Imajin se yu jɔs bigin fɔ tek nyu mɛrɛsin fɔ sɔm sik. Afta lɛk wan ɔ tu wik so, yu nɔ kin fil fayn, lɛk se yu de kam fɔ gɛt kol. Yu bɔdi de pen, yu de fil fiva, yu de shek... Dɔn wantɛm wantɛm, yu bɔdi bigin fɔ brok insay rɛd spat dɛn we de tɔn to wata blista smɔl smɔl, ɛn yu skin bigin fɔ kɔmɔt lɛk se dɛn dɔn bɔn yu. Dis na wan sik wae de mek pɔrsin frayd pasmak, wae de mek pɔrsin fil pen, ɛn kin put pɔrsin in layf pan denja. Tide wi de tɔk bɔt dis denja sik, we na Toxic Epidermal Necrolysis (TEN) .
Fɔ tɔk am simpul wan, wetin na Toxic Epidermal Necrolysis (TEN)?
Toxic Epidermal Necrolysis, ɔ TEN fɔ shɔt, na wan sik we de mek pɔsin fil pen bad bad wan ɛn we kin mek pɔsin in layf de pan denja. I kin mek blista ɛn pul big say dɛn na yu bɔdi, bɔku tɛm at le 30% pan yu bɔdi. dis pil kin apin bak na say dεm we gεt mכkus mεmbran, lεk di mכt, yay, εn di jεnital.
Dis denja sik kin apun bɔrku tɛm as siriɔs riakshɔn to sɔm mɛrɛsin dɛm wae wi kin tek. We di skin dɔn pwɛl dis bad bad wan, i kin gɛt bɔku risk fɔ mek yu nɔ gɛt wata ɛn gɛt siriɔs infɛkshɔn.
Fɔ tɔk tru, TEN na di kayn we we kin rili bad fɔ ɔda sik we dɛn kɔl Stevens-Johnson syndrome (SJS). insay SJS, lεs dan 10% pan di bכdi in skin de shed. we 10% to 30% pan di bכdi de afekt, wi kin kכl am SJS-TEN כvalap kכndishכn. If pas 30% pan di skin dεn shed, dεn kin tek am se na TEN.
Udat de pan denja fɔ gɛt dis sik?
Pipul wae gɛt wik imyun sistɛm kin gɛt Stevens-Johnson syndrome (SJS) ɔ TEN. Bɔku rizin dɛn de we mek di imyun sistɛm kin wik.
- Pipul dɛn we gɛt di sik we dɛn kɔl human immunodeficiency virus (HIV).
- Pipul wae gɛt sɔm kayn kansa, lɛk lymphoma.
Apat frɔm dat, tin dɛn we de mek pɔsin gɛt jɛnɛtiks kin ɛp bak. Sɔm pipul dɛn bɔdi nɔ kin ebul fɔ brok ɛn mɛtabolayz sɔm mɛrɛsin dɛn nɔmal wan. Dis na sɔntin we kɔmɔt frɔm dɛn jin. Insay dɛn kayn tin ya, dɛn drɔgs dɛn de kin gɛda na di bɔdi ɛn mek pɔsin gɛt siriɔs riakshɔn lɛk SJS ɔ TEN. Dɔn bak, bikɔs ɔf chenj (muteshɔn) na sɔm jin dɛm, sɔm pipul dɛn kin gɛt mɔ chans fɔ riak to sɔm drɔgs.
Pan ɔl we TEN kin apin pan ɛni ej, i kin apin mɔ pan pipul dɛn we dɔn ol. Bɔt, na wan sik we nɔ kin apin so ɔltɛm .I impɔtant fɔ mɛmba se na di wɔl, SJS ɛn TEN we dɛn jɔyn togɛda, na lɛk wan ɔ tu milyɔn pipul dɛn nɔmɔ kin afɛkt ɛvri ia.
Wetin na di men tin dɛn we kin mek pɔsin gɛt TƐN?
Bɔku tɛm, dɔktɔ dɛn kin biliv se sɔm mɛrɛsin dɛn na di men tin we kin mek pɔsin gɛt TEN. Lɛ wi tek wan luk pan us mɛrɛsin dɛn de pan ay risk.
| Kategori fɔ drɔgs | Simpul ɛksplen |
|---|---|
| Allopurinol we dɛn kɔl | Na mɛrɛsin we dɛn kin yuz fɔ mɛn sik dɛn lɛk kidni ston ɛn gaut. |
| Di tin dɛn we de mek pɔsin nɔ gɛt kɔnvuls | Wan klas ɔf drɔgs we dɛn kin gi fɔ kɔntrol kɔndishɔn lɛk fɔ sik. |
| Anti-rɛtrovayral drɔgs dɛn | Ɛspɛshali di drɔgs dɛn we dɛn kin yuz fɔ trit HIV infɛkshɔn (e.g. nevirapine). |
| Ɔksikam dɛn | Dis na wan klas fɔ pen kil ɛn anti-inflammatory drɔgs we de insay di grup fɔ NSAID. |
| Sɔlfɔnamid dɛn | Dis na wan kayn mɛrɛsin we de mek pɔsin gɛt antibayɔtik. |
Apat frɔm dɛn mɛrɛsin ya, na smɔl tɛm nɔmɔ, sɔm infɛkshɔn ɔ vaysin dɛn kin mek pɔsin gɛt TEN bak. Bɔt dis nɔ kin apin so ɔltɛm. Sɔntɛnde, dɛn nɔ kin ebul fɔ fɛn di tin we kin mek pɔsin gɛt TEN.
