I vun chu a sen nghal vat a, a blister a, a peel nghal em? He Stevens-Johnson Syndrome (SJS) hlauhawm tak hi i zir dawn teh ang?

I taksaah hian vun rawng a rawn sen nghal vat a, a hring ang maiin a lang a, chutah chuan blisters a lo lang a, vun chu a lo chhuak ta tih i hmu tawh em, i chungah a thleng tawh em? Heng hliamte hi ka chhungah te, mit chhungah te, serh chhungah te pawh a lang thei bawk. Hei hi thil awlsam tak a ni lo va, damdawi ina dah nghal ngai natna khirh tak a ni thei bawk . Vawiin hian he natna Stevens-Johnson Syndrome (SJS) tih hi kan sawi dawn a ni.

Stevens-Johnson Syndrome (SJS) hi eng nge ni?

A awlsam zawngin sawi ila, Stevens-Johnson Syndrome (SJS) leh Toxic Epidermal Necrolysis (TEN) te hi vun natna khirh tak tak pahnih an ni. Chutah chuan i vunah hian rang takin a sen, itchy bumps a lo awm tan a, chu chu blister leh peel off a ni. I mit, mipat hmeichhiatna leh i hmui chhunga mucous membrane te pawh a nghawng thei bawk. Hetiang dinhmun hi i neih chuan damdawi inah enkawl i ngai ngei ang.

Doctor thenkhat chuan SJS leh TEN hi natna hran pahnihah an ngai a, thenkhat chuan natna pakhat stage hrang hrangah an ngai thung. SJS hi TEN aiin a na lo deuh a ni. Entirnan, SJS-ah chuan taksa pum puia vun 10% aia tlem lo a bo thei. TEN ah chuan vun 30% aia tam a bo thei. Mahse, heng dinhmun pahnihte hi nunna atana hlauhawm thei a ni tih hriat reng a pawimawh .

SJS hian eng hming dang nge a neih?

Ni e, hei hi hming dang engemaw zatin an ko bawk. Entir nan:

• Lyell-a natna (Syndrome) a ni
• Stevens-Johnson syndrome/toxic epidermal necrolysis natna avanga natna hrik awm thei
• Stevens-Johnson syndrome toxic epidermal necrolysis spectrum atanga lo chhuak a ni

A châng chuan, a chhan a zirin a hming a inthlâk ṭhîn. Damdawi pakhat avanga lo awm a nih chuan ``drug-induced Stevens-Johnson syndrome'' tia sawi theih a ni a, ``Mycoplasma'' tih hming pu infection avanga lo awm a nih chuan ``mycoplasma-induced Stevens-Johnson syndrome'' tia sawi theih a ni bawk.

Tute nge SJS vei duh zawk?

SJS hi tleirawl kum 30 hnuai lam leh naupang tê têah hmuh tam ber a ni. Mahse, kum eng pawhah a awm thei a, a bikin tarteah a awm thei. Hmeichhia hian mipa aiin SJS an vei tam zawk.

Ngaihtuah teh, naupang tê pakhatin pneumonia ang chi natna a vei a, chutah hetiang vun lama harsatna a neih chuan... SJS a ni thei. Naupangte SJS thlentu ber chu pneumonia ang chi natna hrik a ni. Mahse puitlingah chuan SJS/TEN hi an damdawi ei vang a ni ber.

SJS vei theihna tur risk factors te chu engte nge ni?

He natna hi chhan pakhat mah a awm lo va, thil hrang hrang inzawmkhawm a ni. Chung zinga pawimawh ber chu genetic predisposition a ni. Chu chu i genes hian nghawng engemaw zat a nei thei tihna a ni. Environment factor thenkhat pawhin chu genes te chu a tichak thei bawk. Chung genetic factors zinga pakhat chu kan taksa peng bik `(Human Leukocyte Antigens - HLAs) an tih hi a ni. Heng `(HLAs)` chi hrang hrang nei te hi midang aiin SJS emaw TEN emaw vei an hlauhawm zawk.

SJS natna lan chhuah dan chu engte nge ni?

SJS-ah hian symptom engemaw zat a awm thei. Hengte hi hriat chian a pawimawh:

• Vun natna nasa tak: Pakhatnaah chuan vun a na tan a.
• Khua: Khawsik i nei a.
• Taksa na: I taksa pum a na ang maiin i hria.
• Vunah hian a sen emaw, a hring emaw a awm: Vunah hian a sen emaw, a hring emaw a lo lang thin.
• Khuh.
• Blisters leh sores: Blisters leh sores hi vunah chauh ni lovin, hmui, kawr, mit, serh, leh rectum ang hmunah te pawh mucous membrane-ah a awm thei bawk. Ngaihtuah teh, ka chhunga hliam hian ei mai ni lovin thusawi pawh a ti harsa hle.
• Vun a hring (Peeling of the skin): Vun hi a hring (blisters) atang hian a chhuak chhuak thin.
• Drooling: Kawng natna avang hian i hmui i hup theih loh chuan hmui a chhuak thin.
• Mitmeng a hring: Mit a hring leh a hring chhuak hian mit a ti na a, a hawng thei lo.
• Zun laiin natna: Mucous membranes-a blister awm hian zun laiin natna nasa tak a thlen thin.

