Yintoni iTyhefu ye-Epidermal Necrolysis (TEN)?

Umxholo

• Oonobangela
• Amayeza
• Usulelo
• Iimpawu
• Imizekelo ebonakalayo
• Unxibelelwano ne-Stevens-Johnson syndrome
• Imiba yomngcipheko
• Uxilongo
• Unyango
• Imbonakalo
• Yise kude

Ityhefu yipermermal necrolysis (TEN) yimeko yesikhumba enqabileyo nenobuzaza. Rhoqo, kubangelwa kukusabela okungalunganga kumayeza afana nee-anticonvulsants okanye ii-antibiotics.

Uphawu oluphambili kukuxobuka kakhulu kolusu kunye nokudumba. Ukukhawuleza kuqhubela phambili ngokukhawuleza, kubangele indawo ezinkulu ezinokuthi zikhuphe okanye zilile. Ikwachaphazela inwebu yangaphakathi, kubandakanya umlomo, umqala, amehlo, kunye nommandla wobuni.

Kuba i-TEN ikhula ngokukhawuleza, kubalulekile ukufumana uncedo ngokukhawuleza. I-TEN yimeko esongela ubomi engxamisekileyo efuna unyango kwangoko.

Funda ukuze uphonononge izizathu kunye neempawu ze-TEN, kunye nendlela ephathwa ngayo.

Oonobangela

Ngenxa yokuba i-TEN inqabile, ayiqondwa ngokupheleleyo. Ngokwesiqhelo kubangelwa yimpendulo engaqhelekanga kunyango. Ngamanye amaxesha, kunzima ukuchonga oyena nobangela we-TEN.

Amayeza

Unobangela oqhelekileyo we-TEN kukusabela ngendlela engaqhelekanga kunyango. Kwakhona kwaziwa ngokuba luhlobo oluyingozi lokugqithisa iziyobisi, kwaye luxanduva lokufikelela kuma-95 ekhulwini amatyala e-TEN.

Rhoqo, imeko iyenzeka kwiiveki zokuqala ezisi-8 zokuthatha ichiza.

La mayeza alandelayo aqhelekileyo ahambelana ne-TEN:

• ii-anticonvulsants
• Oxicams (nonsteroidal anti-inflammatory drug)
• sulfonamide antibiotics
• i-allopurinol (yegawuthi kunye nokuthintela amatye ezintso)
• nevirapine (ichiza elichasene ne-HIV)

Usulelo

Kwiimeko ezinqabileyo kakhulu, isifo esifana ne-TEN sinxulunyaniswa nosulelo yintsholongwane eyaziwayo njenge Mycoplasma pneumoniae, ebangela usulelo lokuphefumla.

Iimpawu

Iimpawu ze-TEN zihlukile kumntu ngamnye. Kumanqanaba okuqala, ihlala ibangela iimpawu ezinje ngomkhuhlane. Oku kunokubandakanya:

• ifiva
• iintlungu zomzimba
• bomvu, amehlo ahlabayo
• kunzima ukugwinya
• impumlo enemifinya
• ukukhohlela
• umqala obuhkungu

Emva kweentsuku ezi-1 ukuya kwezi-3, ulusu luyaxobuka kunye okanye ngaphandle kokudumba. Ezi mpawu zinokuqhubela phambili kwiiyure ezininzi okanye kwiintsuku.

Ezinye iimpawu zibandakanya:

• amabala abomvu, apinki, okanye emfusa
• ulusu olubuhlungu
• ezinkulu, iindawo eziluhlaza zesikhumba (ukhukuliseko)
• iimpawu zisasazeka emehlweni, emlonyeni, nakwizitho zangasese

Imizekelo ebonakalayo

Uphawu oluphambili lwe-TEN kukubuhlungu kwesikhumba. Njengoko imeko iqhubeka, i-peeling isasazeka ngokukhawuleza emzimbeni wonke.

Ngezantsi yimizekelo ebonakalayo ye-TEN.

Unxibelelwano ne-Stevens-Johnson syndrome

I-Stevens-Johnson syndrome (i-SJS), njenge-TEN, yimeko yesikhumba esomeleleyo ebangelwa sisiyobisi okanye, kunqabile, inxulunyaniswa nosulelo. Ezi meko zimbini zikwisifo esifanayo kwaye ziyahluka ngokusekwe kubungakanani besikhumba esichaphazelekayo.

I-SJS ayinzima kangako. Umzekelo, kwi-SJS, ngaphantsi kweepesenti ezili-10 zomzimba zichaphazeleka kukuxobuka kolusu. Kwi-TEN, ngaphezulu kweepesenti ezingama-30 zichaphazelekayo.

