Ngaba unesilonda esibuhlungu nesingalindelekanga esikhumbeni? Masifunde ngePyoderma Gangrenosum!

Ngaba wakha waba ne-blister encinci okanye ibala elibomvu eluswini lwakho elaqala njenge-blister encinci okanye ibala elibomvu laza ngequbuliso lajika laba sisilonda esikhulu nesibuhlungu? Linokwenzeka kwiindawo ezingaphezu kwesinye, kodwa linokwenzeka nakwiindawo ezininzi emzimbeni wakho. Esi sisifo esifuna ingqalelo ethile kwaye sinokuba nzima kancinci. Namhlanje siza kuthetha ngesifo sesikhumba esibizwa ngokuba yiPyoderma Gangrenosum, esisifo esingaqhelekanga kodwa esibaluleke kakhulu ekufuneka siqatshelwe. Ungakhathazeki, masihlale silula.

Yintoni le Pyoderma Gangrenosum?

Ngamafutshane, i-pyoderma gangrenosum yimeko yolusu engapheliyo , oko kuthetha ukuba ihlala ixesha elide, kwaye ihlala isenzeka . Okwenzekayo kukuba ulusu lwakho luqala ukuba namadyungudyungu amancinci, anombala omdaka (mhlawumbi obomvu, omfusa, oluhlaza okwesibhakabhaka, omdaka, okanye omnyama), okanye amadyungudyungu azele lulwelo (bullae). Okuyingozi ngakumbi kukuba la madyungudyungu anokukhula ngokukhawuleza, ahlangane, aze abe zizilonda ezinzulu nezivulekileyo (izilonda) .

Khawucinge ukuba bekuya kuba njani ukuba into ethile iqala njengephundu elincinci ize kwiintsuku ezimbalwa ijike ibe sisilonda esibuhlungu esilingana ne-nickel? Yiloo nto eyenzekayo apha. Abanye abantu banokufumana isilonda esinye kuphela, kodwa kwiimeko ezinzima, izilonda ezininzi zinokuvela ngaxeshanye. Ezi zilonda zinokuba buhlungu kakhulu .

Okubalulekileyo kukuba, i-pyoderma gangrenosum idla ngokunxulunyaniswa nezinye izifo zenkqubo yomzimba , oko kuthetha ukuba ayisiyongxaki yesikhumba nje kuphela.

Ngubani onokuthi afumane oku?

I-Pyoderma gangrenosum inokwenzeka nakweyiphi na iminyaka, kodwa ayiqhelekanga kakhulu ebantwaneni . Ixhaphake kakhulu kubasetyhini abaphakathi kweminyaka engama-20 ukuya kwengama-50. Usenokuba namathuba amaninzi okufumana i-pyoderma gangrenosum ukuba unenye yezi meko zilandelayo:

• I-rheumatoid arthritis - Esi sisifo esibangela ukudumba kwamalungu.
• I-ulcerative colitis - Imeko yokudumba enezilonda emathunjini amakhulu.
• Isifo sikaCrohn - Esinye isifo sokudumba esisenzeka kwindlela yokugaya ukutya.
• Ezinye iintlobo zomhlaza, umzekelo, umhlaza wegazi ofana ne-leukemia okanye i-lymphoma.

Kuthiwa kwenzeka kumntu omnye kwabalikhulu lamawaka eMelika . Oko kuthetha ukuba ayixhaphakanga kangako.

Oku kuyichaphazela njani umzimba? Zithini iimpawu?

I-Pyoderma gangrenosum ibangela amadyungudyungu amancinci, anombala omdaka kunye nokudumba, oko kuthetha ukudumba kunye nokubomvu, eluswini lwakho. La madyungudyungu anokuvela naphi na emzimbeni, kodwa ahlala ebonakala emilenzeni, emaqatheni, nasezinyaweni (kwimilenze esezantsi) .

La maqhuqhuva anokugqabhuka ngokukhawuleza, ajike abe zizilonda ezinkulu nezibuhlungu, aze asasazeke.Iimpawu eziphambili zezi:

• Amadyungudyungu amancinci, anombala omdaka (obomvu, omfusa, oluhlaza okwesibhakabhaka, omdaka, okanye omnyama). La madyungudyungu akhula ngokukhawuleza .
• Izilonda ezivulekileyo (izilonda) ziyavela. Imiphetho ejikeleze ezi zilonda iphakanyisiwe kwaye ibonakala ngokucacileyo .
• Ukudumba kunye nentlungu ebukhali ejikeleze inxeba.
• Abanye abantu banokuba nomkhuhlane .
• Intlungu yamalungu inokubakho.

La manxeba ngamanye amaxesha anokuba makhulu kakhulu kwaye anzulu , kwaye intlungu ayinakunyamezeleka.

