Ke ʻike nei ʻoe i nā ʻeha ʻili koʻikoʻi a koke? E aʻo kākou e pili ana iā Pyoderma Gangrenosum!

Ua loaʻa anei iā ʻoe kahi pehu liʻiliʻi a i ʻole kahi ʻulaʻula ma kou ʻili i hoʻomaka me he pehu liʻiliʻi a i ʻole kahi ʻulaʻula a lilo koke i ʻōpū nui a ʻeha? Hiki ke hana ma mua o hoʻokahi wahi, akā hiki nō hoʻi ke hana ma kekahi mau wahi o kou kino. He ʻano maoli kēia e pono ai ka nānā ʻana a hiki ke paʻakikī iki. I kēia lā e kamaʻilio mākou e pili ana i kahi ʻano ʻili i kapa ʻia ʻo Pyoderma Gangrenosum, he ʻano kakaikahi akā he mea nui loa e makaʻala. Mai hopohopo, e mālama kākou i ka maʻalahi.

He aha kēia Pyoderma Gangrenosum?

I ka ʻōlelo maʻalahi, ʻo ka pyoderma gangrenosum kahi maʻi ʻili mau loa , ʻo ia hoʻi he lōʻihi, a hoʻi hou . ʻO ka mea e hana ʻia, ʻo ia ka hoʻomaka mua ʻana o kou ʻili e ulu i nā pehu liʻiliʻi, ʻano ʻulaʻula (ʻulaʻula paha, poni, uliuli, ʻeleʻele, a ʻeleʻele paha), a i ʻole nā ​​pehu piha wai (bullae). ʻO ka mea weliweli loa , hiki i kēia mau mea ke ulu koke a nui, hui pū, a lilo i mau ʻeha hohonu a hāmama (ulcers) .

E noʻonoʻo pehea lā inā i hoʻomaka kekahi mea me he ʻūpē liʻiliʻi lā a i loko o kekahi mau lā ua lilo ia i ʻeha ʻeha e like me ka nikala? ʻO ia ka mea e hana ʻia ma ʻaneʻi. Hoʻokahi wale nō ʻeha e loaʻa i kekahi poʻe, akā i nā hihia koʻikoʻi, hiki ke ulu aʻe nā ʻeha he nui i ka manawa hoʻokahi. Hiki i kēia mau ʻeha ke ʻeha loa .

ʻO ka mea nui, ʻo ka pyoderma gangrenosum e pili pinepine ʻia me nā maʻi ʻē aʻe, ʻo ia hoʻi, ʻaʻole ia he pilikia ʻili wale nō.

ʻO wai ka mea kūpono loa e loaʻa i kēia?

Hiki ke loaʻa ka Pyoderma gangrenosum i kēlā me kēia makahiki, akā he mea kakaikahi loa ia i nā keiki . ʻOi aku ka maʻamau i nā wahine ma waena o 20 a me 50 mau makahiki. Hiki paha iā ʻoe ke loaʻa i ka pyoderma gangrenosum inā loaʻa iā ʻoe kekahi o kēia mau kūlana:

• ʻO ka ʻāʻī Rheumatoid - He maʻi kēia e hoʻoulu ai i ka mumū o nā hono.
• ʻO ka colitis ulcerative - He maʻi mumū me nā ʻeha i loko o ka ʻōpū nui.
• ʻO ka maʻi o Crohn - ʻO kekahi maʻi mumū e kū mai ana i loko o ka ʻōpala digestive.
• ʻO kekahi ʻano maʻi kanesa, no ka laʻana, nā maʻi kanesa koko e like me ka leukemia a i ʻole lymphoma.

Ua ʻōlelo ʻia e loaʻa ana ia ma kahi o hoʻokahi i loko o hoʻokahi haneli tausani kānaka ma ʻAmelika Hui Pū ʻIa . ʻO ia hoʻi, ʻaʻole ia he mea maʻamau.

Pehea kēia e pili ai i ke kino? He aha nā hōʻailona?

Hoʻokumu ʻo Pyoderma gangrenosum i nā pehu liʻiliʻi a me ke kala ʻole, ʻo ia hoʻi ka pehu a me ka ʻulaʻula, ma kou ʻili. Hiki ke ʻike ʻia kēia mau pehu ma nā wahi āpau o ke kino, akā ʻike pinepine ʻia lākou ma nā wāwae, nā kuʻekuʻe wāwae, a me nā wāwae (nā ʻaoʻao haʻahaʻa) .