Nangona kunjalo, i-SJS isekwimeko embi. Ikwafuna unyango kwangoko.

I-SJS kunye ne-TEN zihlala zihamba, ngenxa yoko iimeko ngamanye amaxesha zibizwa ngokuba yi-Stevens-Johnson syndrome / i-epidermal necrolysis, okanye i-SJS / TEN.

Imiba yomngcipheko

Nangona nabani na othatha amayeza anokuphuhlisa i-TEN, abanye abantu banomngcipheko ophezulu.

Izinto ezinokubangela umngcipheko zibandakanya:

• Ukwaluphala. I-TEN inokuchaphazela abantu bayo yonke iminyaka, kodwa kunokwenzeka ukuba ichaphazele abantu abadala.
• Isini. Abasetyhini banokuba nomngcipheko ophezulu we-TEN.
• Amandla omzimba abuthathaka. Abantu abanamajoni omzimba abuthathaka kunokwenzeka ukuba baphuhlise i-TEN. Oku kunokwenzeka ngenxa yeemeko ezinje ngomhlaza okanye i-HIV.
• UGawulayo. I-SJS kunye ne-TEN zihlandlo ezili-1 000 eziqhelekileyo kubantu abane-AIDS.
• Imfuza. Umngcipheko uphezulu ukuba unayo i-HLA-B 1502 allele, exhaphake kakhulu kubantu base-mpuma ye-Asiya, amaTshayina kunye neIndiya. Imfuza inokuwonyusa umngcipheko we-TEN xa usela ichiza elithile.
• Imbali yosapho. Unokuba nakho ukukhula i-TEN ukuba isizalwane esisondeleyo sinayo le meko.
• Ukuphendula kwangaphambili kweziyobisi. Ukuba uphuhlise i-TEN emva kokuthatha iyeza elithile, unobungozi obandayo ukuba uthatha iyeza elifanayo.

Uxilongo

Ugqirha uya kusebenzisa iimvavanyo ezahlukeneyo ukufumanisa iimpawu zakho. Oku kunokubandakanya:

• Uvavanyo lomzimba. Ngexesha lovavanyo lomzimba, ugqirha uya kujonga ulusu lwakho ukukhangela, ukuthamba, ukubandakanyeka kwe-mucosal, kunye nosulelo.
• Imbali yezonyango. Ukuqonda impilo yakho iyonke, ugqirha uya kubuza malunga nembali yakho yonyango. Bazakufuna nokwazi ukuba zeziphi iziyobisi ozithathayo, kubandakanya nawaphi na amayeza amatsha athathwe kwiinyanga ezimbini ezidlulileyo, kunye nazo naziphi na izinto ezaliwa ngumzimba onazo.
• Ulusu lwe-biopsy. Ngexesha le-biopsy yolusu, isampulu yesuntswana lesikhumba elichaphazelekayo lisuswe emzimbeni wakho kwaye lithunyelwe elebhu. Ingcali iya kusebenzisa imicroscope ukuvavanya izicwili kwaye ijonge imiqondiso ye-TEN.
• Uvavanyo lwegazi. Uvavanyo lwegazi lunokunceda ekuchongeni iimpawu zosulelo okanye ezinye iingxaki kwizitho zangaphakathi.
• Iinkcubeko. Ugqirha unokujonga nosulelo ngoku-odola igazi okanye inkcubeko yesikhumba.

Ngelixa ugqirha uhlala ekwazi ukuxilonga i-TEN ngovavanyo lomzimba kuphela, i-biopsy yolusu ihlala isenziwa ukuqinisekisa isifo.

Unyango

Kuzo zonke iimeko, unyango lubandakanya ukuyekisa ichiza ebangele ukuba usabele.

Ezinye iindlela zonyango zixhomekeka kwizinto ezininzi, ezinje:

• iminyaka yakho
• impilo yakho yonke kunye nembali yezonyango
• ubuzaza bemeko yakho
• indawo ezichaphazelekayo zomzimba
• ukunyamezelana kwakho kweenkqubo ezithile

Unyango luya kubandakanya:

• Isibhedlele. Wonke umntu one-TEN ufuna ukukhathalelwa kwicandelo lokutsha.
• Amafutha kunye neebhandeji. Ukhathalelo olufanelekileyo lwenxeba luya kuthintela ukonakala ngakumbi kolusu kwaye lukhusele ulusu oluhlaza ekulahlekelweni lulwelo nakusulelo. Ukukhusela ulusu lwakho, iqela lakho lasesibhedlele liza kusebenzisa amafutha okuthambisa kunye nokunxiba amanxeba.
• Intravenous (IV) ulwelo kunye nee-electrolyte Ukulahleka kolusu njengokutsha okutsha, ngakumbi kwi-TEN, kukhokelela ekulahlekelweni lulwelo kunye nokungalingani kwe-electrolyte. Uya kunikwa IV fluid kunye ne-electrolyte ukunciphisa umngcipheko. Iqela lakho lesibhedlele liya kujonga ngokusondeleyo ii-electrolyte zakho, inqanaba lamalungu akho angaphakathi, kunye nenqanaba lakho lilonke lolwelo
• Ukubekwa wedwa. Kuba ukonakala kwesikhumba kwe-TEN kwandisa umngcipheko wosulelo, uya kubekwa ecaleni kwabanye kunye nakwimithombo enokubakho yosulelo.

