosis KD memerlukan pendekatan komprehensif melalui korelasi klinis, laboratorium, dan histopatologi. Identifikasi dan tatalaksana faktor pencetus, termasuk infeksi jamur, merupakan bagian penting dalam pengobatan KD.
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