Ingabe ubhekene nezilonda zesikhumba eziphuthumayo nezinzima? Ake sifunde nge-Pyoderma Gangrenosum!

Wake waba ne-blister encane noma ibala elibomvu esikhumbeni sakho elaqala njenge-blister encane noma ibala elibomvu laphenduka isilonda esikhulu nesibuhlungu? Lingenzeka ezindaweni ezingaphezu kweyodwa, kodwa lingenzeka nasezindaweni eziningana emzimbeni wakho. Empeleni lesi yisimo esidinga ukunakwa okuthile futhi singaba yinkimbinkimbi kancane. Namuhla sizokhuluma ngesimo sesikhumba esibizwa ngokuthi i-Pyoderma Gangrenosum, okuyisimo esingavamile kodwa esibaluleke kakhulu okufanele usiqaphele. Ungakhathazeki, masikwenze kube lula.

Iyini le Pyoderma Gangrenosum?

Kalula nje, i-pyoderma gangrenosum iyisifo sesikhumba esingamahlalakhona , okusho ukuthi sihlala isikhathi eside, futhi sihlala sivela njalo . Okwenzekayo ukuthi isikhumba sakho siqala ukuba nama-blister amancane, anombala ohlukile (mhlawumbe obomvu, onsomi, oluhlaza okwesibhakabhaka, onsundu, noma omnyama), noma ama-blister agcwele uketshezi (ama-bullae). Okuyingozi kakhulu ukuthi lawa angakhula ngokushesha abe makhulu, ahlangane, futhi abe izilonda ezijulile nezivulekile (izilonda) .

Cabanga ukuthi bekuyoba njani uma into ethile iqala njengenduna encane bese kuthi ezinsukwini ezimbalwa iphenduke isilonda esibuhlungu esilingana ne-nickel? Yilokho okwenzekayo lapha. Abanye abantu bangase babe nesilonda esisodwa kuphela, kodwa ezimweni ezimbi kakhulu, izilonda eziningi zingavela ngesikhathi esisodwa. Lezi zilonda zingaba buhlungu kakhulu .

Okubalulekile, i-pyoderma gangrenosum ivame ukuhlotshaniswa nezinye izifo zesistimu , okusho ukuthi akuyona nje inkinga yesikhumba.

Ubani okungenzeka kakhulu ukuthi athole lokhu?

I-Pyoderma gangrenosum ingavela kunoma yimuphi ubudala, kodwa ayivamile ezinganeni . Ivame kakhulu kwabesifazane abaneminyaka ephakathi kuka-20 no-50. Ungase futhi ube namathuba amaningi okuthola i-pyoderma gangrenosum uma unezinye zezimo ezilandelayo:

• I-rheumatoid arthritis - Lesi yisifo esibangela ukuvuvukala kwamalunga.
• I-ulcerative colitis - Isimo sokuvuvukala esinama-ulcer emathunjini amakhulu.
• Isifo sikaCrohn - Esinye isimo sokuvuvukala okwenzeka endleleni yokugaya ukudla.
• Ezinye izinhlobo zomdlavuza, isibonelo, umdlavuza wegazi njenge-leukemia noma i-lymphoma.

Kuthiwa kwenzeka cishe kubantu abayizinkulungwane eziyikhulu e-United States . Lokho kusho ukuthi akuvamile kangako.

Lokhu kuthinta kanjani umzimba? Ziyini izimpawu?

I-Pyoderma gangrenosum ibangela amabhamuza amancane, anombala ohlukile kanye nokuvuvukala, okusho ukuvuvukala nokubomvu, esikhumbeni sakho. Lawa mabhamuza angavela noma kuphi emzimbeni, kodwa avame ukubonakala emilenzeni, emaqakaleni, nasezinyaweni (emikhawulweni engezansi) .

La maqhubu angaqhuma ngokushesha, aphenduke izilonda ezinkulu nezibuhlungu, futhi asakazeke.Izimpawu eziyinhloko yilezi:

• Amabhamuza amancane, anombala ohlukile (obomvu, onsomi, oluhlaza okwesibhakabhaka, onsundu, noma omnyama). Lawa akhula ngokushesha .
• Izilonda ezivulekile (izilonda) ziyavela. Imiphetho ezungeze lezi zilonda iphakanyisiwe futhi ibonakala ngokucacile .
• Ukuvuvukala kanye nobuhlungu obukhulu eduze kwesilonda.
• Abanye abantu bangase babe nomkhuhlane .
• Ubuhlungu bamalunga bungase buvele.

Lezi zilonda ngezinye izikhathi zingaba zikhulu kakhulu futhi zijule , futhi ubuhlungu bungaba nzima ukububekezelela.

