Kodi khungu lanu limafiira mwadzidzidzi, limatupa, komanso limatuluka? Tiyeni tiphunzire za matenda oopsa a Stevens-Johnson Syndrome (SJS)?

Kodi munayamba mwawonapo, kapena zinakuchitikiranipo, kutupa kwadzidzidzi m'thupi lanu komwe kumasanduka kofiira, kumawoneka ngati kutupa, kenako matuza amaonekera ndipo khungu limatuluka? Matuza amenewa amathanso kuwonekera mkamwa, m'maso, komanso m'malo oberekera. Ichi si chinthu chophweka, ndipo chingakhale vuto lalikulu lomwe limafuna kugonekedwa kuchipatala nthawi yomweyo . Lero, tikambirana za vuto ili lotchedwa Stevens-Johnson Syndrome (SJS).

Kodi Stevens-Johnson Syndrome (SJS) ndi chiyani?

Mwachidule, Stevens-Johnson Syndrome (SJS) ndi Toxic Epidermal Necrolysis (TEN) ndi matenda awiri akuluakulu a pakhungu. Chomwe chimachitika ndichakuti khungu lanu limayamba mwadzidzidzi kukhala ndi ziphuphu zofiira, zoyabwa, zomwe kenako zimatuluka matuza ndi kutuluka. Zingakhudzenso maso anu, ziwalo zoberekera, ndi nembanemba mkamwa mwanu. Ngati mukukumana ndi matendawa, muyenera kugonekedwa kuchipatala kuti mukalandire chithandizo.

Madokotala ena amaona kuti SJS ndi TEN ndi matenda awiri osiyana, pomwe ena amati ndi magawo osiyana a matenda omwewo. SJS ndi mtundu wochepa pang'ono wa matendawa poyerekeza ndi TEN. Mwachitsanzo, mu SJS, khungu lochepera 10% la thupi lonse limatha kutayika. Mu TEN, khungu loposa 30% limatha kutayika. Komabe, ndikofunikira kukumbukira kuti matenda onsewa akhoza kukhala oopsa .

Kodi SJS ili ndi mayina ena ati?

Inde, imatchedwa ndi mayina ena angapo. Mwachitsanzo:

• Matenda a Lyell
• Matenda a Stevens-Johnson/toxic epidermal necrolysis
• Matenda a Stevens-Johnson otchedwa toxic epidermal necrolysis spectrum

Nthawi zina, dzina limasintha kutengera chifukwa chake. Ngati chayambitsidwa ndi mankhwala enaake, chingatchedwe kuti ``drug-induced Stevens-Johnson syndrome'', ndipo ngati chayambitsidwa ndi matenda otchedwa ``Mycoplasma'', chingatchedwe kuti ``mycoplasma-induced Stevens-Johnson syndrome''.

Ndani amene ali ndi mwayi waukulu wopeza matenda a SJS?

Matenda a SJS nthawi zambiri amapezeka mwa achinyamata osakwana zaka 30 komanso mwa ana aang'ono. Komabe, amatha kuchitika mwa anthu azaka zilizonse, makamaka okalamba. Azimayi ndi omwe ali ndi mwayi waukulu wodwala matenda a SJS kuposa amuna.

Tangoganizirani, ngati mwana wamng'ono atenga matenda monga chibayo kenako n’kuyamba vuto la khungu ngati ili... likhoza kukhala SJS. Chifukwa chachikulu cha SJS mwa ana ndi matenda monga chibayo. Koma mwa akuluakulu, SJS/TEN imayamba chifukwa cha mankhwala omwe amamwa.

Kodi ndi zinthu ziti zomwe zimayambitsa matenda a SJS?

Palibe chifukwa chimodzi chomwe chimayambitsa matendawa, koma kuphatikiza kwa zinthu. Chofunika kwambiri mwa izi ndi momwe majini anu amakhalira. Izi zikutanthauza kuti majini anu akhoza kukhala ndi mphamvu zina. Zinthu zina zachilengedwe zimatha kuyambitsa majini amenewo. Chimodzi mwa zinthuzi ndi ziwalo zapadera za thupi lathu zotchedwa `(Human Leukocyte Antigens - HLAs). Anthu omwe ali ndi mitundu ina ya `(HLAs)` ali pachiwopsezo chachikulu chotenga matenda a SJS kapena TEN kuposa ena.

