He aha ka Toxic Epidermal Necrolysis (TEN)?

Anter

• Nā Kumu
• Laau Lapaʻau
• Nā maʻi ʻino
• Nā ʻōuli
• Nā hiʻohiʻona hiʻohiʻona
• Ka pilina me ka maʻi ʻo Stevens-Johnson
• Nā kumu weliweli
• Kānāwai
• Lapaʻau
• Outlook
• Lawe aku

Toxic epidermal necrolysis (TEN) kahi ʻano ʻili laha ʻole a koʻikoʻi hoʻi. ʻO ka manawa pinepine, hoʻokumu ʻia ia e kahi hopena maikaʻi ʻole i nā lāʻau e like me anticonvulsants a i ʻole antibiotics.

ʻO ka hōʻailona nui ka ʻili ʻana i ka ʻili a ʻeha hoʻi. Holomua koke ka peeling, a laila hopena i nā wahi maka nunui i ʻū a i ʻole uē. Hoʻopili pū ia i nā membrane mucous, me ka waha, ka puʻu, nā maka, a me nā ʻāpana genital.

Mai ka hoʻomohala wikiwiki ʻana o TEN, he mea nui e kiʻi i ke kōkua i ka wā hiki wawe. ʻO TEN kahi ola hoʻoweliweli e koi ana i ka lāʻau lapaʻau koke.

E heluhelu e ʻimi i nā kumu a me nā ʻōuli o TEN, me ke ʻano o ka mālama ʻana.

Nā Kumu

Ma muli o ka liʻiliʻi loa o ka TEN, ʻaʻole maopopo loa ia. Hoʻokumu pinepine ʻia ia e kahi hopena maikaʻi ʻole i ka lāʻau. I kekahi manawa, paʻakikī e hoʻomaopopo i ke kumu kumu o TEN.

Laau Lapaʻau

ʻO ke kumu maʻamau o TEN kahi hopena maʻamau i ka lāʻau. ʻIke ʻia kekahi ʻano weliweli o ka ʻino, a nāna ke kuleana a hiki i ka 95 pākēneka o nā hihia UMI.

ʻO ka manawa pinepine, hana ke ʻano i loko o nā hebedoma 8 mua o ka lawe ʻana i ka lāʻau.

ʻO nā lāʻau aʻe e pili pinepine ʻia me TEN:

• anticonvulsants
• oxicams (lāʻau lapaʻau anti-inflammatory nonsteroidal)
• antibiotic sulfonamide
• allopurinol (no ka gout a me ka pale ʻana i nā pōhaku hakuʻala)
• nevirapine (lāʻau anti-HIV)

Nā maʻi ʻino

I nā hanana kakaikahi loa, hoʻopili ʻia kahi maʻi like TEN i kahi maʻi maʻi e ke koʻohune i ʻike ʻia Mycoplasma pneumoniae, ke kumu o ka maʻi hanu.

Nā ʻōuli

ʻOkoʻa nā ʻōuli o TEN no kēlā me kēia kanaka. I nā wā mua, kumu pinepine ia i nā hōʻailona like flu. Hoʻopili paha kēia:

• fiva
• ʻeha ke kino
• ʻulaʻula, ʻōnohi nā maka
• paʻakikī i ka ale ʻana
• ihu ihope
• ʻūhā
• eha ka 'ā'ī

Ma hope o 1 a 3 mau lā, ʻili ka ʻili me a i ʻole ka maʻi ʻole. Hiki ke holomua i kēia mau ʻōuli ma loko o kekahi mau hola a mau lā paha.

ʻO nā ʻōuli ʻē aʻe e like me:

• nā ʻulaʻula, ʻulaʻula, a poni paha
• ʻili ʻeha
• nā wahi nui, maka o ka ʻili (erosions)
• nā ʻōuli e palahalaha ana i nā maka, ka waha, a me nā genital

Nā hiʻohiʻona hiʻohiʻona

ʻO ka ʻōuli nui o TEN ka ʻili ʻeha o ka ʻili. Ke holo nei ke ʻano, hohola koke ka ʻili a puni ke kino.

Ma lalo nā hiʻohiʻona hiʻohiʻona o UMI.

Ka pilina me ka maʻi ʻo Stevens-Johnson

ʻO Stevens-Johnson Syndrome (SJS), e like me TEN, kahi ʻano ʻili koʻikoʻi i hoʻokumu ʻia e kahi lāʻau a i ʻole, pili pinepine ʻole ʻia me kahi maʻi. Aia nā kūlana ʻelua i ka laulima hoʻokahi o ka maʻi a ʻokoʻa i ka nui o ka ʻili i pili.

ʻOi aku ka paʻakikī o ka SJS. ʻO kahi laʻana, ma SJS, ma lalo o 10 pākēneka o ke kino e hoʻopili ʻia e ka ʻili ʻana i ka ʻili. I TEN, ʻoi aku ma mua o 30 pākēneka ka hopena.

Eia nō naʻe, he kūlana koʻikoʻi ʻo SJS. Pono ia i ka mālama olakino koke.