Damdawi thar i ei tan a, ni engemaw zat chhungin i dam lo a, i khawsik a, i na a, chutah rang takin i vunah hmun sen a lo lang a, blisters a lo lang ta ang... Chutih lai chuan hei hi SJS a ni tih i rinhlelh tan tur a ni.

SJS hi eng thilin nge a thlen?

SJS hi a chhan lian ber ber engemaw zat a awm a:

• Damdawi pakhata allergic reaction: Hei hi SJS tam zawk leh TEN case zawng zawng thlentu ber a ni. Hei hi damdawi i ei tur dose i miss a nih chuan a thleng thei.
• Hri kai: Entirnan, Mycoplasma pneumonia, Herpes virus, leh Hepatitis A te ang chi natna.
• Graft-versus-host disease: Hei hi a bik takin ruhro thlak hnua lo awm thei a ni.
• A chhan hmuh tur a awm lo: A châng chuan SJS hi a chhan chiang tak awm lovin a lo awm thei bawk.

Damdawi avanga SJS i neih chuan damdawi i ei tan atanga kar khat, kar hnih emaw kar thum chhungin symptoms a lang tan tlangpui. Khawsik, khuh, leh lu na atanga i tan thei a, chu chu vun rawng leh vun rawng chhuakin i rawn zui thei bawk. TEN vei thenkhatah chuan sam leh nail te pawh a tla thei. A tlem hle a, SJS hi tun hnaia vaccine pek avanga lo awm nia sawi a ni.

Eng damdawi nge SJS thlentu ber?

Damdawi thenkhat SJS thlen theihna sang zawk an awm. Chung zingah chuan:

• Antibacterial sulfa damdawi a ni.
• Epileptic damdawi: Entirnan Phenytoin (Dilantin®), Carbamazepine (Tegretol®), Lamotrigine (Lamictal®), leh Phenobarbital (Luminal®) te hi a ni.
• `(Allopurinol (Aloprim®, Zyloprim®))`: Hei hi Gout leh kal lung natna tan damdawi hman a ni.
• Non-steroidal anti-inflammatory drugs (NSAIDs): Entirnan, Piroxicam (Feldene®), Nevirapine (Viramune®), leh Diclofenac (Cambia®, Flector®) te hi a ni.
• Antibiotics dang pawh a awm bawk.

Pawimawh: Heng damdawi ei zawng zawng hian SJS an nei vek dawn tihna a ni lo. Mahse, heng damdawi te hian SJS vei theihna a tipung tih hmuhchhuah a ni.

SJS vei theihna tipungtu thil dang a awm em?

Ni e, SJS vei theihna tipungtu dinhmun dang engemaw zat a awm bawk. Anni chu:

• Bone marrow transplant a neih tawh avangin.
• `(Systemic lupus erythematosus - SLE)` ang chi autoimmune natna nei.
• Mihring immunodeficiency virus (HIV) hrik kai a ni.
• Joint leh connective tissue natna dang.
• Ngawt.
• Immune system chak lo tak neih.
• I chhungkuaa mi pakhatin SJS (family history) a lo vei tawh a nih chuan.
• Gene bik pakhat ``Human Leukocyte Antigen-B - HLA-B'' tih hming pu variant neih.

Engtin nge doctor-te hian he SJS natna hi an hriat theih?

Doctor-te chuan SJS leh TEN hi hengte hi ngaihtuahin an hmuchhuak thin:

• Vun leh mucous membrane natna enfiah: A tlangpuiin mucous membrane pahnih tal a nghawng thin.
• I natna level a zirin.
• I vun a nghawng rang dan azirin.
• I vun a nghawng dan a zirin.
• Skin biopsy: A chang chuan vun sample te tak te lak a ni a, microscope hmangin enfiah a ni a, a natna hriat chian a ni.

SJS hi engtin nge enkawl a nih?

SJS hi damdawi ina dah nghal a ngai a, enkawl nghal a ngai a ni. In lama enkawl tum hian a natna a tizual thei a ni. A hnuaia mite hi a enkawl dan thenkhat chu an ni:

• Buaina thlentu nia ngaih damdawi ei kha titawp nghal rawh: Hei hi tih hmasak ber a ni.
• Intravenous (IV) fluids to restore electrolytes: Hei hi vun a chhuah ruala taksa atanga tui hloh control nan tih a ni.
• Vun natna hmunah non-adhesive dressing hnawih.
• Dam chakna atana calorie tamna ei tur pek: A châng chuan, tube-feeding a ngai mai thei.
• Infection laka inven nan a tul chuan antibiotics pek.
• Painkiller pek a ni.
• Damdawi inah enkawl a ni a, Intensive Care Unit (ICU) emaw Burn Unit-ah emaw pawh a ni thei.
• Specialist team Dermatology leh Ophthalmology (mit a nghawng chuan) atanga tanpuina dil.
• A then phei chuan enkawlna bik IV immunoglobulin, cyclosporine, IV steroids, emaw amniotic membrane grafts (mit tan) te pawh pek theih a ni.

