Peran kepatuhan pasien pada penatalaksanaan kasus ulser traumatik yang menyerupai Oral Squamous Cell Carcinoma: Laporan kasus

Abstract

ABSTRAK

Pendahuluan: Ulser traumatik adalah lesi ulserasi akibat paparan trauma baik mekanis, termal, dan kimia pada mukosa oral. Gambaran klinis ulser traumatik dapat menyerupai gambaran klinis Oral Squamous Cell Carcinoma (OSCC) yang merupakan epithelial cancer. Ulser traumatik dapat bersifat kronis, sehingga diperlukan kepatuhan pasien untuk keberhasilan perawatan. Laporan kasus ini bertujuan untuk menguraikan keberhasilan penatalaksanaan kasus ulser traumatik yang menyerupai OSCC melalui kepatuhan pasien. Laporan Kasus: Seorang perempuan berusia 24 tahun datang untuk kunjungan kontrol pasca satu minggu lesi ulserasi traumatik pada mukosa labial bawah. Pada kunjungan tersebut ditemukan lesi ulserasi baru pada lateral lidah kanan, berjumlah satu buah, berbentuk oval, berukuran ±5 mm, berwarna kekuningan, dikelilingi halo eritema, dangkal, serta berbatas jelas dan tegas. Setelah dua minggu lesi semakin membesar dari ukuran 5 mm menjadi 1 cm disertai indurasi, seperti pada kasus OSCC. Hasil pemeriksaan penunjang hematologi rutin dan hitung jenis leukosit menunjukkan parameter normal, kecuali kadar neutrofil batang di bawah normal. Pasien diberikan edukasi untuk mencegah trauma berulang. Menimbang kondisi pandemi serta kendala jarak, evaluasi dilakukan dengan kontrol berkala secara langsung dan melalui metode teledentistry. Penyembuhan lesi terjadi dalam waktu lama akibat kepatuhan pasien yang kurang terhadap instruksi yang diberikan. Setelah dilakukan edukasi ulang pada pasien, terdapat perbaikan lesi setelah dua bulan pemberian terapi medikasi dan edukasi kepada pasien. Temuan klinis lesi ulserasi traumatik pada rongga mulut yang bersifat kronis perlu ditindaklanjuti terutama apabila menyerupai tanda klinis keganasan. Simpulan: Kepatuhan pasien sangat mendukung keberhasilan dalam penatalaksanaan kasus ulser traumatik kronis yang menyerupai OSCC.

Kata kunci

ulser traumatik, OSCC, kepatuhan pasien, medikasi, edukasi.

The role of patient compliance in management of traumatic ulcer mimicking Oral Squamous Cell Carcinoma

ABSTRACT

Introduction: Traumatic ulcers arise from exposure to mechanical, thermal, and chemical trauma to the oral mucosa. The clinical appearance of traumatic ulcers in the oral cavity may resemble Oral Squamous Cell Carcinoma (OSCC), a type of epithelial cancer. Traumatic ulcers can sometimes become chronic, necessitating patient compliance for effective treatment. This case report aims to depict the successful management of traumatic ulcer cases that mimic OSCC, underscoring the pivotal role of patient compliance in the process. Case Report: A 24-year-old female returned for a follow-up visit one week after developing a traumatic ulcerated lesion on the lower labial mucosa. During the visit, a new solitary ulcerated lesion was discovered on the lateral right side of the tongue. The lesion was oval-shaped, approximately 5 mm in diameter, and exhibited a yellowish hue. It was encompassed by an erythematous halo, appeared shallow, had distinct borders, and displayed firmness. Over two weeks, the lesion had expanded from 5 mm to 1 cm, exhibiting induration. Remarkably, the lesion was painless, which raised concerns about its resemblance to Oral Squamous Cell Carcinoma (OSCC). Haematological investigations and leukocyte count outcomes returned within normal ranges, except for a below-normal count of stem neutrophils. The patient received guidance on measures to prevent re-trauma. Given the prevailing pandemic conditions and limitations in proximity, evaluations were conducted through periodic direct examination and teledentistry. Due to inadequate patient adherence to the provided instructions, the healing process of the lesion was prolonged. Upon patient re-education, a positive response to treatment was observed after two months of medical therapy and education. The clinical improvement underscored the significance of following up on chronic traumatic ulcerated lesions in the oral cavity, remarkably when their clinical presentation resembles signs of malignancy. Conclusion: Patient compliance significantly contributes to the successful management of chronic traumatic ulcer cases resembling OSCC, alongside eliminating underlying etiological factors.

Keywords

traumatic ulcer, OSCC, patient compliance, medication, education.