Hiki i kēia mau pehu ke poha koke, lilo i mau ʻeha nui a ʻeha, a laha.ʻO nā hōʻailona nui:

• Nā pehu liʻiliʻi, ʻeleʻele ke kala (ʻulaʻula, poni, uliuli, ʻeleʻele, a ʻeleʻele paha). Hoʻonui koke kēia mau mea.
• Hoʻomaka nā ʻeha hāmama (nā ʻōpū). Piʻi aʻe nā kihi a puni kēia mau ʻeha a ʻike maopopo ʻia .
• Ka pehu ʻana a me ka ʻeha nui a puni ka ʻeha.
• Hiki i kekahi poʻe ke loaʻa i ke kuni .
• Hiki nō hoʻi ke ʻeha nā hono .

Hiki i kēia mau ʻeha ke nui a hohonu loa i kekahi manawa, a hiki ʻole ke hoʻomanawanui i ka ʻeha.

Ua hōʻike kekahi mau noiʻi a hiki i ka 70% o ka poʻe me ka pyoderma gangrenosum e loaʻa paha i nā maʻi ʻē aʻe he nui (comorbidities) i ka manawa like. Ke hui pū ʻia ka pyoderma gangrenosum me nā maʻi ʻē aʻe, ua ʻōlelo ʻia hiki ke piʻi ka pilikia o ka make a hiki i ka 30%. No laila, ʻaʻole kēia he mea e lawe māmā ʻia.

He maʻi autoimmune anei kēia?

ʻAe, ua manaʻo ʻia ʻo ka pyoderma gangrenosum he maʻi autoimmune . I ka ʻōlelo maʻalahi, hoʻouka ka ʻōnaehana pale ponoʻī o kou kino, ʻo ia hoʻi ka ʻōnaehana pale, i kou mau hunaola ʻili ponoʻī. No kekahi poʻe, hoʻopau ʻia ka pyoderma gangrenosum ke mālama ʻia nā kūlana ʻē aʻe i ʻōlelo ʻia ma luna.

No ke aha e ulu ai ka pyoderma gangrenosum?

ʻAʻole ʻike nā loea lapaʻau i ke kumu kikoʻī , akā ʻoi aku ma mua o ka hapalua o ka poʻe me ka pyoderma gangrenosum i loaʻa nā maʻi ʻē aʻe (e like me ka arthritis, leukemia, a me ka maʻi Crohn), e like me ka mea i ʻōlelo ʻia ma mua.

Eia kekahi, hiki ke loaʻa ka pyoderma gangrenosum ma hope o kahi ʻeha ʻili, ka ʻoki ʻana, a i ʻole ke ʻoki kino (pathergy) . E noʻonoʻo i kahi ʻoki liʻiliʻi ma kou lima, a i ʻole kahi ʻoki kino liʻiliʻi, a ma aneʻi e hoʻomaka ai kēia maʻi. I kekahi manawa ulu pū kēia mau ʻeha a puni kahi stoma ma hope o ke ʻoki kino. Ua kapa ʻia kēia he peristomal pyoderma gangrenosum.

He mea laha anei kēia?

ʻAʻole. ʻAʻole laha ka Pyoderma gangrenosum . ʻAʻole hiki ke laha mai kekahi kanaka a i kekahi kanaka ma o ka pili ʻana o ka ʻili a i ka ʻili. He mea hopohopo kēia no nā poʻe he nui, no laila he mea nui e maopopo e pili ana i kēia.

Pehea e ʻike ai nā kauka i kēia?

ʻO kaʻoiaʻiʻo, hiki ke paʻakikī iki ka ʻike ʻana i ka pyoderma gangrenosum . ʻAʻohe hoʻāʻo paʻa e hiki ke hōʻoia i ke ʻano. No laila, hana pinepine nā kauka i nā hoʻokolohua e kāpae i nā kūlana ʻē aʻe e hiki ke hoʻoulu i nā pilikia ʻili like. ʻO ia hoʻi, hōʻoia mua lākou ʻaʻole i loaʻa nā kūlana ʻē aʻe i loaʻa nā hōʻailona like. Eia kekahi laʻana:

• Nā maʻi like ʻole.
• Nā maʻi ʻili.
• Ka mumū ʻana o nā kīʻaha koko o ka ʻili.
• Ka maʻi Lupus.
• He kūlana i kapa ʻia ʻo Sweet syndrome.