Hoʻohui pinepine ʻo SJS a me TEN, no laila kapa ʻia nā kūlana i kekahi manawa ʻo Stevens-Johnson Syndrome / ʻumeʻume epidermal nekrolysis, a i ʻole SJS / TEN.

Nā kumu weliweli

ʻOiai hiki i kekahi e lawe ana i ka lāʻau ke hoʻomohala i TEN, ʻoi aku ka nui o ka makaʻu o kekahi poʻe.

Nā kumumea hiki ke pili pū me:

• Makahiki. Hiki i ka TEN ke hoʻopili i ka poʻe o nā makahiki āpau, akā ʻoi aku ka hopena i ka poʻe mākua.
• Hoohanau. Hiki paha i nā wahine ke piʻi i luna o TEN.
• ʻ immunenaehana pale nawaliwali. ʻO ka poʻe me ka ʻōnaehana pale nawaliwali e hoʻomohala i ka TEN. Hiki paha kēia ma muli o nā kūlana e like me ka maʻi ʻaʻai a i ʻole HIV.
• AIDS. ʻO SJS a me TEN he 1000 mau manawa ka nui o ka poʻe maʻamau me ka maʻi SIDA.
• Nā Genetics. ʻOi aku ka kiʻekiʻe inā loaʻa iā ʻoe ka ʻeleu HLA-B * 1502, ka mea maʻamau i nā poʻe o ka Hikina Hema Hikina, Kina, a me nā ʻohana India. Hiki i ka gen ke hoʻonui i kou makaʻi i ka ʻUmi ke lawe ʻoe i kahi lāʻau.
• Mōʻaukala ʻohana. E hoʻomohala hou paha ʻoe iā TEN inā he ʻohana pili loa ka maʻi i loaʻa i kēia maʻi.
• Nā hopena lāʻau i hala. Inā ua hoʻomohala ʻoe TEN ma hope o ka lawe ʻana i kekahi lāʻau, loaʻa iā ʻoe ka nui o ka makaʻu inā ʻoe e lawe i ka lāʻau like.

Kānāwai

E hoʻohana kahi kauka i nā ʻano hoʻokolohua like ʻole e hōʻoia i kāu mau ʻōuli. Hoʻopili paha kēia:

• ʻImi kino. I ka wā o kahi hoʻokolohua kino, e nānā ke kauka i kou ʻili no ka peeling, palupalu, pili mucosal, a me ka maʻi.
• Mōʻaukala olakino. I mea e maopopo ai i kou olakino holoʻokoʻa, e nīnau ke kauka e pili ana i kāu mōʻaukala. Makemake pū lākou e ʻike i nā lāʻau āu e lawe ai, me nā lāʻau hou i lawe ʻia i loko o ʻelua mau mahina i hala, a me nā maʻi āpau āu i loaʻa.
• ʻ biiwi lāʻau. I loko o kahi biopsy o ka ʻili, lawe ʻia kahi ʻāpana o nā ʻili o nā ʻili i hoʻopili ʻia mai kou kino a hoʻouna ʻia i kahi keʻena hana. E hoʻohana kahi loea i kahi microscope e nānā i ke kiko a nānā i nā hōʻailona o TEN.
• Hōʻike koko. Hiki i kahi hōʻoia koko ke kōkua i ka ʻike ʻana i nā hōʻailona o ka maʻi a i ʻole nā ​​pilikia ʻē aʻe me nā mea o loko.
• Nā moʻomeheu. Hiki i ke kauka ke nānā i kahi maʻi ma ke kauoha ʻana i kahi moʻomeheu koko a ʻili paha.

ʻOiai e hiki i ke kauka ke kuhikuhi pono i ka TEN me kahi hōʻike kino wale nō, hana pinepine ʻia kahi biopsy o ka ʻili e hōʻoia i ka ʻike.

Lapaʻau

I nā hihia āpau, mālama ʻia ka mālama ʻana me ka hoʻopau ʻana i ka lāʻau i hoʻokumu i kāu hopena.

Pili nā ʻano lapaʻau ʻē aʻe i nā kumu he nui, e like me:

• kou mau makahiki
• kou nohona olakino olakino mōʻaukala
• ke koʻikoʻi o kou ʻano
• nā wahi o ke kino i hoʻopilikia ʻia
• kou ahonui i kekahi mau kaʻina hana

E hoʻopili ka mālama ʻana:

• Halemai. Pono e mālama i kēlā me kēia me TEN i kahi ʻāpana puhi.
• ʻO nā aila a me nā kāʻei. Mālama ka mālama ʻeha kūpono i ka hōʻino ʻana o ka ʻili a pale i ka ʻili maka mai ka pohō a me ka maʻi. I mea e pale ai i kou ʻili, e hoʻohana ana kāu kime haukapila i nā hamo kumuhana a me nā lole ʻeha.
• Intravenous (IV) wai a me nā electrolytes. ʻO ka nalo ʻana o ka ʻili e like me ka wela, keu hoʻi i ka TEN, alakaʻi i ka nalowale wai a me ke kaulike ʻole electrolyte. Hāʻawi ʻia ʻoe i ka wai IV a me nā electrolytes e hōʻemi i ka makaʻu. E kiaʻi pono ana kāu hui o ka haukapila i kāu mau electrolytes, ke kūlana o kāu ʻokena o loko, a me kou kūlana wai holoʻokoʻa.
• Hoʻokaʻawale. Ma muli o ka hoʻoliʻiliʻi o ka ʻili o TEN e hoʻonui ai i ka maʻi o ka maʻi, e hoʻokaʻawale ʻia ʻoe mai nā poʻe ʻē aʻe a me nā kumu kūpono o ka maʻi.

