Isifo esiyingozi se-epidermal necrolysis (i-TEN) sisifo esichengela ubomi esichengeni ubomi esenza ukuba ithenda ikhuphe phantsi kwesikhumba (i-erythema), ukufa kweeselfusi (i- necrosis ), kunye ne-blistering yolusu kunye neembrane. I-TEN ayixhomekeke kunoma yintoni ubuhlanga okanye isini. Ngoxa iimeko zingabangela ukusuleleka okanye izifo, amaninzi amaninzi adibaniswa neempendulo zamachiza.
Amachiza ayaziwa ukudala i-TEN
Iziyobisi eziziwa ngokubangela i-TEN zibandakanya:
- Ii-antibiotics ezifana ne-sulfonamides, i- penicillin , i-macrolides kunye ne-quinolones
- I-Anticonvulsant (i-antiseizure) iziyobisi
- Iziyobisi ezingekho-steroidal ezichasayo (i-NSAID)
- Allopurinol
- I-tumor necrosis factor (TNF) -iyobisi ezinjenge-Remicade (infliximab), i-Enbrel (etanercept), kunye ne-Humira (adalimumab)
Iziganeko ezibangelwa yiziyobisi zivame ukuba zenzeke kwiiveki enye ukuya kweyithathu ukuqala unyango. Akunqabile ukuphendula kwezidakamizwa ukuba kwenzeke emva kweiveki ezisibhozo. Phantse enye yesithathu yamatyala kubangelwa izinto ezingaziwa.
Iimpawu
Inetyhefu ye-epidermal necrolysis ngokuqhelekileyo iqala ngeempawu ezinjengomkhuhlane, ukukhwehlela, umqala womqala, impumlo yomsindo, kunye neengxaki eziqhelekileyo zokuba zincinci iintsuku ezimbini ukuya kwiintsuku ezintathu. Ezi zimpawu zingaphumelela ukubandakanya:
- Amacandelo amancinci amancinci ahlakulayo abe ngamaqabunga amakhulu ebomvu obomvu afikelela kwipesenti ezingama-30 okanye ngaphezulu komzimba
- Ukugqithisa kakhulu kunye nokukhangela kwesikhumba
- Imbonakalo enomanzi, ebomvu, ebuhlungu apho ulusu lukhuphe khona
- Ukuphazamiseka, imilomo ephumayo eyenza i-crusts
- Amehlo abuhlungu ( conjunctivitis )
- U buhlungu obukhulu
Ezi zihlandlo zihlala zihlala iintsuku ezisibhozo ukuya kwi-12. Ngenxa yobunzima beempawu, iingxaki ezinokuthi ziphuhlise, ezinjenge- pneumonia ; ukuxubha kweembumba ezinomlomo emlonyeni, emqaleni nasemgodini wokutya; zikhuhlane; ukuhluleka kwezintso , ukutyhelwa kwegazi ( sepsis ), kunye nokutshitshiswa.
Ngaphandle kokonyango olufanelekileyo, ezininzi zeziphumo zecala zingaba zibulala.
Ukuxilongwa
I-TEN ihlolwe ngokusekelwe kwiimpawu zesigulane kwakunye nokuhlolwa kwenyama kwesikhumba. Ezinye izifo zesikhumba, ezinjenge-staphylococcal ekhutshwe zizifo zesikhumba, zinokuba neempawu ezifanayo. Ngokuqhelekileyo, isampuli yesikhumba (i-biopsy) iya kuthathwa ukuqinisekisa i-TEN kwaye ilawulwe nayiphi na enye ingxaki.
Unyango
Inetyhefu ye-epidermal necrolysis ingabangela iingxaki ezisongela ubomi. Ukuba ucinga ukuba unayo i-TEN, khangela unyango. I-TEN ithathwa njengongxamiseko lwezonyango kwaye idinga unyango olukhawulezayo. Ekuqaleni le meko iphathwa, kulunge ukuhlaziya. Izinketho zokwelapha zingaquka:
- Ukuyeka nayiphina imithi enokubangela i-TEN
- Intravenous (IV) amanzi kunye ne-electrolytes
- Ukususa izicubu zesikhumba ezifile (ukuhlawula)
- Amagada okukhusela
- Amayeza anokuthintela okanye aphathe izifo
- Iimpawu zobuhlungu
- Ukunyangwa iingxaki ezinjenge-pneumonia okanye ukungaphumeleli kwezintso
- Ukusebenzisa ityhubhu yokutya ukuhambisa izondlo
Unyango lunokubandakanya i-IV immunoglobulin, i-cyclosporine, i- plasmapheresis , okanye i-oksijeni ye-hyperbaric. Izifundo zibonise ukuba abo bathunyelwa kwi-unit burn or in-care unit yokuqala baye banciphisa amazinga okusuleleka kunye nokunciphisa izinga lokufa kunye nobude bokubhedlelelwa esibhedlele.
Nawaphi na amayeza anokubangela i-TEN kufuneka imiswe ngokukhawuleza. Olunye uphando lubonise ukuba ukufa okuhlobene ne-TEN kungancitshiswa ngama-5 kuya kuma-25 ekhulwini xa unyango olusisigxina luye lwacima ngokukhawuleza xa kuqalisa ukuvuvukala.
Imithombo:
Ngan, uVanessa. Inetyhefu ye-epidermal necrolysis. Ukusabela Kwesikhumba kuma Agente angaphandle. 26 Disemba 2006 iNew Zealand iDermatological Society.
"I-Toxic Epidermal Necrolysis." Ukuqhwala kwesibatho (ukuhlambalaza). 31 uJuni 2008 IYunivesithi yaseMary Medical Centre.
Netyhefu Epidermal Necrolysis. Index of Distractions Disorders. I-National Organisation for Distress Disorders.
Medscape. "I-Toxic Epidermal Necrolysis" (2015).