Mokokotlo oa Stevens-Johnson (SJS) o atisa ho nkoa e le mofuta o matla oa erythema multiforme, e leng oona mofuta oa hypersensitivity e sebetsanang le meriana, ho akarelletsa le ho feta lithethefatsi, kapa tšoaetso, joaloka herpes kapa pneumonia e tsamaeang e bakoang ke Mycoplasma pneumoniae .
Litsebi tse ling li nahana ka lefu la Stevens-Johnson e le boemo bo fapaneng ho tloha ho erythema multiforme, eo ba e arolelang ho erythema multiforme e nyenyane le erythema multiform mefuta e meholo.
Ho etsa hore lintho li ferekane le ho feta, ho na le mofuta o matla oa lefu la Stevens-Johnson: Toxic Epidermal Necrolysis (TEN), eo hape e tsejoang e le Lyell's Syndrome.
Stevens-Johnson Syndrome
Lingaka tse peli tsa bana, Albert Mason Stevens le Frank Chambliss Johnson, li fumane boloetse ba Stevens-Johnson ka 1922. Matšoao a Stevens-Johnson a ka beha bophelo ba hae kotsing 'me a ka baka matšoao a tebileng a kang letlalo le letlalo la ngoana.
Lefu la Stevens-Johnson le hlaha ka karolelano ea linyeoe tse ka bang 1.5 ho isa ho tse peli ho batho ba limilione selemo se seng le se seng, kahoo ha se fumaneha hangata. Ka bomalimabe, hoo e ka bang karolo ea 5 lekholong ea batho ba nang le lefu la Stevens-Johnson le karolo ea 30 lekholong le Toxic Epidermal Necrolysis ba na le matšoao a matla joalo hoo ba sa hlaphoheloeng.
Bana ba nang le lilemo leha e le life le batho ba baholo ba ka angoa ke lefu la Stevens-Johnson, le hoja batho ba sa khoneng ho itšoara hampe, joalo ka ho ba le HIV , ba ka 'na ba ba kotsing.
Matšoao a Stevens-Johnson Syndrome
Hangata lefu la Stevens-Johnson le qala ka matšoao a kang a mafu , a kang feberu, 'metso le ho khohlela. Ka mor'a moo, matsatsi a 1 ho isa ho a mararo hamorao, ngoana ea nang le lefu la Stevens-Johnson o tla hlahisa:
- ho utloahala mollo molomong, ka har'a marameng a bona (buccal mucosa) le mahlo
- ho phatloha ho bofubelu, ho ka 'nang ha e-ba le litsi tse lefifi, kapa ho fetoha marabele
- ho ruruha sefahleho, likopi, le / kapa leleme
- bofubelu, mahlo a mali
- kutloisiso ea leseli (photophobia)
- lisosa tse utloisang bohloko kapa likhatello tse tsoang molomong, nko, mahlo, le mucosa ea thobalano, e ka lebisang ho fokotseha
Mathata a lefu la Stevens-Johnson a ka kenyeletsa ho bolaoa ke lesea le bofofu, pneumonitis, myocarditis, lefu la sebete, hematuria, ho hloleha ha liphio le sepsis.
Pontšo e ntle ea Nikolsky, eo ho eona ho hlahang letlalo la ngoana ha ho etsoa rubbed, ke letšoao la lefu le matla la Stevens-Johnson kapa hore le fetohile Toxic Epidermal Necrolysis.
Ngoana o boetse o khetholloa ho ba le Toxic Epidermal Necrolysis haeba a na le karolo ea 30 lekholong ea sesole sa epidermal (letlalo).
Mabaka a Stevens-Johnson Syndrome
Le hoja meriana e fetang 200 e ka baka kapa ea baka lefu la Stevens-Johnson, le tloaelehileng le kenyeletsa:
- li-anticonvulsants (phekolo ea lefu la sethoathoa kapa lefuba), ho akarelletsa le Tegretol (Carbamazepine), Dilantin (Phenytoin), Phenobarbital, Depakote (Valproic Acid), le Lamictal (Lamotrigine)
- li-antibiotic tsa sulfonamide, tse kang Bactrim (Trimethoprim / Sulfamethoxazole), e atisang ho sebelisoa ho tšoara UTIs le MRSA
- lithibela-beta-lactam, ho akarelletsa le penicillin le cephalosporins
- li-anti-inflammatory drugs, haholo-holo tsa mofuta oa oxicam, tse kang Feldene (Piroxicam) (eo hangata e sa fuoang bana)
- Zyloprim (allopurinol), e tloaelehileng e sebelisetsoang ho phekola gout
Hangata lefu la Stevens-Johnson le nahanoa hore le bakiloe ke liphello tsa lithethefatsi, empa tšoaetso e ka 'nang ea amahanngoa le eona e ka kenyelletsa e bakoang ke:
- virus ea herpes simplex
- Lik'hemik'hale tsa Mycoplasma pneumoniae (ho tsamaea pneumonia)
- hepatitis C
- Histoplasma capsulatum fungus (Histoplasmosis)
- Lefu la Epstein-Barr ( mono )
- Adenovirus
Kalafo bakeng sa Stevens-Johnson Syndrome
Litlhare tsa lefu la Stevens-Johnson li atisa ho qala ka ho emisa lithethefatsi leha e le life tse ka 'nang tsa etsa hore li arabeloe mme ka nako eo li hlokomeloe ho fihlela mokuli a hlaphoheloa libeke tse ka bang 4.
Bakuli bana ba atisa ho hlokomeloa ka setsi sa tlhokomelo e kholo, ka mekhoa e ka kenyelletsang:
- Lisebelisoa tsa IV
- phepo e nepahetseng
- lithibela-mafu ho phekola tšoaetso ea bobeli
- meriana ea bohloko
- tlhokomelo ea leqeba
- li-steroids le immraoglobulin (IVIG), le hoja tšebeliso ea tsona e ntse e ngangisana
Mekhoa ea phekolo ea lefu la Stevens-Johnson e atisa ho hokahanngoa ka mokhoa oa sehlopha, le ngaka ea ICU, dermatologist, setsebi sa likokoana-hloko, pulmonologist le gastroenterologist.
Batsoali ba lokela ho ea ngakeng hang-hang haeba ba nahana hore ngoana oa bona a ka ba le lefu la Stevens-Johnson.
Lisebelisoa:
Habif: Dermatology ea Kliniki, la bohlano.
Kliegman: Nelson Textbook ea Pediatrics, la 18th.
Koh MJ. Matšoao a Stevens-Johnson le lefuba la kankere ea necrolysis ho bana ba Asia. J Am Acad Dermatol - 01-JAN-2010; 62 (1): 54-60.
Mandell: Mandell, Douglas le melao-motheo ea Bennett le mekhoa ea mafu a tšoaetsanoang, la 7th ed.
Natacha Levi, PharmD. Meriana e le Lintho Tse Kotsing tsa Stevens-Johnson Syndrome le Toxic Epidermal Necrolysis ho Bana: Tlhahlobo e Senyehileng. Phekolo ea bana, Feb 2009; 123: e297 - e304.