Hoʻohana ʻia nā lāʻau e mālama ai i ka ʻUmi:

• Nā Antibiotics. ʻAneʻane hāʻawi ʻia nā kānaka āpau me TEN i nā lāʻau antibiotic e pale a mālama i nā maʻi āpau.
• Immunoglobulin intravenous G (IVIG). ʻO nā Immunoglobulins he mau mea ʻino e kōkua i kou ʻōnaehana pale. Hoʻohana ʻia ʻo IVIG i kekahi manawa e kaohi i ka hopena. ʻO kēia kahi hoʻohana inoa inoa ʻole o IVIG.
• ʻO ka TNF alpha mea kāohi etanercept a me ka cyclosporine immunosuppressant. ʻO kēia nā lāʻau lapaʻau hoʻohiki e koi pinepine ʻia e ka poʻe loea i ka mālama ʻana iā TEN. ʻO kēia kahi hoʻohana inoa ʻole o nā lāʻau ʻelua.

Pono paha nā ʻāpana kikoʻī i nā ʻano lāʻau ʻokoʻa. ʻO kahi laʻana, inā pili kou waha, hiki ke hoʻohana ʻia kahi kuʻina lāʻau kuhikuhi kūikawā me ka hoʻohui ʻana i nā lāʻau ʻē aʻe.

E nānā pono kāu kime haukapila i kou mau maka a me nā genital no nā hōʻailona. Inā ʻike lākou i nā hōʻailona, ​​e hoʻohana lākou i nā ʻano lāʻau kumuhana kikoʻī e pale ai i nā pilikia, e like me ka nalo ʻana o ka hihiʻo a me ka scarring.

I kēia manawa, ʻaʻohe hana hoʻoponopono maʻamau no TEN. Hoʻololi paha ka hoʻomaʻamaʻa e pili ana i ka haukapila. ʻO kahi laʻana, hoʻohana paha kekahi mau haukapila i ka IVIG, ʻoiai e hoʻohana paha kekahi i kahi hui o etanercept a me cyclosporine.

ʻAʻole ʻae ʻia ʻo Etanercept a me cyclosporine i kēia manawa e ka Food and Drug Administration (FDA) e mālama iā TEN. Eia nō naʻe, hiki iā lākou ke hoʻohana ʻia i ka lepili lepili no kēia kumu. ʻO ka hoʻohana ʻana i ka lepili hōʻailona ʻo ia ka mea i hiki i kāu kauka ke kuhikuhi i kahi lāʻau no kahi kūlana i ʻae ʻole ʻia inā manaʻo lākou e pōmaikaʻi paha ʻoe i ka lāʻau. E aʻo hou aʻe e pili ana i ka hoʻohana ʻana i ka lāʻau lapaʻau i waho o ka lepili.

Outlook

ʻO ka helu make o TEN ma kahi o 30 pākēneka, akā hiki ke ʻoi aku ke kiʻekiʻe. Eia nō naʻe, pili nā mea he nui i kāu kuana ponoʻī, me kāu:

• makahiki
• olakino holoʻokoʻa
• ke koʻikoʻi o kāu kūlana, e pili ana i ka ʻili o ke kino i pili
• papa o ka lapaʻau

Ma ka laulā, hiki i ke ola ke lawe i 3 a 6 mau pule. ʻO nā hopena lōʻihi lōʻihi e pili pū ana paha:

• ʻiliʻiliʻili
• scarring
• ʻili maloʻo a me nā membrane mucous
• poho lauoho
• pilikia urino
• ʻono maikaʻi ʻole
• genities abnormalities
• loli ka ʻike, me ka nalowale

Lawe aku

ʻO ka necrolysis epidermal ʻumekau (TEN) kahi pilikia nui. Ma ke ʻano ʻili e hoʻoweliweli nei i ke ola, hiki ke alakaʻi koke i ka make wai a me ka maʻi. E kiʻi koke i ka lāʻau inā ʻoe a i ʻole kekahi mea āu i ʻike he hōʻailona o TEN.

Hoʻopili ka mālama ʻana i ka haukapila a me ke komo ʻana i kahi ʻāpana puhi. E hoʻonohonoho ka hui o kāu haukapila i ka mālama ʻana i ka ʻeha, ka hoʻōla wai, a me ka mālama ʻeha. Hiki iā 6 mau pule ke ʻoi aku ka maikaʻi, akā ʻo ka hoʻomaʻamaʻa mua ʻana e hoʻomaikaʻi ai i kou hoʻōla a me ka nānā.