Hiki i nā hoʻāʻo no kēia ke komo pū me:

• Nā hoʻāʻo koko.
• Ke lawe ʻana i kahi ʻāpana ʻili liʻiliʻi no ka hoʻokolokolo ʻana (Biopsy).
• Ka hāpana ʻana o ka iwi iwi - ʻoiai inā kānalua ʻia nā mea e like me ke kanesa koko.
• Proctoscopy.
• Colonoscopy - inā kānalua ʻia nā kūlana e like me ka maʻi o Crohn.

Ma hope wale nō o ka hana ʻia ʻana o kēia mau hoʻokolohua a pau a ua kāpae ʻia nā mea ʻē aʻe a pau, hoʻoholo ke kauka he pyoderma gangrenosum ia.

He aha nā lāʻau lapaʻau?

Aia kekahi mau koho lapaʻau no ka pyoderma gangrenosum. He mea nui ka ʻike mua a me ka mālama ʻana e pale aku i ka ʻeha .

Lapaʻau no nā hihia maʻamau, ʻaʻole koʻikoʻi

Inā ʻaʻole ʻoi loa ka ʻeha, hiki i ke kauka ke kuhikuhi i nā kirīmi a i ʻole nā ​​​​​​mea ʻaila. ʻO kēia mau mea:

• ʻO Corticosteroids: He mau lāʻau lapaʻau kēia e hōʻemi i ka mumū. Hiki ke hoʻopili ʻia i nā ʻeha ma ke ʻano he kirīmi a lawe ʻia paha ma ke ʻano he pila. Nā laʻana: cortisone, prednisone. Eia nō naʻe, hiki i kēia mau mea ke loaʻa nā hopena ʻaoʻao e like me ka hoʻonui ʻana i ka makemake, ka piʻi ʻana o ke kaumaha, nā loli o ke ʻano, ka ʻāʻī, a me ka hiamoe ʻole.
• Nā lāʻau anti-inflammatory nonsteroidal (NSAIDs): He mau lāʻau hōʻoluʻolu ʻeha kēia. Nā laʻana: aspirin, ibuprofen. Hiki i kēia ke hoʻoulu i ke kinoea , ka pehu ʻana, ka ʻeha o ka ʻōpū, ka nausea, ka luaʻi ʻana, ka maʻi diarrhea, a me ka constipation.
• Kirimina ʻili kālā sulfadiazine: He kirimina antibiotic kēia i hoʻopili ʻia i nā mea kuni e pale aku i ka maʻi. Hoʻohana ʻia i kekahi manawa no kēia ʻano. Hiki iā ia ke hana i ka maneʻo, ke kuni, ke anu, nā ʻeha ʻili, a me ka ʻike i ka lā.

He ʻano ʻino iki paha?

Inā ʻoi aku ka koʻikoʻi o ka ʻeha, hiki i ke kauka ke kuhikuhi i nā lāʻau lapaʻau e like me kēia:

• Nā lāʻau lapaʻau immunosuppressant: Hana kēia ma ka hōʻemi ʻana i ka hiki o kāu ʻōnaehana pale e hōʻino i kona kino ponoʻī. Nā laʻana: mycophenolate, cyclosporine.
• Nā mea olaola: He mau ʻano lāʻau hou kēia. Hana lākou ma ke kuhikuhi ʻana i nā protein kikoʻī i loko o ke kino e hoʻoulu ai i ka mumū. Nā laʻana: infliximab, adalimumab, ustekinumab.
• ʻO ka lāʻau lapaʻau oxygen hyperbaric: Pili kēia i ka hāʻawi ʻana i ka 100% oxygen i loko o kahi keʻena kūikawā. Ua ʻōlelo ʻia e wikiwiki i ka ho'ōla ʻana o nā ʻiʻo o ke kino.

E aʻo pū kākou e pili ana i ke ʻoki kino.

I kekahi mau hihia, he mea kōkua paha ka wehe ʻana i nā ʻiʻo make mai ka ʻeha (debriding). Eia nō naʻe, he mau pilikia nō hoʻi kēia .Ma muli o ka hōʻino ʻana o ka ʻili (pathergy) hiki ke hoʻonui i nā hōʻailona o ka pyoderma gangrenosum, pono e hana ʻia kēia me ke akahele nui a ma ka manaʻo o kāu kauka.

