Necrobiosis lipoidica diabeticorum

ʻO Necrobiosis lipoidica diabeticorum kahi maʻi ʻili maʻamau e pili ana i ka maʻi kō. ʻO nā hopena i nā wahi ʻulaʻula ʻulaʻula o ka ʻili, ʻo ka mea maʻamau ma nā wāwae o lalo.

ʻO ke kumu o ka necrobiosis lipoidica diabeticorum (NLD) ʻike ʻole ʻia. Manaʻo ʻia e hoʻopili ʻia i ka lula o ke kīʻaha koko e pili ana i nā kumu autoimmune. Hoʻopōʻino kēia i nā protein i ka ʻili (collagen).

ʻO ka poʻe me ka maʻi diabetes type 1 ka mea ʻoi aku ka loaʻa o ka NLD ma mua o ka poʻe me ka maʻi diabetes type 2. ʻOi aku ka hopena o nā wahine ma mua o nā kāne. Hoʻonui ka puhipaka i ka makaʻu no NLD. Ma lalo o hoʻokahi hapalua o hoʻokahi pākēneka o ka poʻe me ka maʻi diabetes e ʻeha i kēia pilikia.

ʻO kahi ʻili liona kahi ʻili o ka ʻili ʻokoʻa i ka ʻili a puni. Me NLD, hoʻomaka nā leona e like me ke kūpaʻa, ʻoluʻolu, ʻulaʻula (papule) ma nā ʻāpana a me ka ʻaoʻao haʻahaʻa o nā wāwae. Kū pinepine lākou i nā wahi like ma nā ʻaoʻao ʻaoʻao o ke kino. ʻAʻohe o lākou ʻeha i ka pae mua.

I ka nui ʻana o nā papula, pālahalaha lākou. Hoʻolālā lākou i kahi kikowaena ʻalani ʻalani ʻōmaʻomaʻo me ka ʻulaʻula i hāpai ʻia i nā lihi purplish. ʻIke ʻia nā veins ma lalo o ka melemele o nā leona. He pōʻai a poepoe ʻole paha nā leona me nā palena i ho'ākāka pono ʻia. Hiki iā lākou ke pālahalaha a hui pū e hāʻawi i ke ʻano o kahi pāʻina.

Hiki pū kekahi nā leona ma nā forearms. Kākaʻikahi, hiki iā lākou ke hana ma ka ʻōpū, ka maka, ka ʻili, nā poho lima, a me nā kapuwaʻi o nā wāwae.

Hiki i ka trauma ke hoʻoulu i nā lehelehe. E hoʻomohala pū kekahi ʻo Nodules. Maliʻa a ʻeha hoʻi ka ʻāpana.

ʻOkoʻa ʻo NLD mai nā maʻi palaki e hiki ke hana ma nā wāwae a i ʻole nā ​​kuʻekuʻe wāwae i ka poʻe me ka maʻi kō.

Hiki i kāu mea mālama ola ke nānā i kou ʻili e hōʻoia i ka ʻike.

Inā pono, hana paha kāu mea hāʻawi i kahi biopsy punch e kuhikuhi i ka maʻi. Lawe ka biopsy i kahi laʻana o nā kiko mai ka lihi o ka leona.

Hana paha kāu mea hāʻawi i kahi hōʻoia tolerance glucose e ʻike inā he maʻi diabetes kou.

Hiki i ka NLD ke paʻakikī e mālama. ʻAʻole ka hoʻomaikaʻi ʻana o ka glucose koko i nā ʻōuli.

Hiki ke hoʻopili ʻia i ka mālama ʻana:

• Pālolo Corticosteroid
• ʻO Corticosteroids i hoʻopili ʻia
• Nā lāʻau e kāohi i ka ʻōnaehana pale
• Nā lāʻau anti-inflammatory
• ʻO nā lāʻau e hoʻomaikaʻi i ke kahe o ke koko
• Hiki ke hoʻohana ʻia ʻo Hyperbaric oxygen therapy e hoʻonui ai i ka nui o ka oxygen i loko o ke koko e hāpai i ka hoʻōla ʻana o nā ulcer
• Phototherapy, kahi hana olakino kahi e akahele ai ka ʻili i ke kukui ultraviolet
• Hoʻomaʻo laser

I nā hihia koʻikoʻi, hiki ke hoʻoneʻe ʻia ka liona e ke ʻoki kino, a ukali ʻia e ka neʻe ʻana (grafting) ʻili mai nā ʻāpana ʻē aʻe o ke kino i ka wahi i hana ʻia.

I ka wā o ka mālama ʻana, e nānā i kāu pae glucose e like me ke kauoha. Hōʻalo i ka hōʻeha i kahi e pale ai i nā lehelehe mai ka huli ʻana i ulcer.

Inā hoʻomohala ʻoe i nā maʻi puʻupuʻu, e hāhai i nā kaupae pehea e mālama pono ai i nā maʻi maʻi.

Inā puhi ʻoe, e aʻo ʻia ʻoe e haʻalele. Hiki i ka puhihihi ke hoʻolohi i ka hoʻōla o nā leona.

He maʻi lōʻihi ʻo NLD. ʻAʻole hoʻōla maikaʻi nā liona a hiki ke hana hou. He paʻakikī ka mālama ʻana i nā ulcer. Lōʻihi paha ka helehelena o ka ʻili e lilo i mea maʻamau, ʻoiai ma hope o ka lapaʻau ʻana.

ʻAʻole hiki i ka NLD ke loaʻa ka hopena i ka maʻi ʻaʻai (ʻāpepa carcinoma uila).

Hoʻonui ka pilikia o ka poʻe me NLD no:

• Retinopathy diabetic
• Nephropathy diabetic

Kāhea i kāu mea hāʻawi inā loaʻa ʻoe i ka maʻi kō a ʻike i nā leona hōʻola ʻole ma kou kino, keu hoʻi i ka ʻaoʻao haʻahaʻa o nā wāwae.

Necrobiosis lipoidica; NLD; Diabetes - nekrobiosis

• Necrobiosis lipoidica diabeticorum - ʻōpū
• Necrobiosis lipoidica diabeticorum - wāwae

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James WD, Elston DM, Hana iā JR, Rosenbach MA, Neuhaus IM. Nā hemahema i ka metabolism. I: James WD, Elston DM, mālama iā JR, Rosenbach MA, Neuhaus IM, eds. Nā maʻi o Andrews 'o ka ʻili: Dermatology Haumāna. 13th ed.Piladelapia, PA: Elsevier; 2020: chap 26.

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