Kodi zizindikiro za SJS ndi ziti?

Pali zizindikiro zingapo zomwe zingachitike mu SJS. Ndikofunikira kudziwa izi:

• Kupweteka kwambiri pakhungu: Choyamba, khungu limayamba kupweteka.
• Malungo: Muli ndi malungo.
• Kupweteka kwa thupi: Kumamva ngati thupi lanu lonse likupweteka.
• Madontho ofiira kapena madontho pakhungu: Madontho ofiira kapena madontho amaonekera pakhungu.
• Chifuwa.
• Matuza ndi zilonda: Matuza ndi zilonda sizingachitike pakhungu lokha, komanso pa nembanemba ya mucous m'malo monga pakamwa, pakhosi, m'maso, m'mimba, ndi m'matumbo. Tangoganizirani, zilonda zomwe zili m'kamwa zimapangitsa kuti zikhale zovuta osati kungodya kokha komanso kulankhula.
• Kuchotsa khungu: Khungu limachotsa matuza.
• Kutulutsa madzi m'kamwa: Chifukwa cha zilonda mkamwa, malovu amatuluka mukalephera kutseka pakamwa panu.
• Kutupa kwa zikope: Matuza ndi kutupa m'maso kumapangitsa maso kutupa kwambiri moti sangathe kutsegulidwa.
• Ululu pokodza: ​​Matuza m'matumbo a mucous amayambitsa ululu waukulu pokodza.

Tangoganizani kuti mwayamba mankhwala atsopano, ndipo patangopita masiku ochepa mukumva kusasangalala, kutentha thupi, ndi kupweteka, kenako mwadzidzidzi mawanga ofiira amaonekera pakhungu lanu ndipo matuza amaonekera... Pamenepo ndi pomwe muyenera kuyamba kukayikira kuti iyi ndi SJS.

Kodi chimayambitsa matenda a SJS ndi chiyani?

Pali zifukwa zingapo zazikulu za SJS:

• Kusamva bwino kwa mankhwala: Ichi ndiye chifukwa chachikulu cha matenda ambiri a SJS ndi matenda onse a TEN. Izi zitha kuchitika ngati mwaphonya mlingo wa mankhwala omwe mukumwa.
• Matenda: Mwachitsanzo, matenda monga Mycoplasma pneumonia, Herpes virus, ndi Hepatitis A.
• Matenda a graft-versus-host: Imeneyi ndi vuto lomwe lingachitike, makamaka pambuyo poika mafupa enaake.
• Palibe chifukwa chopezeka: Nthawi zina SJS imatha kupangika popanda chifukwa chodziwika bwino.

Ngati muli ndi SJS chifukwa cha mankhwala, zizindikiro zake nthawi zambiri zimayamba kuonekera mkati mwa sabata imodzi, ziwiri, kapena zitatu mutayamba kumwa mankhwalawo. Mungayambe ndi malungo, chifuwa, ndi mutu, kenako ziphuphu pakhungu ndi kutuluka. Kwa anthu ena omwe ali ndi TEN, tsitsi ndi misomali zimatha kugwa. Nthawi zambiri, SJS yanenedwa kuti imayambitsidwa ndi katemera waposachedwa.

Ndi mankhwala ati omwe angayambitse matenda a SJS?

Pali mankhwala ena omwe ali ndi chiopsezo chachikulu choyambitsa matenda a SJS. Izi zikuphatikizapo:

• Mankhwala oletsa mabakiteriya a sulfa.
• Mankhwala oletsa khunyu: Zitsanzo zake ndi monga Phenytoin (Dilantin®), Carbamazepine (Tegretol®), Lamotrigine (Lamictal®), ndi Phenobarbital (Luminal®).
• `(Allopurinol (Aloprim®, Zyloprim®))`: Iyi ndi mankhwala omwe amagwiritsidwa ntchito pochiza gout ndi miyala ya impso.
• Mankhwala oletsa kutupa omwe si a steroidal (NSAIDs): Zitsanzo zake ndi Piroxicam (Feldene®), Nevirapine (Viramune®), ndi Diclofenac (Cambia®, Flector®).
• Mankhwala ena opha tizilombo.