Amayeza asetyenziselwa ukunyanga i-TEN aquka:

• Amayeza okubulala iintsholongwane. Phantse wonke umntu one-TEN unikwa amayeza okubulala iintsholongwane ukukhusela okanye ukunyanga nasiphi na isifo.
• I-immunoglobulin G (IVIG) efakwa ngaphakathi. Ii-Immunoglobulins zizinto ezinceda amajoni akho omzimba. Ngamanye amaxesha i-IVIG isetyenziselwa ukulawula ukuphendula. Oku kukusetyenziswa kwelebheli engekho kwi-IVIG.
• I-TNF alpha inhibitor etanercept kunye ne-immunosuppressant cyclosporine. Ezi zonyango ezithembisayo ezihlala zinconyelwa ziingcali kunyango lwe-TEN. Oku kusetyenziswa ngaphandle kwelebheli kuwo omabini amayeza.

Amalungu athile omzimba anokufuna unyango olwahlukileyo. Umzekelo, ukuba umlomo wakho uchaphazelekile, unokusetyenziswa ngokuhlamba umlomo ngomlomo ukongeza kolunye unyango.

Iqela lakho lasesibhedlele liza kujonga ngokusondeleyo amehlo kunye namalungu esini kwiimpawu. Ukuba bafumanisa naziphi na iimpawu, baya kusebenzisa unyango oluthile lwentloko ukukhusela iingxaki, njengokulahleka kombono kunye nokuqhekeka.

Okwangoku, akukho rejimeni yonyango ilungileyo ye-TEN. Unyango lunokwahluka ngokuxhomekeke esibhedlele. Umzekelo, ezinye izibhedlele zingasebenzisa i-IVIG, ngelixa ezinye zinokusebenzisa indibaniselwano ye-etanercept kunye necyclosporine.

I-Etanercept kunye ne-cyclosporine okwangoku azamkelwa yi-Food and Drug Administration (FDA) ukunyanga i-TEN. Nangona kunjalo, banokusetyenziselwa ngaphandle kwelebheli ukulungiselela le njongo. Ukusetyenziswa kwelebheli engekho mthethweni kuthetha ukuba ugqirha wakho angamisela iyeza kwimeko engavunyelwanga ukuba bacinga ukuba ungazuza kwichiza. Funda ngakumbi malunga nokusetyenziswa kwelebheli emiselweyo

Imbonakalo

Izinga lokusweleka kwe-TEN limalunga neepesenti ezingama-30, kodwa lingangaphezulu. Nangona kunjalo, zininzi izinto ezichaphazela umbono wakho, kubandakanya eyakho:

• ubudala
• impilo iyonke
• ubukrakra bemeko yakho, kubandakanya indawo yomhlaba ebandakanyekayo
• Inkqubo yokonyango

Ngokubanzi, ukuchacha kunokuthatha iiveki ezi-3 ukuya kwezi-6. Iziphumo ezinokubakho zexesha elide zibandakanya:

• ukujika kwesikhumba
• izilonda
• isikhumba esomileyo kunye neembumba ezinomqolo
• ukulahleka kweenwele
• ingxaki yokuchama
• incasa kakuhle
• ukungaqheleki kwilungu lobufazi
• utshintsho lombono, kubandakanya ukulahleka

Yise kude

Ityhefu yepidermal necrolysis (TEN) yimeko engxamisekileyo enkulu. Njengobungozi besikhumba, inokukhokelela ekuphelisweni kwamanzi emzimbeni kunye nosulelo. Fumana unyango ngokukhawuleza ukuba wena okanye umntu omaziyo uneempawu ze-TEN.

Unyango lubandakanya ukungeniswa esibhedlele nokwamkelwa kwicandelo lokutsha. Iqela lakho lesibhedlele liya kubeka phambili ukhathalelo lwenxeba, unyango lwamanzi, kunye nolawulo lwentlungu. Kungathatha ukuya kwiiveki ezi-6 ukuba ube ngcono, kodwa unyango lwakwangoko luya kuphucula ukubuyela kwimeko yesiqhelo kunye nembonakalo yakho.