I kekahi manawa hiki ke hana ʻia kahi hoʻopili ʻili . ʻO ke ʻano kēia, lawe ʻia ka ʻili mai kahi ʻāpana olakino o ke kino a hoʻoili ʻia i kahi i ʻeha ai.

He aha kāu e pono ai e ʻike ma ke ʻano he kanaka me kēia maʻi?

Inā loaʻa iā ʻoe ka pyoderma gangrenosum, ʻo kēlā me kēia ʻano trauma i kou ʻili - nā ʻoki, nā ʻōpala, nā palapū - hiki ke hoʻonui i kou mau hōʻailona . No laila pono ʻoe e akahele e like me ka hiki. E noʻonoʻo e hana ana ʻoe ma ka māla a i ʻole ma ka lumi kuke, a hiki i kahi ʻōpala liʻiliʻi ke lilo i pilikia nui.

Eia kekahi, he mea nui ka mālama ʻana i nā ʻeha i ka maʻemaʻe e pale ai i ka maʻi .

• E holoi pono i nā ʻeha me ka wai maʻemaʻe e kahe ana a me ke kopa.
• A laila, e uhi pono i ka ʻeha me kahi kāʻei ʻaʻole e hoʻopili. E pale kēia i ka lepo a me nā germs mai ke komo ʻana.
• E hāʻawi aku kāu kauka ʻili iā ʻoe i ka ʻike hou aku e pili ana i ka mālama ʻana i ka ʻeha maʻemaʻe a pehea e hoʻopili ai i nā kāʻei. E hahai pono i kēlā mau kuhikuhi.
• Inā ua hāʻawi ʻia iā ʻoe kahi mea poni, e holoi i ka ʻeha, e kau i ka mea poni, a laila e kāʻei iā ia.

No nā ʻeha koʻikoʻi, hiki i kāu kauka ke ʻōlelo aku i kahi kāʻei hydrocolloid . Mālama kēia i ka ʻeha mai ka hamo hou ʻana a me ka maʻi. E "hehee" lākou i loko o ka ʻili i loko o ʻelua a ʻekolu mau lā.

ʻEhia ka lōʻihi e ho'ōla ai?

He maʻi paʻakikī ka mālama ʻana i ka Pyoderma gangrenosum. ʻOiai me ka mālama kūpono ʻana, hiki i nā ʻeha ke hala i nā hebedoma, i kekahi manawa he mau mahina, e ho'ōla ai. No laila, pono ʻoe e hoʻomanawanui.

Hiki ke pale ʻia kēia?

ʻOiai ʻaʻole ʻike ʻia ke kumu kikoʻī, he paʻakikī ke ʻōlelo maopopo pehea e pale aku ai . Eia nō naʻe, inā he mau mea pilikia kou e like me ka leukemia a i ʻole ka maʻi ʻōpū mumū, a loaʻa iā ʻoe kekahi mau pilikia ʻili hou (ʻoi aku hoʻi nā ʻeha e ulu koke ana) , e haʻi koke i kāu kauka . E noi i kāu kauka e kuhikuhi iā ʻoe i kahi dermatologist a i ʻole kekahi loea ʻē aʻe i loaʻa ka ʻike me ka pyoderma gangrenosum.

Āhea wau e ʻike ai i ke kauka?

Pono ʻoe e ʻike i ke kauka i kēia mau hihia:

• Inā loaʻa iā ʻoe ka maʻi ʻōpū mumū, ka maʻi ʻāʻī, a i ʻole kahi maʻi koko a loaʻa nā pehu a i ʻole nā ​​​​ʻeha e ulu koke ana .
• Inā ʻike ʻia kou ʻeha he maʻi (ʻulaʻula, poni, hina a keʻokeʻo paha, pehu, a ʻeha paha).
• Inā ʻoe e hoʻomohala i nā hōʻailona hou .
• Inā loaʻa iā ʻoe nā hopena ʻino ma hope o ka lawe ʻana i ka lāʻau.

