Kab lus no yuav tham txog dab tsi yog ntsia thawv psoriasis, dab tsi ua rau tus kab mob, nws tshwm sim thiab kev kho mob. Qhov no pathology yog ib qho tseem ceeb diagnostic kos npe rau ntawm psoriatic mob caj dab. Yog tias pom cov tsos mob hauv qab no, thiab tsis muaj pob khaus ntawm daim tawv nqaij, ces koj yuav tsum sab laj nrog kws kho mob, vim tias tsis muaj kev kho raws sij hawm tuaj yeem ua rau cov txheej txheem rov qab tsis zoo hauv cov pob qij txha.
Psoriatic hloov pauv ntawm cov ntsia hlau daim hlau
Nail puas hauv psoriasis tshwm sim hauv 80% ntawm cov neeg mob. Qhov no yog ib qho kab mob uas tsis yog tsuas yog cov tsos mob ntawm cov ntsia hlau daim hlau tsis zoo xwb, tab sis kuj pathologically active faib ntawm epidermal hlwb tsim, deposition ntawm keratin thiab cov rog yog cuam tshuam, vim hais tias cov stratum corneum ntawm daim tawv nqaij ua elastic thiab ruaj, Kev hloov pauv tshwm sim hauv cov kab mob musculoskeletal thiab cov kab mob hauv nruab nrog cev.
Nail psoriasis (cov duab ntawm cov ntsia hlau cuam tshuam, muab tso rau nws me me, tsis kaj siab) muaj ntau hom. Thaum pib, 3 lub cim tsim:
- point dystrophy ntawm tus ntsia thawv phaj (thimble syndrome), thaum taw tesgrooves thiab nto ntawm tus ntsia thawv zoo li lub thimble;
- khaus khaus, kub hnyiab;
- papular psoriasis, uas me me nodules tshwm ntawm lub txaj ntawm tus ntsia thawv.
Nyob rau theem tom qab ntawm tus kab mob, cov tsos mob hauv qab no tshwm sim:
- subungual hyperkeratosis, lossis keratinization ntawm tus ntsia thawv txaj;
- ua kom cov ntsia hlau tsis muaj zog, hloov xim (lawv tig daj);
- sib sib zog nqus los yog longitudinal grooves ntawm tus ntsia thawv daim hlau;
- "roj me ntsis" - daj, liab lossis xim av me ntsis nrog txoj kab uas hla ntawm ob peb millimeters, translucent los ntawm tus ntsia thawv hauv cheeb tsam cov menyuam;
- kev sib cais ntawm tus ntsia thawv phaj ntawm qhov kawg ntawm tus phalanx ntawm tus ntiv tes;
- mob plab periungual quav;
- leukonychia - pob dawb;
- liab ntawm daim tawv nqaij hauv qab tus ntsia thawv, hemorrhages nyob rau hauv daim ntawv ntawm bands.
Nyob zoo ib tsoom niam txiv kwv tij neej tsas sawv daws.
Ntxhais deformation
Feem ntau cov neeg mob muaj kev hloov pauv ntawm cov ntsia hlau phaj:
- onychogryphosis - thickening ntawm tus ntsia thawv, raws li nws zoo li ib tug claw ntawm ib tug noog ntawm prey;
- onycholysis - detachment;
- ntau zaus, kev puas tsuaj nrog kev tso tawm tiav.
Cov kev hloov pauv hauv psoriasis ntawm tus ntsia thawv phaj (daim duab saum toj no schematically qhia tias qhov kev hloov pauv tau pom hauv tus kabmob) yog tus yam ntxwv ntawm theem siab ntawm tus kabmob.
Ntxhais tes thiab kev koom tes feem ntau tshwm sim hauv cov neeg mob hnub nyoog 40 xyoo.
Qhov txawv ntawm lwm hom onychodystrophy
kab mob fungalntsia thawv (onychomycosis) hauv nws cov tsos mob zoo ib yam li tus ntsia thawv psoriasis. Daim duab hauv qab no qhia tau hais tias cov ntsia hlau cuam tshuam zoo li cas hauv ntau yam kab mob.
Nyob rau hauv ob qho tib si, tus ntsia thawv cais tawm ntawm nws lub txaj ntawm qhov kawg ntawm phalanx, tab sis muaj qee qhov sib txawv:
- kab mob fungal feem ntau tshwm sim thawj zaug ntawm tus ntiv tes, thiab tom qab ntawd kis mus rau cov rau tes;
- nrog onychomycosis, tus ntsia thawv phaj ua xim av lossis tsaus;
- nrog psoriasis, tsis zoo li cov kab mob fungal, tsis muaj ntxhiab tsw ntxhiab los ntawm cov rau tes.