Ezinye izifundo zibonise ukuthi abantu abangafika ku-70% abane-pyoderma gangrenosum bangaba nezinye izimo ezingaphezu kwesisodwa (ama-comorbidities) ngesikhathi esisodwa. Uma i-pyoderma gangrenosum ihlanganiswa nezinye izimo, kuthiwa ingozi yokufa inganda ngamaphesenti afinyelela ku-30. Ngakho-ke, lokhu akuyona into okufanele ithathwe kalula.

Ingabe lesi yisifo sokuzivikela komzimba?

Yebo, i-pyoderma gangrenosum kukholakala ukuthi iyisifo sokuzivikela komzimba . Kalula nje, uhlelo lokuzivikela lomzimba wakho, uhlelo lokuzivikela komzimba, luhlasela amangqamuzana esikhumba sakho. Kwabanye abantu, i-pyoderma gangrenosum iyaphela lapho ezinye izimo ezishiwo ngenhla zelashwa.

Kungani i-pyoderma gangrenosum ikhula?

Ochwepheshe bezokwelapha abakayazi imbangela eqondile , kodwa abantu abangaphezu kwengxenye abane-pyoderma gangrenosum banezinye izimo (njenge-arthritis, i-leukemia, nesifo sikaCrohn), njengoba kushiwo ngaphambili.

Ngaphezu kwalokho, i-pyoderma gangrenosum ingavela futhi ngemva kokulimala kwesikhumba, ukuklwebheka, noma ukuhlinzwa (i-pathergy) . Cabanga ngokuklwebheka okuncane esandleni sakho, noma ukuhlinzwa okuncane, futhi yilapho lesi sifo singaqala khona. Ngezinye izikhathi la manxeba akhula eduze nendawo ye-stoma ngemva kokuhlinzwa. Lokhu kubizwa ngokuthi i-peristomal pyoderma gangrenosum.

Ingabe lokhu kuyathelelana?

Cha. I-Pyoderma gangrenosum ayithelelani . Ayikwazi ukusabalala isuka komunye umuntu iye komunye ngokuthintana kwesikhumba nesikhumba. Lokhu kuyinkinga abantu abaningi abanayo, ngakho-ke kubalulekile ukucaca ngalokhu.

Odokotela bakubona kanjani lokhu?

Uma ngikhuluma iqiniso, ukuxilonga i-pyoderma gangrenosum kungaba yinselele kancane . Akukho ukuhlolwa okuqondile okungaqinisekisa ukuthi yilesi simo. Ngakho-ke, odokotela bavame ukwenza izivivinyo ukuze banqume ezinye izimo ezingabangela izinkinga zesikhumba ezifanayo. Okusho ukuthi, baqale baqinisekise ukuthi ezinye izimo ezinezimpawu ezifanayo azikho. Isibonelo:

• Izifo ezahlukahlukene.
• Umdlavuza wesikhumba.
• Ukuvuvukala kwesikhumba emithanjeni yegazi.
• Isifo se-Lupus.
• Isimo esibizwa ngokuthi i-Sweet syndrome.

Ukuhlolwa kwalokhu kungafaka:

• Ukuhlolwa kwegazi.
• Ukuthatha ingcezu encane yesikhumba ukuze iyohlolwa (i-Biopsy).
• Ukuthatha amasampula omnkantsha wethambo - ikakhulukazi uma kusolwa izinto ezifana nomdlavuza wegazi.
• I-Proctoscopy.
• I-Colonoscopy - uma kusolwa izimo ezifana nesifo sikaCrohn.

Kuphela ngemva kokuba zonke lezi zivivinyo seziqediwe futhi konke okunye sekukhishiwe lapho udokotela ephetha ngokuthi yi-pyoderma gangrenosum.

Yiziphi izindlela zokwelapha?

Kunezindlela eziningana zokwelapha i-pyoderma gangrenosum. Ukuxilongwa kusenesikhathi kanye nokwelashwa kubalulekile ukuvimbela izibazi .

Ukwelashwa kwamacala avamile, anganzima kangako

Uma amanxeba engekho mabi kakhulu, udokotela angase akunike ama-cream noma amafutha okugcoba. Lokhu kufaka phakathi:

• Ama-Corticosteroids: Lezi yizidakamizwa ezinciphisa ukuvuvukala. Zingasetshenziswa emanxebeni njengokhilimu noma zithathwe njengamaphilisi. Izibonelo: i-cortisone, i-prednisone. Kodwa-ke, lezi zingaba nemiphumela emibi njengokwanda kwesifiso sokudla, ukukhuluphala, ukushintshashintsha kwemizwa, induna, kanye nokungalali.
• Imithi elwa nokuvuvukala engeyona eye-steroidal (ama-NSAID): Lezi ziqeda izinhlungu. Izibonelo: i-aspirin, i-ibuprofen. Lezi zingabangela igesi , ukuqunjelwa, ubuhlungu besisu, isicanucanu, ukuhlanza, uhudo kanye nokuqunjelwa.
• Ukhilimu wesikhumba wesiliva we-sulfadiazine: Empeleni lo ukhilimu wama-antibiotic osetshenziswa ekushiseni ukuvimbela ukutheleleka. Ngezinye izikhathi usetshenziselwa nalesi simo. Ungabangela ukulunywa, umkhuhlane, ukubanda, izilonda zesikhumba, kanye nokuzwela ukukhanya kwelanga.