Nā nīnau koʻikoʻi e nīnau aku i kāu kauka

Ke hele ʻoe e ʻike i ke kauka, he mea nui loa e nīnau i kēia mau nīnau:

• Pehea lā ʻoe e ʻōlelo ai he pyoderma gangrenosum koʻu?
• Inā ʻaʻohe oʻu pyoderma gangrenosum, he aha nā maʻi ʻili ʻē aʻe?
• He aha ke ʻano o nā hoʻokolohua āu e manaʻo nei e hana?
• He aha ke ʻano o ka lāʻau lapaʻau a i ʻole ka lāʻau lapaʻau āu e paipai nei?
• Hiki iā ʻoe ke hāʻawi mai iaʻu i kahi kirīmi e kau ai a i ʻole kekahi lāʻau lapaʻau e inu ai?
• He aha ka papa inoa piha o nā hopena ʻaoʻao o kēia mau lāʻau lapaʻau a me nā lāʻau lapaʻau?
• He aha hou aʻe kaʻu e hana ai e hōʻemi i koʻu mau hōʻailona?
• Pono anei au e ʻike i kahi dermatologist, plastic surgeon, gastroenterologist, immunologist, a i ʻole kekahi loea ʻē aʻe?

He mea nui loa e nīnau i kēia mau nīnau a loaʻa kahi ʻike maopopo o kou kūlana.

He aha ka ʻokoʻa ma waena o ka Pyoderma Gangrenosum a me ka Ecthyma Gangrenosum?

Ua like iki kēia mau inoa ʻelua, no laila hiki ke huikau.

He maʻi ʻili laha ʻole ka Ecthyma gangrenosum i hoʻokumu ʻia e ka Pseudomonas bacteraemia, kahi bacteria i loaʻa pinepine i ka wai a me ka lepo. Hiki iā ia ke hana i nā ʻeha ʻili a me ka necrosis o nā ʻiʻo a puni. Hoʻopilikia pinepine ia i ka poʻe me nā ʻōnaehana pale nāwaliwali .

ʻO Pyoderma gangrenosum kekahi kumu o nā ʻeha ʻili. ʻAʻole ʻike ʻia ke kumu pololei. Ua manaʻo ʻia he maʻi autoimmune ia. Eia naʻe, ʻaʻole ia he maʻi nui e hoʻopilikia i ka poʻe me nā ʻōnaehana pale nāwaliwali .

Aia kekahi ʻano like ʻole o nā lesion pyoderma gangrenosum?

ʻAe, ʻehā mau ʻano nui o nā lesions pyoderma gangrenosum:

• ʻO ka pyoderma gangrenosum maʻamau: ʻO kēia ke ʻano maʻamau. Hoʻomohala pinepine ʻia nā ʻeha ʻeha ma nā wāwae.
• ʻO ka pyoderma gangrenosum atypical a bullous paha: ʻIke ʻia kēia ʻano he mau pehu piha i ka wai. ʻIke pinepine ʻia ma nā lima. ʻOi aku ka maʻamau i nā poʻe me ka leukemia.
• Pustular pyoderma gangrenosum: ʻIke ʻia he mau pehu liʻiliʻi i piha i ka pus (pustules) ma nā lima a me nā wāwae. ʻOi aku ka maʻamau o kēia i nā poʻe me ka maʻi mumū o ka ʻōpū.
• ʻO ka pyoderma gangrenosum mea kanu: ʻAʻole ʻeha kēia ʻano lesion.

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai

ʻO ka Pyoderma gangrenosum kahi maʻi e hoʻomaka ana me nā pehu liʻiliʻi ma ka ʻili a hiki ke lilo koke i mau ʻeha nui. Hiki ke paʻakikī ke ʻike a mālama , no laila pono ʻoe a me kāu kauka e hoʻomanawanui.

E hoʻomanaʻo, he mea nui loa ia e makaʻala i kekahi ʻeha i kou ʻili, no ka mea, hiki i kēia ke alakaʻi i nā ʻeha hou.

Inā koʻikoʻi ka pyoderma gangrenosum a loaʻa iā ʻoe nā maʻi ʻē aʻe, hiki iā ia ke hōʻeha nui, ka ʻeha, a me nā pilikia e hoʻoweliweli ai i ke ola. No laila, inā loaʻa iā ʻoe kahi maʻi autoimmune a ke ʻike nei ʻoe i nā ʻeha ʻili e ulu wikiwiki ana, e ʻimi koke i ke kōkua lapaʻau. Hiki i ka ʻike mua a me ka mālama ʻana ke kōkua iā ʻoe e hoʻomaikaʻi. Mai hopohopo , akā e makaʻala.

ʻO Pyoderma Gangrenosum, Nā Maʻi ʻIli, Nā ʻEha, Nā Ulcers, ʻŌnaehana Palekana, Dermatology, Nā Maʻi Mau