Khawsik i nei a, i taksa a na a, doctor-in damdawi a pek i ei tan ang tih han ngaihtuah teh. Ni engemaw zat chhungin, kar khat emaw kar hnih emaw pawh ni se, i taksaah hmun sen i lo awm nghal a, i hmui chhungah te, i mitmengah te, leh i serh chhungah te hliam i nei a, i vun chu kang ang maiin a lo hring chhuak a, a lo hring chhuak tan a nih chuan engtin nge ni ang? Hei hi thil hlauhawm tak, hlauhawm tak leh hmuh tur awm lo tak a ni tak zet a ni. Vawiin hian he natna Stevens-Johnson Syndrome (SJS) tih hi kan sawi dawn a ni. Hei hi mi zawng zawngin kan hriat chian a pawimawh hle.
SJS leh TEN te hi eng nge ni? An pahnih inthlauhna chu eng nge ni?
Stevens-Johnson Syndrome (SJS) hi hypersensitivity reaction na tak a ni a, a tlangpuiin damdawi pakhatah a awm thin. Kan vun leh mucous membrane te a tichhia a, chu chuan cell te a thi a, vun a tifai bawk. Mucous membrane hi kan hmui, hnar, mit, serh leh hnute line-a awm, nalh tak, hnim hring (moist membrane) a ni.
Hetiang natna khirh tak dang a awm a, chu chu Toxic Epidermal Necrolysis (TEN) kan ti a ni. A awlsam zawngin sawi ila, SJS leh TEN hi natna pakhata a sir hnih ang mai an ni.
- SJS (Stevens-Johnson Syndrome): Hetiang a nih chuan , taksa vun chunglam 10% aia tlem lo chu a slough off a ni.
- TEN (Toxic Epidermal Necrolysis): Hei hi natna khirh tak leh nunna atana hlauhawm tak a ni a, taksa vun 30% aia tam a bo a ni.
Heng dinhmun pahnih hi a na hle a, chuvangin damlo chu damdawi inah dah a ngai a , a châng chuan intensive care unit (ICU) emaw burn unit emaw-ah dah a ngai bawk.
He natna hi tuin nge vei tam ber?
SJS hi kum eng pawhah a awm thei a, mahse naupang leh tleirawl kum 30 hnuai lam zingah a tam ber a, kum upa zawkah pawh a awm thei bawk. SJS hi mipa aiin hmeichhiaah a tam zawk deuh.
A chhan kan en hian a danglamna tlem a awm:
- Naupangte zinga SJS vei chhan ber chu natna hrik kai theihna pneumonia ang chi a ni .
- Puitlingah SJS/TEN awm chhan ber chu damdawi pakhat allergy vang a ni .
SJS natna lan chhuah dan dik tak chu engte nge ni?
Heng symptoms te hi hriat chian a pawimawh hle a, a chhan chu i hriat hma poh leh enkawlna i zawng thuai thei a ni. Damdawi ei tan atanga kar khat emaw kar thum emaw chhungin natna lan chhuah dan a lang tlangpui.
A lan chhuah hmasak ber chu khawsik natna tlangpui, khawsik, taksa na, lu na, khuh te hi a ni. Hei hian a tir lamah SJS hmuhchhuah a ti harsa hle. Chumi hnuah chauh chuan vun natna khirh tak tak a lo lang thin.
A hnuaia tarlan te hi SJS natna lan chhuah dan tlangpui tarlan a ni.
| Symptom a ni | A awlsam zawngin sawifiah a ni |
|---|---|
| Vun natna nasa tak | I vun khawih theih loh khawpa kang natna nasa tak hriat. |
| Khawsik leh taksa na | A lan chhuah dan chu khawsik sang, taksa na, leh lu na te a ni. |
| Hmun sen leh patch te | Hmai leh rilru atanga intan leh taksa pum huapa darh chhuak, hliam sen emaw, hliam emaw a awm. |
| Blisters leh hliam te | Vun, ka chhung, ka chhung, mit, mipat hmeichhiatna leh rectum-a hliam leh hliam na tak tak te. |
| Vun peeling | A blisters chu a puak a, vun chunglam layer chu flake lian takah a inher chhuak thin. |
| Kawng atanga hmui chhuak chhuak | Kawng ulcer avanga tui chhuak, hmui khar theih loh. |
| Mit hmanga inhnaih | Mit ah hian blister leh swelling a awm a, mit hawn a harsa hle. |
| Zun laiin natna | Zun laiin natna nasa tak a awm a, chu chu mucous membranes a blister vang a ni. |
SJS thlen theihna chhan ber leh damdawi chi hrang hrang
SJS thlentu ber chu damdawi pakhat allergy vang a ni. Mahse, ruihhlo zawng zawngah hetiang hi a thleng lo. SJS thlen theihna tur damdawi chi hrang hrang a awm a.
| Chhan | Hrilhfiahna |
|---|---|
| Damdawi avanga allergy nei | Hei hi SJS leh TEN case tam zawk chhan a ni. |
| Infection awm thei te | A bik takin naupangte tan chuan natna hrik, Mycoplasma pneumonia, Herpes, leh Hepatitis A te avanga lo awm thei a ni. |
| Chhan dang | Graft-versus-host disease, ruhro (bone marrow transplant), vaccine (a tlem hle) hnua lo awm thin, a chang chuan a chhan hmuh tur a awm lo. |
SJS thlen theihna chance sang zawk damdawi
- Antibacterial sulfa damdawi: Antibiotics chi thenkhat.