Chofunika: Izi sizikutanthauza kuti aliyense amene amamwa mankhwalawa adzakhala ndi matenda a SJS. Komabe, mankhwala amenewa apezeka kuti akugwirizana ndi chiopsezo chowonjezeka cha matenda a SJS.

Kodi pali zinthu zina zomwe zimawonjezera chiopsezo cha matenda a SJS?

Inde, pali matenda ena omwe amawonjezera chiopsezo cha matenda a SJS.

• Ataikidwa mafupa.
• Kukhala ndi matenda a autoimmune monga `(Systemic lupus erythematosus - SLE)`.
• Matenda a kachilombo ka HIV (human immunodeficiency virus).
• Matenda ena osatha a mafupa ndi minofu yolumikizana.
• Khansa.
• Kukhala ndi chitetezo chamthupi chofooka.
• Ngati wina m'banja mwanu adadwalapo kale matenda a SJS (mbiri ya banja).
• Kukhala ndi mtundu wina wa jini yotchedwa ``Human Leukocyte Antigen-B - HLA-B''.

Kodi madokotala amazindikira bwanji matenda a SJS awa?

Madokotala amazindikira matenda a SJS ndi TEN poganizira zinthu izi:

• Kuwunika khungu ndi ma mucous nembanemba zomwe zakhudzidwa: Nthawi zambiri ma mucous nembanemba awiri kapena kuposerapo amakhudzidwa.
• Kutengera ndi kuchuluka kwa ululu womwe mukumva.
• Kutengera momwe khungu lanu linakhudzidwira mwachangu.
• Kutengera ndi momwe khungu lanu lakhudzidwira.
• Kufufuza khungu: Nthawi zina, khungu laling'ono limatengedwa ndikuyang'aniridwa pogwiritsa ntchito maikulosikopu kuti atsimikizire kuti matendawa ndi otani.

Kodi SJS imachiritsidwa bwanji ?

SJS ndi matenda omwe amafunika kugonekedwa kuchipatala nthawi yomweyo komanso kulandira chithandizo. Kuyesa kuwachiza kunyumba kungapangitse kuti vutoli liwonjezeke. Nazi zina mwa njira zochizira:

• Siyani nthawi yomweyo mankhwala omwe akuganiziridwa kuti akuyambitsa vutoli: Ichi ndiye chinthu choyamba kuchita.
• Madzi olowa m'mitsempha (IV) kuti abwezeretse ma electrolyte: Izi zimachitika kuti achepetse kutayika kwa madzi m'thupi pamene khungu likutuluka.
• Kupaka ma dressing osamatirira pakhungu lomwe lakhudzidwa.
• Kupatsa mwana zakudya zokhala ndi ma calories ambiri kuti achire msanga: Nthawi zina, kudyetsa mwana m'njira ya chubu kungakhale kofunikira.
• Kupereka mankhwala opha tizilombo ngati pakufunika kutero kuti tipewe matenda.
• Kupereka mankhwala ochepetsa ululu.
• Chithandizo kuchipatala, mwina m'chipinda chosamalira odwala kwambiri (ICU) kapena chipinda chotenthedwa.
• Kufuna thandizo kuchokera ku magulu apadera monga Dermatology ndi Ophthalmology (ngati maso akhudzidwa).
• Nthawi zina, mankhwala enaake monga IV immunoglobulin, cyclosporine, IV steroids, kapena amniotic membrane grafts (ya maso) angaperekedwe.

Kodi mavuto omwe angakhalepo chifukwa cha SJS ndi ati?

Popeza SJS ndi TEN ndi matenda aakulu, mavuto amatha kukhala aakulu.

• Imfa: Imeneyi ndi vuto lalikulu kwambiri. Pafupifupi 10% ya odwala omwe ali ndi matenda a SJS ndi pafupifupi 50% ya odwala omwe ali ndi matenda a TEN amatha kufa.
• Chibayo.
• Sepsis: Iyi ndi matenda oopsa a bakiteriya, ofanana ndi poizoni m'magazi.
• Mkhalidwe wodabwitsa `(Wodabwitsa)`.
• Kulephera kwa ziwalo zingapo.