Ezinye izifundo zibonise ukuba ukuya kuthi ga kwi-70% yabantu abane-pyoderma gangrenosum banokuba nezinye izifo ezingaphezulu kwesinye (ii-comorbidities) ngaxeshanye. Xa i-pyoderma gangrenosum idityaniswe nezinye izifo, kuthiwa umngcipheko wokufa unokunyuka ukuya kuthi ga kwi-30%. Ke ngoko, oku akuyonto ifanele ithathwe lula.

Ngaba esi sisifo sokuzikhusela komzimba?

Ewe, i-pyoderma gangrenosum ikholelwa ukuba sisifo esibangelwa kukuzikhusela komzimba . Ngamafutshane, inkqubo yokuzikhusela yomzimba wakho, inkqubo yokuzikhusela yomzimba, ihlasela iiseli zakho zolusu. Kwabanye abantu, i-pyoderma gangrenosum iyaphela xa ezinye iimeko ezikhankanyiweyo apha ngasentla zinyangwa.

Kutheni i-pyoderma gangrenosum ikhula?

Iingcali zonyango azikayazi imbangela echanekileyo , kodwa ngaphezulu kwesiqingatha sabantu abane-pyoderma gangrenosum banezinye iimeko (ezifana nesifo samathambo, i-leukemia, kunye nesifo sikaCrohn), njengoko bekutshiwo ngaphambili.

Ukongeza, i-pyoderma gangrenosum inokwenzeka nasemva kokwenzakala kwesikhumba, ukukrweleka, okanye utyando (i-pathergy) . Khawucinge ngokukrweleka okuncinci esandleni sakho, okanye utyando oluncinci, kwaye kulapho esi sifo sinokuqala khona. Ngamanye amaxesha la manxeba akhula ajikeleze indawo ye-stoma emva kotyando. Oku kubizwa ngokuba yi-peristomal pyoderma gangrenosum.

Ingaba oku kuyasulela?

Hayi. I-Pyoderma gangrenosum ayosuleli . Ayinakusasazwa ukusuka komnye umntu ukuya komnye ngokudibana kwesikhumba nolusu. Le yinkxalabo abantu abaninzi abanayo, ngoko ke kubalulekile ukuba icace le nto.

Oogqirha bayibona njani le nto?

Inyaniso kukuba, ukufumanisa i-pyoderma gangrenosum kunokuba nzima kancinci . Akukho vavanyo oluqinisekileyo olunokuqinisekisa ukuba yimeko leyo. Ke ngoko, oogqirha badla ngokwenza uvavanyo ukuze basuse ezinye iimeko ezinokubangela iingxaki zolusu ezifanayo. Oko kukuthi, baqala baqinisekise ukuba ezinye iimeko ezineempawu ezifanayo azikho. Umzekelo:

• Iintsholongwane ezahlukeneyo.
• Umhlaza wolusu.
• Ukudumba kwesikhumba ngemithambo yegazi.
• Isifo seLupus.
• Imeko ebizwa ngokuba yiSweet syndrome.

Uvavanyo loku lungabandakanya:

• Uvavanyo lwegazi.
• Ukuthatha iqhekeza elincinci lesikhumba ukuze lihlolwe (iBiopsy).
• Ukuthathwa kwesampulu yomongo wethambo - ingakumbi ukuba kukho izinto ezirhanelekayo ezifana nomhlaza wegazi.
• Iproctoscopy.
• I-Colonoscopy - ukuba kukho ingcinga yokuba kukho iimeko ezifana nesifo sikaCrohn.

Kuphela emva kokuba zonke ezi mvavanyo zenziwe kwaye zonke ezinye izinto zisusiwe apho ugqirha agqiba kwelokuba yi-pyoderma gangrenosum.

Zithini iindlela zonyango?

Kukho iindlela ezahlukeneyo zonyango lwe-pyoderma gangrenosum. Ukuxilongwa kwangoko kunye nonyango kubalulekile ukuthintela amanxeba .

Unyango lweemeko eziqhelekileyo, ezingabalulekanga kangako

Ukuba amanxeba akanzima kakhulu, ugqirha angakunika iikhrimu okanye amafutha aqholiweyo. Ezi ziquka:

• IiCorticosteroids: Ezi ziziyobisi ezinciphisa ukudumba. Zingafakwa emanxebeni njengekhrimu okanye zithathwe njengeepilisi. Imizekelo: i-cortisone, i-prednisone. Nangona kunjalo, ezi zinokuba neziphumo ebezingalindelekanga ezifana nokunyuka komnqweno wokutya, ukutyeba, utshintsho lweemvakalelo, i-acne, kunye nokungalali.
• Amayeza angengowe-steroidal alwa nokuvuvukala (ii-NSAID): La ngamayeza okunciphisa iintlungu. Imizekelo: i-aspirin, i-ibuprofen. La mayeza anokubangela igesi , ukudumba, iintlungu zesisu, isicaphucaphu, ukuhlanza, urhudo, kunye nokuqhina.
• Ikrimu yesikhumba yesilivere yesulfadiazine: Le yikrimu yokubulala iintsholongwane esetyenziswa ekutshiseni ukuthintela usulelo. Ngamanye amaxesha isetyenziselwa nale meko. Inokubangela ukurhawuzelela, umkhuhlane, ukubanda, izilonda zesikhumba, kunye nokungaziva kukhanya kwelanga.

