Dambudziko repidermal necrolysis (TEN) inogona kuisa upenyu hwehutachiona hwehutachiona hunokonzera kushungurudzika pasi peganda (erythema), ganda reganda rinouraya ( necrosis ), uye kuputika kweganda uye mucous membrane. CHENYU hachibatanidzi kune rumwe rudzi rwakasiyana kana kuti chikadzi. Kunyange zvazvo chirwere chacho chinogona kukonzerwa nehutachiona kana tumarara, maitiro akawanda anowirirana nekushandiswa kwemishonga.
Mishonga Inozivikanwa Kuti Iite TEN
Mishonga inozivikanwa kuti inokonzera TEN inosanganisira:
- Mishonga inorwisa mabhakitiriya yakafanana sulfonamide, penicillin , macrolides, uye quinolones
- Anticonvulsant (antiseizure) zvinodhaka
- Kwete-steroidal anti-inflammatory drugs (NSAIDs)
- Allopurinol
- Tumor necrosis factor (TNF) -alpa madhiragi akadai Remicade (infliximab), Enbrel (etanercept), uye Humira (adalimumab)
Mhosva dzinodhaka-zvinokonzerwa kazhinji dzinowanzoitika mukati memamwe masvondo matatu kutanga kurapwa. Hazviwanzoiti kuitika kwezvinodhaka kuitika shure kwevhiki masere. Inenge chikamu chetatu chemhosva chinokonzerwa nezvinhu zvisingazivikanwi.
Zviratidzo
Dhiyabhorosi epidermal necrolysis kazhinji inotanga nemiratidzo yakafanana neyechirwere yakadai sefivha, kukwepa, chirwere cheputi, mhepo inoputika, uye manzwiro evanhu vemazuva maviri kusvika matatu. Zviratidzo izvi zvinogona kuenderera mberi kuisa:
- Zviduku zvitsvuku izvo zvinokura kuva mashizha makuru emucheka mutsvuku anofukidza 30 muzana kana kupfuura muviri
- Kunyanya kunetseka uye kufungidzira kweganda
- Yakaratidzwa yakanyorova, yakatsvuka, inorwadza nzvimbo apo ganda rave rakaneta
- Inokanganisa, miromo inopa ropa inogadzira makanda
- Meso maziso ( conjunctivitis )
- Kunyanya kurwadziwa
Zviratidzo izvi zvinowanzopedza mazuva masere kusvika ku12. Nemhaka yekuoma kwezviratidzo izvi, zvinetso zvinogona kukura, zvakadai sepineumonia ; kukanganiswa kwemukasi memukati mumuromo, kumutsipa uye kugadzirwa kwegumbo; skin skin infections; itsvo kusakanganiswa , ropa rinouraya ( sepsis ), uye kushamiswa.
Pasina kurapwa kwakakodzera, dzakawanda dzemigumisiro iyi inogona kuuraya.
Kuziva
TEN inowanzoongororwa inobva mumararamiro emurwere pamwe nekuongorora kwepanyama ganda. Zvimwe zvirwere zveganda, zvakadai se staphylococcal scalded skin syndrome, zvingave nezviratidzo zvakafanana. Kazhinji, mucheche weganda (biopsy) inotorwa kutsigira TEN uye kutonga kunze kweimwe dambudziko.
Chirapi
Dhiyabhorosi epidermal necrolysis inogona kukonzera kutyisa upenyu. Kana iwe uchifunga kuti unogona kuva neEEN, tsvaka kurapwa. TEN inonzi inofanirwa mune zvehutano uye inoda kurapwa nokukurumidza. Iyo yekare chirwere chacho chinorapwa, zviri nani kupembera. Zvirwere zvinogona kusanganisira:
- Kuchengeta chero mishonga inogona kukonzera TEN
- Intravenous (IV) mvura uye electrolytes
- Kubvisa zvitunha zveganda rakafa (debridement)
- Kudzivirira mabhandeji
- Mishonga inorwisa mabhakitiriya yekudzivirira kana kubata zvirwere
- Pain medicine
- Kurapa zvinetso zvakadai sepneumonia kana kusvuta kwepvo
- Kushandisa tubhuti yekufudza kupa mishonga
Kurapa kunogonawo kusanganisira IV immunoglobulin, cyclosporine, plasmapheresis , kana hyperbaric oksijeni. Zvidzidzo zvakaratidza kuti avo vanoendeswa kunzvimbo inopisa kana kuti huru yekuchengetedza zvigadzirwa zvakaderera vakaderedza maitiro ehutachiona pamwe nekuderera kwekufa kwehuwandu uye urefu hwehutachiona.
Chero mishonga inogona kukonzera TEN inofanira kumira pakarepo. Chimwe chidzidzo chakaratidza kuti kufa kwe-gumi kunogona kuderedzwa ne5 kusvika ku25 muzana kana kukanganiswa kwemishonga kwakagadziriswa pakarepo kungotanga kunetseka.
Sources:
Ngan, Vanessa. Dhiyabhorosi epidermal necrolysis. Kugadziriswa Kweganda kune Vashandi Vokunze. 26 Dec 2006 New Zealand Dermatological Society.
"Toxic Epidermal Necrolysis." Ganda Kubvumira (Rashes). 31 Jan 2008 University of Maryland Medical Center.
Toxic Epidermal Necrolysis. Index of Rare Disorders. National Organisation for Rare Disorders.
Medscape. "Toxic Epidermal Necrolysis" (2015).