SJS avanga harsatna awm thei te chu engte nge ni?

SJS leh TEN hi natna khirh tak a nih avangin harsatna a thlen nasa thei hle.

• Thihna: Hei hi harsatna lian ber a ni. SJS vei zinga 10% vel leh TEN vei zinga 50% vel chu an thi thei a ni.
• Pneumonia natna (Pneumonia) a ni.
• Sepsis: Hei hi bacteria infection na tak a ni a, thisen rimchhia nen a inang.
• Shock state `(Shock)` tih a ni.
• Organ tam tak a tlakchhiat.

Heng harsatna na tak tak avang hian SJS/TEN condition te hian damdawi ina dah nghal a ngai thin.

SJS hi ven theih a ni em?

Dik tak chuan a tam zawkah chuan SJS hi ven theih a ni lo. Damdawi pakhat avanga beisei loh taka thil thleng vang a nih fo avangin damdawi ei hmain hetiang hi a thleng dawn em tih hriat theih a ni lo.

Mahse, ruihhlo vanga natna i vei nia hriat i nih chuan a pawimawh ber chu chu damdawi emaw, chutiang damdawi chi khat emaw chu hmang tawh ngai lo tur a ni. Hemi chungchang hi i doctor hriattir a, i medical record-a record a pawimawh hle.

SJS vei tan chuan eng nge a hmalam hun? (Hmuh dan tur) .

SJS vei zawng zawng hian symptom inang an nei vek lo. Mi thenkhat chu kar tlemte chhungin an dam leh thin. Mahse, symptoms a nasat chuan a dam kim theih nan thla tam tak a ngai thei. Mi thenkhat chuan hun rei tak chhung nghawng a nei thei. Entir nan:

• Vun: Vun a vawt, a hring, vun rawng a danglam.
• Mit: Mit a hring leh/ emaw a vawt fo, mit a na fo, mit a fiah lo, êng a sensitive (photophobia).
• Thaw hah lutuk.
• Lung chhiatna: Chronic obstructive pulmonary disease (COPD), asthma ang chi natna.
• Nail tla emaw, a chhe emaw.
• Sam tlakchham (Alopecia).
• Mucous membranes a vawt: Hei hian zun harsatna ang chi thil a thlen thei.
• Chronic fatigue syndrome tih hi a ni.
• Taste a inthlak danglam thin.

Pawimawh tak chu, chu mi chu a tir atanga SJS thlentu damdawi a ei leh chuan natna hi a lo lang leh thei a ni. Chutiang a nih chuan a vawi hnihnaah chuan a natna lan chhuah dan chu a na zawk tlangpui.

SJS vei 10% vel leh TEN vei 30% vel an thi a, hei hi sepsis, acute respiratory distress syndrome (ARDS), leh multiple organ failure vang a ni ber.

Kan sawi tawh (Take-Home Message) atanga i hriat reng tur thenkhat chu hetiang hi a ni:

Okay, chuvangin he SJS an tih dinhmun hlauhawm tak hi kan sawi nasa hle. I hriat reng tur thenkhat chu hetiang hi a ni:

• Stevens-Johnson Syndrome (SJS) leh Toxic Epidermal Necrolysis (TEN) te hi vun natna a na hle a, nunna atana hlauhawm tak pawh a ni.
• Damdawi thar i ei hnuah, a bik takin kar khat emaw kar hnih emaw chhunga vun natna, vun sen, vun hring, vun hring, emaw hmui emaw mit na emaw ang chi symptoms i neih chuan doctor lam pan nghal rawh. SJS a ni thei.
• Damdawi pakhat allergy emaw, adverse reaction na tak emaw i neih tawh chuan doctor hnenah hrilh fo ang che.
• SJS thlentu nia hriat damdawi emaw, a ang chi emaw hmang tawh ngai suh.**
• Hetiang dinhmun hi i rinhlelh chuan in lamah awm lo la, damdawi in pan nghal rawh. Enkawlna rang tak chuan i nunna a chhanhim thei a ni.

He thu hi i tan a tangkai ngei ka beisei. Hrisel takin awm rawh!

` Stevens-Johnson Syndrome, SJS, Toxic Epidermal Necrolysis, TEN, Vun natna, Allergy, Damdawi side effects, Blisters, Vun natna, Vun natna