Ubukhali kancane?

Uma ukulimala kukubi kakhulu, udokotela angase anikeze ukwelashwa okufana nalokhu:

• Imithi yokucindezela amasosha omzimba: Le mithi isebenza ngokunciphisa ikhono lesimiso sakho somzimba lokonakalisa umzimba waso. Izibonelo: i-mycophenolate, i-cyclosporine.
• Izinto eziphilayo: Lezi izinhlobo ezintsha zemithi. Zisebenza ngokugxila kumaprotheni athile emzimbeni abangela ukuvuvukala. Izibonelo: i-infliximab, i-adalimumab, i-ustekinumab.
• Ukwelashwa nge-hyperbaric oxygen: Lokhu kuhilela ukunikeza i-oxygen engu-100% ekamelweni elikhethekile. Kuthiwa kusheshisa ukuphulukiswa kwezicubu zomzimba.

Ake sifunde nangokuhlinzwa.

Kwezinye izimo, ukususwa kwezicubu ezifile esilondeni (ukususwa kwezicubu) ngokuhlinzwa kungaba usizo. Kodwa-ke, lokhu kunezingozi .Ngenxa yokuthi ukulimala kwesikhumba (i-pathergy) kungenza izimpawu ze-pyoderma gangrenosum zibe zimbi kakhulu, lokhu kufanele kwenziwe ngokucophelela okukhulu nangokubona kukadokotela wakho.

Ngezinye izikhathi kungenziwa ukufakelwa kwesikhumba . Lokhu kusho ukuthi isikhumba sithathwa engxenyeni yomzimba enempilo bese sitshalwa endaweni yenxeba.

Yini okudingeka uyazi njengomuntu onalesi simo?

Uma une-pyoderma gangrenosum, noma yiluphi uhlobo lokulimala esikhumbeni sakho - ukusikeka, imihuzuko, imihuzuko - kungenza izimpawu zakho zibe zimbi kakhulu . Ngakho-ke kudingeka uqaphele ngangokunokwenzeka. Cabanga ukuthi usebenza engadini noma ekhishini, futhi ngisho nokuklwebheka okuncane kungaba yinkinga enkulu.

Futhi, ukugcina amanxeba ehlanzekile kubalulekile ukuvimbela ukutheleleka .

• Geza amanxeba kahle ngamanzi ahlanzekile, agobhozayo kanye nensipho.
• Bese umboza inxeba ngokucophelela ngebhandeji elinganamatheli. Lokhu kuzovimbela ukungcola namagciwane ukuthi angangeni.
• Udokotela wakho wesikhumba uzokunikeza ulwazi olwengeziwe mayelana nendlela yokugcina inxeba lihlanzekile nokuthi ungalifaka kanjani amabhandeji. Landela leyo miyalelo ngokucophelela.
• Uma unikezwe umuthi wokugcoba, geza inxeba, uligcobe, bese ulibopha.

Uma unezilonda ezinzima, udokotela wakho angase akuncome ngebhandeji le-hydrocolloid . Lokhu kuvikela inxeba ekukhuhlekeni nasekuthelelekeni okuqhubekayo. "Lizoncibilika" esikhumbeni zingakapheli izinsuku ezimbili kuya kwezintathu.

Kuthatha isikhathi esingakanani ukuphulukiswa?

I-Pyoderma gangrenosum iyisimo esinzima ukwelapha . Ngisho nangokwelashwa okufanele, amanxeba angathatha amasonto, ngezinye izikhathi izinyanga, ukuphola. Ngakho-ke, udinga ukubekezela.

Ingabe lokhu kungavinjelwa?

Njengoba imbangela eqondile ingaziwa, kunzima ukusho ngokuqinisekile ukuthi ungayivimbela kanjani . Kodwa-ke, uma unezici eziyingozi njenge-leukemia noma isifo samathumbu esivuvukalayo, futhi uthola noma yiziphi izinkinga zesikhumba ezintsha (ikakhulukazi izilonda ezikhula ngokushesha) , tshela udokotela wakho ngokushesha . Cela udokotela wakho ukuthi akuthumele kudokotela wesikhumba noma omunye uchwepheshe onolwazi nge-pyoderma gangrenosum.

Kufanele ngimbone nini udokotela?

