I-necrolysis eyingozi ye-epidermal (i-TEN) iyisifo esingasongela isikhumba esingaba ukuphila esibangela ukuqhuma kwethenda ngaphansi kwesikhumba (i-erythema), i-skin cell cell death ( necrosis ), nokuphunga isikhumba kanye nezibungu zamangqamuzana. I-TEN ayixhunyiwe kunoma yiluphi uhlobo lobuhlanga noma ubulili. Ngenkathi isimo singabangelwa ukutheleleka noma izicubu, amacala amaningi ahlobene nokuphendula kwezidakamizwa.
Imithi Eyaziwa Ukubangela TEN
Imithi eyaziwa ukuthi ibangele i-TEN ihlanganisa:
- Ama-antibiotics afana ne-sulfonamides, amapenicillin , ama-macrolides, nama-quinolones
- Izidakamizwa ze-Anticonvulsant (antiseizure)
- Izidakamizwa ezingekho-steroidal anti-inflammatory (NSAIDs)
- I-Allopurinol
- I-tumor necrosis factor (TNF) - izidakamizwa ezifana ne-Remicade (infliximab), i-Enbrel (etanercept), ne-Humira (i-adalimumab)
Amacala asetshenziselwa izidakamizwa ngokuvamile avela emasontweni owodwa kuya kwamathathu ukuqala ukwelashwa. Akuvamile ukuthi ukusabela kwezidakamizwa kwenzeke ngemuva kwamasonto ayisishiyagalombili. Cishe ingxenye yesithathu yamacala ibangelwa izici ezingaziwa.
Izimpawu
I-necrolysis eyingozi ye-epidermal ngokuvamile iqala ngezimpawu ezifana nemfiva, ukukhwehlela, umkhuhlane, impumu egijimayo, kanye nokuzwa okungahambi kahle kwezinsuku ezimbili kuya kwezintathu. Lezi zimpawu zingase ziqhubeke zibandakanya:
- Izindawo ezincane ezibomvu ezikhuphuka zibe izikhonkwane ezinkulu zesikhumba esibomvu ezimboza amaphesenti angu-30 noma ngaphezulu komzimba
- Ukwehliswa okujulile nokucubungula isikhumba
- Izindawo ezibucayi, ezibomvu, ezibuhlungu lapho isikhumba sikhishwe khona
- Ukuphahlazeka, izindebe eziphaphayo ezakha ama-crusts
- Amehlo amancane ( conjunctivitis )
- Ubuhlungu obukhulu
Lezi zimpawu ngokuvamile zihlala izinsuku eziyisishiyagalombili kuya kwezingu-12. Ngenxa yobunzima balezi zimpawu, izinkinga zingase zikhule, njenge- pneumonia ; ukuxubana kwamakhanda emlonyeni emlonyeni, emphinjeni nasendleleni yokugaya ukudla; izifo zesikhumba; ukuhluleka kwezinso , ukubulawa kwegazi ( sepsis ), nokushaqeka.
Ngaphandle kokwelashwa okufanele, eziningi zalezi zemihelo zingabulala.
Ukuxilongwa
I-TEN ngokuvamile ihlolwe isekelwe ezimpawu zesiguli kanye nokuhlolwa ngokomzimba kwesikhumba. Ezinye izifo zesikhumba, njenge-staphylococcal scalded skin syndrome, zingase zibe nezimpawu ezifanayo. Ngokuvamile, isampula yesikhumba (i-biopsy) izothathwa ukuqinisekisa i-TEN futhi ilawule noma yiziphi ezinye izifo.
Ukwelashwa
I-necrolysis ye-epidermal enobuhlungu ingabangela izinkinga zokusongela ukuphila. Uma ucabanga ukuthi ungaba ne-TEN, funa ukwelashwa. I-TEN ibhekwa njengesimo esiphuthumayo sezokwelapha futhi sidinga ukwelashwa okusheshayo. Ekuqaleni isimo siphathwa, kungcono ukubikezelwa. Izinketho zokwelapha zingafaka:
- Ukuyeka noma yimiphi imithi engabangela i-TEN
- Ama-intravenous (IV) amanzi kanye nama-electrolyte
- Ukususa izicubu zesikhumba ezifile (ukukhathala)
- Amabhandeshi okuvikela
- Ama-antibiotics ukuvimbela noma ukuphatha izifo
- Imithi yobuhlungu
- Ukuphatha izinkinga ezifana ne-pneumonia noma ukwehluleka kwezinso
- Ukusebenzisa ithubhu yokudla ukuletha izakhi
Ukwelashwa kungase kuhlanganise ne-IV immunoglobulin, i-cyclosporine, i- plasmapheresis , noma i-hyperbaric oxygen. Ucwaningo luye lwabonisa ukuthi labo abadluliselwa esitokisini esishisayo noma esinakekelwayo okuphuthumayo ekuqaleni baye banciphisa amazinga okutheleleka kanye nokunciphisa izinga lokufa kanye nobude bokubhedlela.
Noma yimiphi imithi engabangela i-TEN kufanele imiswe ngokushesha. Ucwaningo olulodwa lubonise ukuthi ukufa okuhlobene ne-TEN kunganciphisa ngamaphesenti angu-5 kuya kuma-25 uma imithi ephulukisayo imiswa ngokushesha nje lapho kuqhuma isibhamu.
Imithombo:
Ngan, Vanessa. I-necrolysis ye-epidermal enobuhlungu. Ukusabela Kwesikhumba kuma Agent angaphandle. 26 Dec 2006 New Zealand Dermatological Society.
"I-Epidermal Necrolysis eyingozi." Isikhumba sokuvuvukala (ukuhlambalaza). 31 Jan 2008 Isikhungo Sezokwelapha sase-University of Maryland.
I-Epidermal Necrolysis enobuthi. Inkomba Yezinkinga Eziyingozi. Inhlangano Kazwelonke Yezinkinga Ezinzima.
I-Medscape. "I-Epicermermal Necrolysis enobuthi" (2015).