- Epileptic dona damdawi: Entirnan, damdawi te chu `Phenytoin (Dilantin®)`, `Carbamazepine (Tegretol®)`, `Lamotrigine (Lamictal®)`, `Phenobarbital (Luminal®)` te hi a ni.
- Allopurinol: Gout leh kal lung chi thenkhat (`Aloprim®`, `Zyloprim®`) enkawlna atana hman thin damdawi a ni.
- Natna tidamtu (NSAIDs): Steroid hmang lo natna tidamtu te chu `Piroxicam (Feldene®)`, `Diclofenac (Cambia®, Flector®)` te hi a ni. Damdawi dang `Nevirapine (Viramune®)` ang chi te.
- Antibiotics dang: Antibiotics chi dang thenkhat pawhin hetiang hi a thlen thei bawk.
Pawimawh: Heta damdawi tarlan atang hian mi zawng zawngin SJS an nei vek dawn lo. Mi maktaduai tam takin an hmang a ni. Mahse, heng damdawi te hi SJS vei theihna a sang zawk tih hmuhchhuah a ni. He thuziak atanga doctor-in a pek damdawi ei hi titawp ngai suh.
Natna hriatchhuah leh enkawl dan
Nangmah emaw, i hriat mi emaw chuan a chunga kan sawi ang chite hi i neih chuan, a bik takin damdawi thar i ei tan chauh a nih chuan, damdawi in hnai ber Emergency Department (ETU) pan nghal a pawimawh hle
Doctor-te chuan he natna hi hetiang hian an hmuchhuak thin:
- I vun leh i mucous membrane (kawng, mit ang chi) enfiahin.
- I natna level zawtin.
- Skin symptoms darh chak dan leh a darh dan enin.
- A tul chuan vun te tak te lak a, enfiah (skin biopsy) theih a ni.
SJS enkawl dan tur
SJS enkawlna atana thil tum ber chu natna thlentu damdawi tihtawp te, a natna lan chhuah dan control te, harsatna awm thei venna te, vun dam lehna tura puih te hi a ni. Chumi atan chuan damdawi ina dah ngei ngei tur a ni.
Enkawl dan thenkhat chu a hnuaia mi ang hian tarlan a ni:
| Enkawl dan tur | Hrilhfiahna |
|---|---|
| Causative drug hman tawh loh | Hei hi a hmasa ber leh a pawimawh ber a ni. SJS thlentu nia rinhlelh ruihhlo chu tihtawp nghal a ni. |
| Taksa tana tui leh chi (salt) pek | Skin peeling hian taksa atanga tui tam tak a bo a, chuvangin IV fluids hmangin tui leh electrolyte mamawh tak tak an pe chhuak thin. |
| Vun enkawl dan | Hliam vun chu kangmei enkawlna ang bawkin non-adhesive dressing bik hmanga khuh a ni. |
| Ei leh in pekna | Kawng a nat avangin ei a harsa hle. Dam nan chakna tam tak a mamawh avangin calorie tamna ei tur chu hnar atanga pum chhunga kal (tube-feeding) kaltlangin tube hmangin pek thin a ni. |
| Natna control | Hei hi a na em em a, chuvangin natna tidam thei damdawi chak tak tak an pe thin. |
| Specialist damdawi lam service a ni | Dermatologist tanpuina la la, mit a nghawng chuan mit lam doctor tanpui rawh. |
SJS natna leh a dam leh hnua a nghawng dan
SJS hi natna khirh tak a ni a, thihna thlengin a thlen thei a ni. SJS vei zinga 10% vel leh a na zawk, TEN vei zinga 50% thleng an thi a ni. Thihna thlentu ber chu harsatna na tak tak, sepsis, pneumonia, leh multiple organ failure te a ni.
Natna hi tihdam a nih pawhin mi thenkhat chuan hun rei tak chhung nghawng a nei thei a ni.
- Vun inthlak danglam: Vun a vawt, a hring, vun rawng a danglam.
- Mit lama harsatna: mit a vawt, mit a na fo, mit a fiah lo, êng en harsa (photophobia).
- Thil dang: Thawmhnaw tam lutuk, lung chhiatna, nail hloh emaw deformity emaw, sam tlakchham, thlum tihbuai.
Pawimawh tak: SJS thlentu damdawi i ei leh chuan a vawi hnihnaah chuan a hmasa aiin a na zawk thei hle. Chuvangin, SJS leh a ang chi damdawi thlentu damdawi hming hi i dam chhung zawng hriat reng a, doctor i hmuh apiang hriattir zel a pawimawh hle.
Take-Home Thuchah a ni
- Stevens-Johnson Syndrome (SJS) hi vun natna khirh tak, nunna atana hlauhawm tak a ni a, a tlangpuiin damdawi avanga lo awm a ni.
- A tir lamah chuan khawsik leh taksa na te a ni a, mahse a hnuah chuan vunah natna sen hring, vun hring, leh vun hring hring (peeling skin) thlengin a lo lang leh thin.
- Damdawi thar i tan hnua heng symptoms te hi i neih chuan damdawi in Emergency Department (ETU) ah tihkhawtlai lohvin kal nghal mai tur a ni.
- Enkawlna ber chu natna thlentu damdawi hriatchhuah leh tihtawp a ni a, damdawi inah pawh supportive care pek a ni.
- I dam chhung zawnga i SJS thlentu damdawi hming kha hre reng la, enkawl tura i kal apiangin i doctor hnenah hriattir thin ang che. Hei hian i nunna a chhanhim thei a ni.
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