Stevens-Johnson syndrome (SJS) inowanzofungidzirwa sechimiro chakaipa che erythema multiform, iyo iyo pachayo iyo rudzi rwehutachiona hwehutano hwemishonga kune mishonga, kusanganisira pamusoro pemiti-mishonga, kana utachiona, semhepepe kana kufamba pneumonia iyo inokonzerwa naMycoplasma pneumoniae .
Dzimwe nyanzvi dzinofunga nezve Stevens-Johnson syndrome semamiriro akasiyana eerythema multiform, izvo zvinoparadzanisa mu erythema multiforme maduku uye erythema multiform maitiro makuru.
Kuita kuti zvinhu zviwedzere kuvhiringidza, panewo maitiro akaoma a Stevens-Johnson syndrome: Toxic Epidermal Necrolysis (TEN), iyo inozivikanwawo seRyell's Syndrome.
Stevens-Johnson Syndrome
Vanachipiri vevana vana, Albert Mason Stevens naFrancis Chambliss Johnson, vakawana Stevens-Johnson syndrome muna 1922. Stevens-Johnson syndrome inogona kuisa upenyu pangozi uye inogona kuita zviratidzo zvakakomba, zvakadai sehombodo huru dzeganda uye kucheneswa kweganda remwana.
Stevens-Johnson syndrome inowanzoitika inenge inenge 1.5 kusvika ku 2 mamiriyoni evanhu vane mamiriyoni gore roga roga, saka hazviwanzoitiki. Zvinosuruvarisa, vanenge 5 muzana yevanhu vane Stevens-Johnson syndrome uye 30 muzana neToxic Epidermal Necrolysis vane zviratidzo zvakanyanya zvokuti havadzoki.
Vana vezera chero ripi zvaro uye vanhu vakuru vangakanganiswa naStevens-Johnson syndrome, kunyange zvazvo vanhu vasingazivikanwi, sekuita neHIV , vangangodaro vari pangozi.
Zviratidzo zveStevens-Johnson Syndrome
Stevens-Johnson syndrome inowanzotanga nemiratidzo yakafanana neyechirwere , yakadai sefivha, kurwadziwa, uye kuora. Zvadaro, mazuva matatu kusvika matatu gare gare, mwana ane Stevens-Johnson syndrome achakudziridza:
- kunzwa kunopisa pamiromo, mukati memasaya avo (buccal mucosa), nemaziso
- kubhururuka kwakatsvuka, kunogona kuva nenzvimbo dzemafu, kana kuti kukura kuva blisters
- kurira kwechiso, maziso, uye / kana rurimi
- tsvuku, maziso eropa
- kunzwisisika ku chiedza (photophobia)
- zvipembenene zvinorwadza kana kukanganisa mumuromo, mhuno, maziso, uye mucosa yebonde, izvo zvinogona kutungamirira kukura
Zvinetso zveStevens-Johnson syndrome zvinogona kusanganisira kurwara kwepachimara nekupofumadza, pneumonitis, myocarditis, hepatitis, hematuria, kusvuta kwepvo, uye sepsis.
Chiratidzo chakanaka cha Nikolsky, umo maitiro makuru emucheche emwana anobva paanobviswa, chiratidzo chekukurira kweStevens-Johnson kana kuti yakashanduka kuTyxic Epidermal Necrolysis.
Mwana anongorongedzerwa seAction Toxic Epidermal Necrolysis kana ane anopfuura 30 muzana yemasasa epidermal (ganda).
Zvinokonzera Stevens-Johnson Syndrome
Kunyange zvazvo mishonga inopfuura 200 inogona kukonzera kana kutema Stevens-Johnson syndrome, yakawanda inowanzo:
- anticonvulsants (chirwere chekufa kana kuurayiwa), kusanganisira Tegretol (Carbamazepine), Dilantin (Phenytoin), Phenobarbital, Depakote (Valproic Acid), uye Lamictal (Lamotrigine)
- sulfonamide antibiotics, zvakadai seBactrim (Trimethoprim / Sulfamethoxazole), iyo inowanzoshandiswa kurapa UTIs naMRSA
- beta-lactam antibiotics, kusanganisira penicillin uye cephalosporins
- nonsteroidal anti-inflammatory drugs, kunyanya yemhando ye oxicam, yakadai seFeldene (Piroxicam) (isingawanzogadzirirwa vana)
- Zyloprim (allopurinol), iyo inowanzoshandiswa kurapa gout
Stevens-Johnson syndrome inowanzofungidzirwa kuti inokonzerwa nekushandiswa kwezvinodhaka, asi zvirwere zvingangosanganiswa nazvo zvinogona kusanganisira izvo zvinokonzerwa ne:
- herpes simplex virus
- Mycoplasma pneumoniae mabhakitiriya (kufamba pneumonia)
- hepatitis C
- Histoplasma capsulatum fungus (Histoplasmosis)
- Epstein-Barr virus ( mono )
- Adenovirus
Mishonga yaStevens-Johnson Syndrome
Mishonga ye Stevens-Johnson syndrome inowanzotanga nekumira chero mishonga ipi zvingangodaro yakakonzera kugadzirisa uye yotsigira kutarisira kusvikira murwere achidzoka mukati mavhiki mana.
Varwere ava vanowanzoda kutarisirwa muIntensive Care Unit, nemishonga inogona kusanganisira:
- IV mvura
- nutritional supplements
- mishonga inorwisa mabhakitiriya kuti iite zvirwere zvechipiri
- kurwadziwa kwemarwadzo
- ronda ronda
- steroid uye intraogous immunoglobulin (IVIG), kunyange zvazvo kushandiswa kwavo kuchiri kukakavadzana
Stevens-Johnson syndrome mishonga inowanzorongedzerwa muboka, pamwe nechiremba ICU, dermatologist, ophthalmologist, pulmonologist, uye gastroenterologist.
Vabereki vanofanira kutsvaga kurapwa pakarepo kana vachifunga kuti mwana wavo angave ane Stevens-Johnson syndrome.
Sources:
Habif: Clinical Dermatology, 5th ed.
Kliegman: Nelson Nhamba yeBhuku rePediatrics, 18th ed.
Koh MJ. Stevens-Johnson syndrome uye chepidermal necrolysis muAsia vana. J Am Acad Dermatol - 01-JAN-2010; 62 (1): 54-60.
Mandell: Mandell, Douglas, uye Bennett's Principles and Practice of Infectious Diseases, 7th ed.
Natacha Levi, PharmD. Mishonga seIngozi dzeStevens-Johnson Syndrome uye Toxic Epidermal Necrolysis muvana: A Pooled Analysis. Pediatrics, Feb 2009; 123: e297 - e304.