Kufanele nakanjani ubone udokotela kulezi zimo:

• Uma unesifo samathumbu esivuvukalayo, isifo samathambo, noma isifo segazi bese uba namaqhubu noma izilonda ezikhula ngokushesha .
• Uma inxeba lakho libonakala lithelelekile (elibomvu, elinsomi, elimpunga noma elimhlophe, elivuvukele, noma elibuhlungu).
• Uma uthola izimpawu ezintsha .
• Uma uhlangabezana nemiphumela emibi kakhulu ngemva kokuthatha umuthi.

Imibuzo ebalulekile okufanele uyibuze udokotela wakho

Uma uya kudokotela, kubaluleke kakhulu ukubuza le mibuzo:

• Usho kanjani ukuthi ngine-pyoderma gangrenosum?
• Uma ngingenayo i-pyoderma gangrenosum, yisiphi esinye isifo sesikhumba esingaba yiso?
• Hlobo luni lokuhlolwa onethemba lokulwenza?
• Hlobo luni lomuthi noma ukwelashwa oluncomayo?
• Unganginika ukhilimu engizowusebenzisa noma umuthi engizowuphuza?
• Yiluphi uhlu oluphelele lwemiphumela emibi yale mithi kanye nokwelashwa?
• Yini enye okufanele ngiyenze ukuze nginciphise izimpawu zami?
• Ingabe kufanele ngibone udokotela wesikhumba, udokotela ohlinzayo we-plastic, udokotela we-gastroenterologist, udokotela we-immunologist, noma omunye uchwepheshe?

Kubaluleke kakhulu ukubuza le mibuzo nokuqonda kahle isimo sakho.

Uyini umehluko phakathi kwe-Pyoderma Gangrenosum ne-Ecthyma Gangrenosum?

La magama amabili afana kancane, ngakho-ke angadideka.

I-Ecthyma gangrenosum ukutheleleka kwesikhumba okungavamile okubangelwa yi -Pseudomonas bacteraemia, igciwane elivame ukutholakala emanzini nasenhlabathini. Lingabangela nezilonda zesikhumba kanye nokonakala kwezicubu ezizungezile. Livame ukuthinta abantu abanamasosha omzimba abuthakathaka .

I-Pyoderma gangrenosum nayo ibangela izilonda zesikhumba. Imbangela eqondile ayaziwa. Kucatshangwa ukuthi iyisifo sokuzivikela komzimba. Kodwa-ke, akuyona inkinga ethinta abantu abanamasosha omzimba abuthakathaka .

Ingabe kunezinhlobo ezahlukene zezilonda ze-pyoderma gangrenosum?

Yebo, kunezinhlobo ezine eziyinhloko zezilonda ze-pyoderma gangrenosum:

• I-pyoderma gangrenosum yakudala: Lolu uhlobo oluvame kakhulu. Izilonda ezibuhlungu zivame ukuvela emilenzeni.
• I-pyoderma gangrenosum engavamile noma ebukhali: Lolu hlobo lubonakala njengama-blisters agcwele uketshezi. Ngokuvamile lubonakala ezandleni. Luvame kakhulu kubantu abane-leukemia.
• I-pustular pyoderma gangrenosum: Ibonakala njengama-blister amancane agcwele ubomvu (ama-pustules) ezandleni nasezinyaweni. Lokhu kuvame kakhulu kubantu abanesifo samathumbu esivuvukalayo.
• I-Vegetative pyoderma gangrenosum: Lolu hlobo lwesilonda ngokuvamile alubuhlungu.

Okokugcina, izinto okufanele uzikhumbule

I-Pyoderma gangrenosum yisimo esiqala njengamaqhubu amancane esikhumbeni futhi singaphenduka ngokushesha sibe izilonda ezinkulu. Kungaba nzima ukusixilonga nokwelapha , ngakho-ke wena nodokotela wakho kudingeka nibekezele.

Khumbula, kubaluleke kakhulu ukuqaphela noma yikuphi ukulimala esikhumbeni sakho, njengoba lokhu kungaholela ezilondeni ezintsha.

Uma i-pyoderma gangrenosum inzima futhi unezinye izifo ezihambisana nayo, ingabangela ubuhlungu obukhulu, izibazi, ngisho nezinkinga ezisongela ukuphila. Ngakho-ke, uma unesifo sokuzivikela komzimba futhi ubhekene nezilonda zesikhumba ezikhula ngokushesha, funa usizo lwezokwelapha ngokushesha. Ukutholwa kusenesikhathi kanye nokwelashwa kungakusiza ukuthi ululame. Ungesabi , kodwa qaphela.

I- Pyoderma Gangrenosum, Izifo Zesikhumba, Amanxeba, Izilonda, Isimiso Sokuzivikela Emzimbeni, I-Dermatology, Izifo Ezingamahlalakhona