Ngaba lukhuni kancinci?

Ukuba ukwenzakala kukhulu, ugqirha angakunika unyango olufana nolu:

• Amayeza okunciphisa umzimba: La mayeza asebenza ngokunciphisa amandla omzimba wakho okonakalisa umzimba wawo. Imizekelo: i-mycophenolate, i-cyclosporine.
• Iiarhente zebhayoloji: Ezi ziintlobo ezintsha zamayeza. Zisebenza ngokujolisa kwiiproteni ezithile emzimbeni ezibangela ukudumba. Imizekelo: i-infliximab, i-adalimumab, i-ustekinumab.
• Unyango lwe-hyperbaric oxygen: Oku kuquka ukunika i-100% ye-oxygen kwigumbi elikhethekileyo. Kuthiwa ikhawulezisa ukuphiliswa kwezicubu zomzimba.

Masifunde nangotyando.

Kwezinye iimeko, ukususwa kwezicubu ezifileyo enxebeni (ukususwa kwezicubu) ngotyando kunokuba luncedo. Nangona kunjalo, oku kukwanobungozi .Ngenxa yokuba umonakalo wolusu (i-pathergy) unokwenza iimpawu ze-pyoderma gangrenosum zibe mandundu, oku kufuneka kwenziwe ngononophelo olukhulu nangokubona kukagqirha wakho.

Ngamanye amaxesha ukufakelwa kwesikhumba kungenziwa. Oku kuthetha ukuba ulusu luthathwa kwinxalenye yomzimba ephilileyo luze lufakwe kwindawo yenxeba.

Yintoni ekufuneka uyazi njengomntu onesi sifo?

Ukuba une-pyoderma gangrenosum, naluphi na uhlobo lokulimala eluswini lwakho - ukusikeka, imikrwelo, ukukrweleka - kunokwenza iimpawu zakho zibe zimbi ngakumbi . Ngoko ke kufuneka uqaphele kangangoko unako. Khawuthelekelele usebenza egadini okanye ekhitshini, kwaye nokuba umkrwelo omncinci unokuba yingxaki enkulu.

Kwakhona, ukugcina amanxeba ecocekile kubalulekile ukuthintela usulelo .

• Hlamba amanxeba kakuhle ngamanzi acocekileyo, ahambayo kunye nesepha.
• Emva koko, gquma inxeba ngononophelo ngebhandishi enganamatheliyo. Oku kuya kuthintela ukungcola neentsholongwane ukuba zingangeni.
• Ugqirha wakho wesikhumba uza kukunika ulwazi oluthe kratya malunga nendlela yokugcina inxeba licocekile kunye nendlela yokufaka amabhandeji. Landela loo miyalelo ngononophelo.
• Ukuba unikwe i-ointment, hlamba inxeba, ulithambise, uze ulibophe ngebhanti.

Kwizilonda ezinzima, ugqirha wakho unokucebisa ibhandeji ye-hydrocolloid . Ezi zikhusela inxeba ekukhuhlekeni nasekusulelekeni. Ziya "kunyibilika" eluswini kwiintsuku ezimbini ukuya kwezintathu.

Kuthatha ixesha elingakanani ukuphiliswa?

I-Pyoderma gangrenosum yimeko enzima ukunyangwa . Nokuba unyango olufanelekileyo, amanxeba angathatha iiveki, ngamanye amaxesha iinyanga, ukuba aphole. Ngoko ke, kufuneka ube nomonde.

Ngaba oku kungathintelwa?

Ekubeni unobangela ochanekileyo ungaziwa, kunzima ukutsho ngokuqinisekileyo indlela yokuwuthintela . Nangona kunjalo, ukuba unezinto ezinobungozi ezifana ne-leukemia okanye isifo samathumbu esidumbileyo, kwaye uvela naziphi na iingxaki ezintsha zolusu (ingakumbi izilonda ezikhula ngokukhawuleza) , xelela ugqirha wakho ngoko nangoko . Cela ugqirha wakho ukuba akuthumelele kugqirha wesikhumba okanye kwenye ingcali enamava nge-pyoderma gangrenosum.

Ndifanele ndimbone nini ugqirha?

