थप जानकारी ― नेपाली

Pyoderma gangrenosum छालाको दुर्लभ अवस्था हो जसले रातो वा बैजनी छाला भएका पीडादायी अल्सरहरू निम्त्याउँछ। यो एक भडकाऊ रोग को रूप मा वर्गीकृत छ र neutrophilic dermatoses भनिन्छ समूह को एक हिस्सा हो। pyoderma gangrenosum को कारण जटिल छ, जसमा आनुवंशिक रूपमा प्रवण भएका व्यक्तिहरूमा जन्मजात र अनुकूली प्रतिरोधात्मक क्षमता दुवै समस्याहरू समावेश छन्। हालै, अनुसन्धानकर्ताहरूले कपालको फोलिक्युलमा रोगको सम्भावित सुरुवात बिन्दुको रूपमा ध्यान केन्द्रित गरेका छन्।
Pyoderma gangrenosum is a rare inflammatory skin disease classified within the group of neutrophilic dermatoses and clinically characterized by painful, rapidly evolving cutaneous ulcers with undermined, irregular, erythematous-violaceous edges. Pyoderma gangrenosum pathogenesis is complex and involves a profound dysregulation of components of both innate and adaptive immunity in genetically predisposed individuals, with the follicular unit increasingly recognized as the putative initial target.

Pyoderma gangrenosum एक दुर्लभ छाला अवस्था हो जसले अत्यन्त पीडादायी अल्सर निम्त्याउँछ। यद्यपि हामीले यसको कारणलाई पूर्ण रूपमा बुझ्दैनौं, हामीलाई थाहा छ कि यसले निश्चित प्रतिरक्षा कोशिकाहरूको बढ्दो गतिविधि समावेश गर्दछ। रोगको उपचार अझै सजिलो छैन। हामीसँग विभिन्न औषधिहरू छन् जसले प्रतिरक्षा प्रणालीलाई दबाउन वा यसको गतिविधि परिमार्जन गर्दछ। यी बाहेक, हामी घाउको उपचार र पीडा व्यवस्थापनमा पनि ध्यान केन्द्रित गर्छौं। Corticosteroids र cyclosporine अक्सर उपचार को लागी पहिलो छनोट हो, तर हालै, TNF-α अवरोधकहरु जस्तै जैविक उपचार को प्रयोग मा अधिक अनुसन्धान भएको छ। यी जीवविज्ञानहरू बढ्दो प्राथमिकतामा छन्, विशेष गरी अन्य भडकाऊ अवस्था भएका बिरामीहरूमा, र तिनीहरू रोग प्रक्रियामा पहिले प्रयोग भइरहेका छन्।
Pyoderma gangrenosum is a rare neutrophilic dermatosis that leads to exceedingly painful ulcerations of the skin. Although the exact pathogenesis is not yet fully understood, various auto-inflammatory phenomena with increased neutrophil granulocyte activity have been demonstrated. Despite the limited understanding of the pathogenesis, it is no longer a diagnosis of exclusion, as it can now be made on the basis of validated scoring systems. However, therapy remains a major multidisciplinary challenge. Various immunosuppressive and immunomodulatory therapies are available for the treatment of affected patients. In addition, concomitant topical pharmacologic therapy, wound management and pain control should always be addressed. Corticosteroids and/or cyclosporine remain the systemic therapeutics of choice for most patients. However, in recent years, there has been an increasing number of studies on the positive effects of biologic therapies such as inhibitors of tumour necrosis factor-α; interleukin-1, interleukin-17, interleukin-23 or complement factor C5a. Biologics have now become the drug of choice in certain scenarios, particularly in patients with underlying inflammatory comorbidities, and are increasingly used at an early stage in the disease rather than in therapy refractory patients.