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Koinfeksi Sifilis Sekunder, Condyloma Acuminata dan Human Immundeficiency Virus (HIV) pada Pria Homoseksual

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Pendahuluan: Pria homoseksual merupakan kelompok yang berisiko tinggi terkena infeksi menular seksual (IMS). Sifilis merupakan salah satu jenis IMS yang bersifat kronis dan sistemik. Infeksi virus human immunodeficiency virus (HIV) dan atau human papillomavirus (HPV) merupakan faktor risiko terjangkitnya infeksi sifilis, dan infeksi HIV serta koinfeksi sifilis dapat saling meningkatkan risiko IMS lainnya. Kasus: Seorang laki-laki 22 tahun, orientasi seksual sesama jenis, mengeluh bercak merah bersisik di kedua telapak tangan dan kaki, tidak gatal, rambut rontok dan benjolan di daerah genital. Pemeriksaan regio oksipital tampak adanya alopesia tanpa disertai jaringan parut, regio palmar dan plantar pedis bilateral tampak patch, plak eritem multipel sebagian hiperpigmentasi konfluens dengan skuama di atasnya, dan pada regio perineal tampak papul nodul multipel dengan permukaan licin merah pucat. Pemeriksaan acetowhite positif pada lesi papul verukosa. Hasil pemeriksaan CD4 112 sel/µl, VDRL/RPR reaktif 1:256 dan TPHA reaktif >1:5.120. Gambaran histopatologi kulit sesuai dengan gambaran sifilis kulit dan condyloma acuminata. Pada pemeriksaan imunohistokimia didapatkan gambaran Spirochaeta berwarna kecoklatan. Pasien didiagnosis dengan koinfeksi sifilis sekunder, condyloma acuminata, dan HIV. Kesimpulan: Pada kasus ini didapatkan seorang pasien homoseksual dengan koinfeksi sifilis sekunder, condyloma acuminata dan HIV. Infeksi HPV dan HIV sering ditemukan bersamaan, dan keduanya saling meningkatkan risiko infeksi menular seksual.
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