Ngokuqinisekileyo kufuneka ubone ugqirha kwezi meko zilandelayo:

• Ukuba unesifo samathumbu esidumbileyo, isifo samathambo, okanye ingxaki yegazi kwaye uvelisa amadyungudyungu okanye izilonda ezikhula ngokukhawuleza .
• Ukuba inxeba lakho libonakala linesifo (libomvu, limfusa, lingwevu okanye limhlophe, lidumbile, okanye libuhlungu).
• Ukuba ubonakalisa iimpawu ezintsha .
• Ukuba ufumana iziphumo ebezingalindelekanga ezibi kakhulu emva kokusela iyeza.

Imibuzo ebalulekileyo yokubuza ugqirha wakho

Xa usiya kugqirha, kubaluleke kakhulu ukubuza le mibuzo:

• Utsho njani kanye kanye ukuba ndine-pyoderma gangrenosum?
• Ukuba andinayo i-pyoderma gangrenosum, ingaba sesiphi esinye isifo solusu?
• Luhlobo luni lovavanyo onethemba lokulwenza?
• Luhlobo luni lonyango okanye unyango olucebisayo?
• Ungandinika ikhrimu yokuyithambisa okanye amayeza okusela?
• Luthini uluhlu olupheleleyo lweziphumo ebezingalindelekanga zala mayeza kunye nonyango?
• Yintoni enye endifanele ndiyenze ukunciphisa iimpawu zam?
• Ngaba kufuneka ndidibane nogqirha wesikhumba, ugqirha wotyando lweplastiki, ugqirha wezifo zamathumbu, ugqirha wezifo zomzimba, okanye omnye ugqirha wezifo zamathambo?

Kubaluleke kakhulu ukubuza le mibuzo uze uqonde kakuhle imeko yakho.

Yintoni umahluko phakathi kwePyoderma Gangrenosum kunye ne-Ecthyma Gangrenosum?

La magama mabini afana kancinci, ngoko ke anokudideka.

I-Ecthyma gangrenosum lusulelo olungaqhelekanga olubangelwa yi- Pseudomonas bacteraemia, intsholongwane efumaneka emanzini nasemhlabeni. Inokubangela izilonda zesikhumba kunye nokonakala kwezicubu ezijikelezileyo. Idla ngokuchaphazela abantu abaneenkqubo zomzimba ezibuthathaka .

I-Pyoderma gangrenosum ikwabangela izilonda zesikhumba. Isizathu esichanekileyo asaziwa. Kucingelwa ukuba sisifo esibangelwa kukuzikhusela komzimba. Nangona kunjalo, asikuko imeko echaphazela abantu abaneenkqubo zomzimba ezibuthathaka .

Ngaba kukho iintlobo ezahlukeneyo zezilonda ze-pyoderma gangrenosum?

Ewe, kukho iintlobo ezine eziphambili zezilonda ze-pyoderma gangrenosum:

• I-Classic pyoderma gangrenosum: Olu lolona hlobo luqhelekileyo. Izilonda ezibuhlungu zihlala zikhula emilenzeni.
• I-pyoderma gangrenosum engaqhelekanga okanye ebukhali: Olu hlobo lubonakala njengama-blisters azaliswe lulwelo. Ihlala ibonakala ezandleni. Ixhaphake kakhulu kubantu abane-leukemia.
• I-Pustular pyoderma gangrenosum: Ibonakala njengeempumlo ezincinci ezigcwele ubovu ezandleni nasezinyaweni. Oku kuxhaphake kakhulu kubantu abanesifo samathumbu esidumbileyo.
• I-Vegetative pyoderma gangrenosum: Olu hlobo lwesilonda aludli ngokuba buhlungu.

Okokugqibela, izinto ekufuneka uzikhumbule

I-Pyoderma gangrenosum yimeko eqala njengamaqhuqhuva amancinci eluswini kwaye inokuthi iguquke ngokukhawuleza ibe zizilonda ezinkulu. Kunokuba nzima ukuyixilonga nokuyinyanga , ngoko ke wena nogqirha wakho kufuneka nibe nomonde.

Khumbula, kubaluleke kakhulu ukuba uqaphele naluphi na ukonakalisa ulusu lwakho, kuba oku kunokukhokelela kwizilonda ezintsha.

Ukuba i-pyoderma gangrenosum inzima kwaye unezinye izifo ezihambisana nayo, inokubangela iintlungu ezinzima, amanxeba, kwaneengxaki ezisongela ubomi. Ke ngoko, ukuba unesifo sokuzikhusela komzimba kwaye ufumana izilonda zesikhumba ezikhula ngokukhawuleza, funa uncedo lwezonyango ngokukhawuleza. Ukufunyanwa kwangoko kunye nonyango kunokukunceda uphile. Musa ukoyika , kodwa lumka.

I- Pyoderma Gangrenosum, Izifo Zolusu, Amanxeba, Izilonda, Inkqubo Yokuzikhusela Emzimbeni, I-Dermatology, Izifo Ezingapheliyo