Wetin na di sayn dɛm fɔ TEN?
TƐN simptom dɛn kin bigin fɔ sho insay sɔm wiks afta dɛn dɔn bigin fɔ tek nyu mɛrɛsin. I kin bigin wit sayn dɛm we tan lɛk kol.
- Bɔdi pen
- Kɔf
- Fiva ɛn kol kol
- Ed de at
- Ay rɛd ɛn inflamɛns
Afta dɛn fɔs simptom ya, rɛd spat (rash) we de mek yu fil pen kin bigin fɔ apia na di skin. Dɛn spat ya kin big smɔl smɔl, tɔn to blista dɛn we ful-ɔp wit wata, ɛn leta di skin kin bigin fɔ kɔmɔt. di wund dεm we kin kכmכt we di skin kכl dεn kכl dεm erosion . Dis na wund dɛn we de mek pɔsin fil pen bad bad wan, we opin ɛn we tan lɛk se pɔsin dɔn bɔn bad bad wan.
Dɛn lɛsin ya kin apia fɔs na di fes ɛn chɛst, ɛn afta dat dɛn kin spre to ɔda pat dɛn na di bɔdi.
- Ay: Di insay pat pan di aylid (conjunctiva) ɛn di ɔda pat pan di blak yay (kɔnia) kin pwɛl.
- di mכkus mεmbran dεm: di lεsin kin apin insay di mכt, nos, trot, εn di say we yu de blo.
- Yurethral tract, anus, ɛn genitals: Dɛn say ya kin wund bad bad wan bak.
Dɛn injury ya kin mek ivin simpul wok dɛn lɛk fɔ it, fɔ swɛla, fɔ blo, fɔ lɔk yu yay, ɛn fɔ pis bad bad wan ɛn i nɔ kin izi fɔ yu.
Siriɔs kɔmplikɛshɔn dɛn we kin apin bikɔs ɔf TEN
TƐN nɔto kɔndishɔn we pɔsin fɔ tek am layt. I kin mek pɔsin gɛt siriɔs prɔblɛm dɛn we kin mek pɔsin in layf de pan denja.
- Infεkshכn: We di skin brok, chans de fכ mek jεm go insay di bכdi. If dɛn jem ya go insay di blɔd, wan sik we rili denja we dɛn kɔl sɛpsis kin apin.
- Bɔku ɔgan dɛn we nɔ de wok fayn: If yu gɛt siriɔs inflamɛns ɛn infɛkshɔn na di bɔdi, dat kin mek di ɔgan dɛn we de insay di bɔdi lɛk di kidni, di liva, ɛn di lɔng dɛn nɔ wok.
- Nyumonia: Di risk de fɔ gɛt lɔng infɛkshɔn bikɔs ɔf injury na di respiratory tract.
Bikɔs dɛn kayn bad bad prɔblɛm ya kin apin, pɔsin we gɛt TEN sik fɔ go na ɔspitul ɛn trit am wantɛm wantɛm .
Aw dɔktɔ dɛn kin no bɔt dis sik?
Bɔku tɛm, dɔktɔ we kwalifay kin no se yu gɛt TEN bay we i de chɛk yu skin ɛn aks bɔt yu sik dɛn. Sɔntɛnde, dɛn kin nid fɔ tek di skin bayɔpsi fɔ kɔnfirm di sik.
Dis involv fɔ tek wan rili smɔl pat pan di skin frɔm wan skin lɛshɔn ɔnda anestezi ɛn chɛk am ɔnda maykroskɔp. dis tεst kin si klia wan if dεd skin sεl dεm de (nεkrכtik sεl dεm) εn if di כp layεr na di skin (epidamis) dεn dכn separet frכm di lכw layεr.
Wetin na di tritmɛnt dɛm fɔ dis?
Di tin we impɔtant pas ɔl na dat, TEN na mɛdikal imejensi.Dis nɔto sik we pɔsin kin trit na os. Yu fɔ go na ɔspitul in Imejɛnsi Tritmɛnt Yunit (ETU) wantɛm wantɛm we di sik bigin.
Insay ɔspitul, bɔku tɛm dɛn kin admit di pɔsin na intensiv kia yunit (ICU) ɔ bɔn sɛnta, bikɔs dɛn sik pipul ya nid spɛshal kia we fiba di wan we dɛn kin gi pɔsin we dɔn bɔn.