Chifukwa cha mavuto aakulu awa, matenda a SJS/TEN amafunika kugonekedwa kuchipatala nthawi yomweyo.

Kodi SJS ingapewedwe?

Ndipotu, nthawi zambiri, SJS singathe kupewedwa. Chifukwa nthawi zambiri imayamba chifukwa cha zomwe zimachitika mwadzidzidzi chifukwa cha mankhwala, palibe njira yodziwira ngati izi zidzachitika musanamwe mankhwala.

Komabe, ngati mwapezeka ndi vuto loyambitsidwa ndi mankhwala, chofunika kwambiri ndichakuti musagwiritsenso ntchito mankhwala amenewo kapena mtundu wina wofanana nawo. Ndikofunikira kwambiri kudziwitsa dokotala wanu za izi ndikuzilemba m'mabuku anu azachipatala.

Kodi chiyembekezo cha munthu amene ali ndi matenda a SJS ndi chotani? (Outlook)

Si aliyense amene ali ndi matenda a SJS amene amakumana ndi zizindikiro zomwezo. Anthu ena amachira pakatha milungu ingapo. Komabe, ngati zizindikirozo zili zazikulu, zingatenge miyezi kuti achire mokwanira. Anthu ena angakumane ndi zotsatirapo za nthawi yayitali. Mwachitsanzo:

• Khungu: Khungu louma, kuyabwa, kusintha mtundu wa khungu.
• Maso: Kutupa ndi/kapena kuuma pafupipafupi, kutupa kwa maso pafupipafupi, kusawona bwino, kusamva kuwala (photophobia).
• Kutuluka thukuta kwambiri.
• Kuwonongeka kwa mapapo: Matenda monga matenda osatha oletsa kupuma (COPD), mphumu.
• Misomali ikugwa kapena ikusokonekera.
• Kutaya tsitsi (Alopecia).
• Kuuma kwa nembanemba ya mucous: Izi zingayambitse zinthu monga kuvutika kukodza.
• Matenda otopa nthawi zonse.
• Kusintha kwa kukoma.

Chofunika kwambiri n'chakuti matendawa amatha kubwereranso ngati munthuyo abwereranso kumwa mankhwala omwe adayambitsa SJS poyamba. Ngati zimenezo zitachitika, zizindikiro zake nthawi zambiri zimakhala zoopsa kwambiri nthawi yachiwiri.

Pafupifupi 10% ya odwala a SJS ndi 30% ya odwala TEN amafa, makamaka chifukwa cha sepsis, acute respiratory distress syndrome (ARDS), komanso multiple organ failure.

Nazi zinthu zina zomwe muyenera kukumbukira kuchokera pa zomwe takambirana (Uthenga Wopita Nawo Kunyumba):

Chabwino, takambirana zambiri za vuto loopsa ili lotchedwa SJS. Nazi zinthu zina zomwe muyenera kukumbukira:

• Matenda a Stevens-Johnson Syndrome (SJS) ndi Toxic Epidermal Necrolysis (TEN) ndi matenda oopsa kwambiri, omwe amatha kupha anthu.
• Ngati mukumva zizindikiro monga kupweteka pakhungu, mawanga ofiira, matuza, khungu lotupa, kapena zilonda pakamwa kapena m'maso mutayamba kumwa mankhwala atsopano, makamaka mkati mwa sabata imodzi kapena ziwiri, funsani upangiri wa dokotala nthawi yomweyo. Ikhoza kukhala SJS.
• Nthawi zonse uzani dokotala wanu ngati munakhalapo ndi vuto la ziwengo kapena vuto lalikulu la mankhwala kale.
• Musagwiritse ntchito mankhwala kapena mankhwala ena ofanana ndi omwe apezeka kuti akuyambitsa SJS kachiwiri.**
• Ngati mukukayikira vutoli, musakhale panyumba, pitani kuchipatala nthawi yomweyo. Chithandizo chachangu chingapulumutse moyo wanu.

Ndikukhulupirira kuti izi zikuthandizani. Khalani ndi thanzi labwino!

Matenda a Stevens -Johnson, SJS, Toxic Epidermal Necrolysis, TEN, Matenda a pakhungu, Ziwengo, Zotsatira zoyipa za mankhwala, Matuza, Ziphuphu pakhungu, Matenda a pakhungu