Nthenda yotchedwa epidermal necrolysis (TEN) ndi matenda omwe amawopsyeza khungu, omwe amachititsa kuti ziphuphu zisawonongeke pakhungu (erythema), khungu la khungu lakufa ( necrosis ), ndi khungu la khungu komanso mazira. ZISANU sizigwirizana ndi mtundu uliwonse kapena fuko. Ngakhale kuti matendawa amayamba chifukwa cha matenda kapena matenda, nthawi zambiri zimagwirizanitsidwa ndi mankhwala.
Mankhwala Odziwika Kuti Awononge ZISANU
Mankhwala omwe amadziwika kuti amachititsa TEN ndi awa:
- Maantibayotiki monga sulfonamides, penicillins , macrolides, ndi quinolones
- Mankhwala a antiticonvulsant (antiseizure)
- Mankhwala osagwirizana ndi zotupa ( anti-steroidal anti-inflammatory drugs (NSAIDs)
- Allopurinol
- Matenda a tumor necrosis (TNF) -alpha mankhwala monga Remicade (infliximab), Enbrel (etanercept), ndi Humira (adalimumab)
Milandu yomwe imayambitsidwa ndi mankhwala nthawi zambiri imakhala mkati mwa masabata atatu kapena atatu kuyamba mankhwala. Ndizosavuta kuti zotsatira za mankhwala zichitike pakatha milungu eyiti. Pafupifupi gawo limodzi mwa magawo atatu a milandu amayamba chifukwa cha zinthu zosadziwika.
Zizindikiro
Mankhwala oopsa a epidermal necrolysis amayamba ndi zizindikiro zofanana ndi chimfine monga fever, chifuwa, pakhosi, mphuno, komanso kumverera kwabwino kwa masiku awiri kapena atatu. Zizindikiro izi zingapitirize kuphatikizapo:
- Mawanga aang'ono ofiira omwe amayamba kukhala zikopa zazikulu za khungu lofiira lomwe limaphimba 30 peresenti kapena thupi loposa
- Kuthamanga kwambiri ndi kuyang'ana khungu
- Zimaoneka ngati zouma, zofiira, zopweteka zomwe khungu limachotsa
- Kutha, milomo yamagazi yomwe imapanga makina
- Maso oipa ( conjunctivitis )
- Kupweteka kwambiri
Zizindikirozi zimakhala masiku asanu ndi atatu kapena 12. Chifukwa cha kuopsa kwa zizindikirozi, mavuto angayambe, monga chibayo ; Kuthamanga kwa mucous membranes mkamwa, mmero ndi m'mimba; matenda a khungu; kuperewera kwa impso , poizoni magazi ( sepsis ), ndi mantha.
Popanda chithandizo chamankhwala, zambiri za zotsatirazi zingathe kupha.
Kudziwa
TEN nthawi zambiri imapezeka kuti imachokera ku zizindikiro za wodwalayo komanso kuunika khungu. Matenda ena a khungu, monga staphylococcal scalded skin disease, angakhale ndi zizindikiro zofanana. Kawirikawiri, chinyama (biopsy) chidzatengedwa kuti chitsimikizire TEN ndikuchotsa zovuta zina zilizonse.
Kuchiza
Matenda owopsa a epidermal necrolysis angayambitse mavuto owopsa. Ngati mukuganiza kuti muli ndi zaka khumi, funsani mankhwala. TEN amadziwika kuti ndiwopereka chithandizo chamankhwala ndipo amafunika kuchiza mwamsanga. Poyamba matendawa amachiritsidwa, ubwino wake umakhala wabwino. Njira zochizira zingaphatikizepo:
- Kutseka mankhwala alionse omwe angayambitse TEN
- Mankhwala osakaniza (IV) ndi electrolytes
- Kuchotsa minofu yakufa (kagawo)
- Zida zoteteza
- Maantibayotiki kuteteza kapena kuchiza matenda
- Mankhwala owawa
- Kulimbana ndi mavuto ngati chibayo kapena impso kulephera
- Pogwiritsa ntchito chubu kuti adye zakudya
Chithandizo chingaphatikizepo IV immunoglobulin, cyclosporine, plasmapheresis , kapena oxyperic hyperbaric. Kafukufuku wasonyeza kuti awo omwe amasamutsidwa ku chipatala choyambitsa matenda kapena kuchepa kwambiri adayamba kuchepetsa chiwerengero cha matenda komanso kuchepa kwa chiwerengero cha kufa ndi kutalika kwa chipatala.
Mankhwala aliwonse omwe angachititse TEN ayenera kuimitsidwa mwamsanga. Kafukufuku wina adawonetsa kuti imfa zokhudzana ndi amuna khumi ndi ziwiri zimachepetsedwa ndi 5 mpaka 25 peresenti ngati mankhwala okhumudwa amaletsedwa posachedwa.
Zotsatira:
Ngan, Vanessa. Mthendayi yotchedwa epidermal necrolysis. Zochita za Khungu kwa Agents Akunja. 26 Dec 2006 New Zealand Dermatological Society.
"Toxic Epidermal Necrolysis." Khungu Kutentha (Rashes). 31 Jan 2008 University of Maryland Medical Center.
Toxic Epidermal Necrolysis. Mndandanda wa Zovuta Zambiri. National Organisation for Disorder Disorders.
Kusaka. "Toxic Epidermal Necrolysis" (2015).