Dɛn kin sheb di we aw dɛn kin trit am to tu men pat.
| Tritmɛnt opshɔn dɛn fɔ TEN | |
|---|---|
| Tritmɛnt wantɛm wantɛm | |
| Fɔ stɔp di mɛrɛsin we de mek pɔsin sik | Dɛn kin stɔp ɔl di mɛrɛsin dɛn we dɛn tink se de mek pɔsin gɛt TEN wantɛm wantɛm. |
| Kɔntrol fɔ di bɔdi wata lɛvɛl | Di skin we de kɔmɔt de mek bɔku bɔku wata kɔmɔt na di bɔdi. fכ dat, dεn de gi salin (IV fluid) tru wan vein fכ kכntro di bכdi in fכluid lεvεl. |
| Fɔ mek dɛn nɔ gɛt infɛkshɔn | Dɛn kin put antiseptik krim ɔ ɔntmɛnt pan wund dɛn we opin. Dɛn kin gi antibayɔtik di fɔs sayn dɛn we de sho se pɔsin gɛt di sik. |
| Ɔda patikyula tritmɛnt dɛn | |
| Imyun globulin (IVIG) . | Dis na wata we dɛn kin gi tru wan vein. I gɛt antibodi dɛn we dɛn tek frɔm di blɔd plasma fɔ pipul dɛn we gɛt wɛlbɔdi. Dɛn tin ya kin ɛp fɔ kɔntrol di bad bad tin dɛn we di bɔdi de du. |
| Di tin dɛn we de mek di bɔdi nɔ ebul fɔ fɛt di sik | Dɛn kin gi drɔgs fɔ stɔp di bɔdi in imyun sistɛm fɔ atak in yon sɛl dɛn, ɛn dis kin mek in wok wik. |
| Plasmafɛrɛsis we dɛn kin yuz | Dis min se dɛn kin sɛn di pɔsin in blɔd to wan spɛshal mashin, dɛn kin sheb ɛn pul di bad bad antibodi dɛn we de na di blɔd plasma, ɛn put di blɔd we dɛn dɔn klin bak na di bɔdi. |
Lɔng tɛm ifɛkt dɛn afta yu dɔn wɛl
Di wan dɛn we nɔ day pan TEN kin gɛt sɔm tin dɛn we kin apin fɔ lɔng tɛm. Ivin if di skin wɛl ɔl, ɔda prɔblɛm dɛn kin kam.
- Skin, ia ɛn nel: di nel we nɔ de gro ɔ we de shed, di skin gɛt spat (blak ɔ wayt), di ia we de lɔs na sɔm say dɛn (alopecia areata), di skin we dray ɛn it, we yu de swet pasmak.
- Ay: Di yay kin inflamɛns ɔ rɛd fɔ lɔng tɛm, di yay kin dray, di aylid nɔ kin fayn, i kin fil lɛk layt, i nɔ kin si fayn ɔ, i nɔ kin izi fɔ am, i kin blaynd.
- Mɔt, nos ɛn di we aw yu de blo: Bronchitis, lכng sik lεk COPD, dray mכt, gכm sik, lכs tεst εn smεl, lכng dεm we de pwεl.
- di urinary εn riprodaktiv sistεm: di injuri כ inflameshn fכ lכng tεm na di urethra, vagina, כ penis, i at fכ pis, di vagina dray na uman.
I rili impɔtant fɔ tɔk to yu dɔktɔ bɔt dɛn tin ya we kin apin to yu fɔ lɔng tɛm ɛn fɔ fɛn di tritmɛnt we yu nid.
Mɛsej we dɛn kin kɛr go na os
- Toxic Epidermal Necrolysis (TEN) na wan tin we rili bad, we kin mek pɔsin in layf de pan denja we pɔsin tek sɔm mɛrɛsin dɛn.
- I kin bigin wit kɔmɔn sayn dɛm lɛk fiva ɛn bɔdi pen, bɔt afta dat i kin go bifo to blista we de pen ɛn we de pul di skin lɛk se i dɔn bɔn.
- Dis na mɛdikal imejensi. If yu gɛt dɛn sik ya, yu fɔ go na ɔspitul in Imejɛnsi Tritmɛnt Yunit (ETU) wantɛm wantɛm.
- If yu gɛt rɔsh na yu skin, yu gɛt blista, ɔ ɔda tin dɛn we nɔ kɔmɔn afta yu dɔn bigin fɔ tek nyu mɛrɛsin, nɔ ɛva ignore am. Si yu dɔktɔ wantɛm wantɛm.
- If yu bin dɔn gɛt alɛji fɔ ɛni mɛrɛsin bifo, mek shɔ se yu tɛl yu dɔktɔ bɔt dis ɛnitɛm we yu go fɔ tek mɛrɛsin.
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