Nrog eczema, dystrophic hloov ntawm tus ntsia thawv phaj thiab o ntawm daim tawv nqaij ib puag ncig kuj pom. Ib tug yam ntxwv feature ntawm tus kab mob no yog hais tias lub ntug ntawm tus ntsia thawv nyob ib sab mus rau lub posterior roller raug cuam tshuam, thiab tsis yog dawb kawg. Nrog lichen planus, kev puas tsuaj rau cov ntsia hlau phaj yog yuav luag ib txwm ua ke nrog cov yam ntxwv ntawm daim tawv nqaij ua pob. Ua ntej sau tshuaj kho mob, kev kuaj mob sib txawv ntawm cov kab mob no tau ua tiav.
Tus kws kho mob twg kho tus kab mob no?
Nail psoriasis thiab nws txoj kev kho mob yog nyob rau hauv kev muaj peev xwm ntawm tus kws kho mob dermatologist. Kev tswj hwm tus kheej ntawm cov tshuaj tsis raug pom zoo, vim nws yog qhov tsim nyog los txiav txim siab qhov tseeb. Cov tsos mob zoo sib xws tshwm sim nrog lwm cov kab mob dermatological uas yuav tsum tau siv cov tshuaj tshwj xeeb.
Raws li cov xwm txheej uas ua rau kev puas tsuaj rau cov ntsia hlau phaj, nws kuj tseem yuav tsum tau sab laj nrog kws kho mob endocrinologist thiabimmunologist. Yog tsis muaj ib tug kws kho mob tshwj xeeb, kev kho mob yog muab los ntawm tus kws kho mob.
Ua rau tus ntsia thawv phaj psoriasis
Lub hauv paus ntsiab lus ntawm tus kab mob no tseem tsis tau qhia meej. Ntawm cov kev ua txhaum cai uas tuaj yeem ua rau nws, cov hauv qab no yog qhov txawv:
- kab mob kis;
- deterioration ntawm metabolism;
- kev txiav txim siab caj ces ntawm cov ntshav capillaries hauv daim tawv nqaij;
- neurological ntshawv siab;
- congenital instability ntawm cellular ntsiab thiab keratin deposits nyob rau hauv daim tawv nqaij.
Risk yam yog:
- txo qis kev tiv thaiv;
- mob rau tus ntsia thawv phaj;
- kev nyab xeeb hloov pauv;
- kev nyuaj siab thiab qaug zog;
- siv sijhawm ntev ntawm cov tshuaj tua kab mob.
Diagnosis
Kev kuaj mob ntawm "psoriasis ntawm tus ntsia thawv phaj" yog ua los ntawm kev kuaj xyuas sab nraud thiab tsis suav nrog cov kab mob fungal. Txhawm rau ua qhov no, nqa ib qho txhuam los yog ib qho me me ntawm cov ntsia hlau, uas yog siv rau kev coj noj coj ua, kev tshuaj xyuas microscopic thiab kev txiav txim siab ntawm rhiab heev rau cov tshuaj tiv thaiv kab mob. Hauv qee tus neeg mob, ochcomycosis thiab psoriasis muaj nyob rau tib lub sijhawm.
Tsis muaj ib qho kev ntsuam xyuas tshwj xeeb los txiav txim tus kab mob no. Txij li cov ntsia hlau psoriasis yog qhov tsis zoo rau kev kuaj mob, feem ntau qhia txog kev txhim kho ntawm cov txheej txheem rheumatic, tus kws kho mob tuaj yeem sau tshuaj ntsuam ntshav.
Muaj Teeb Meem
Psoriasisntsia thawv txaj thiab phaj tsis yog ib qho kev kho kom zoo nkauj xwb. Nws tuaj yeem ua rau muaj teeb meem hauv qab no:
- atrophy;
- kev puas tsuaj ntawm tus ntsia thawv;
- kev loj hlob ntawm tus ntsia thawv phaj.
Lub neej zoo ntawm cov neeg mob uas nco ntsoov cov kev hloov pauv hauv qab no tsis zoo:
- nyuaj ua haujlwm nrog cov khoom me me, txwv kev ua haujlwm ntawm lub cev;
- teeb meem kev puas siab ntsws thiab kev sib raug zoo vim qhov tsis zoo ntawm ob txhais tes, qhov tsis zoo ntawm lub siab lub ntsws;
- txo qis hauv kev hnov qab;
- mob;
- nyuaj hauv kev khi hlua khau, xaws ntawm cov nyees khawm thiab lwm yam hauv tsev.
Yuav ua li cas kho tus ntsia thawv psoriasis?
Txawm hais tias tam sim no muaj ntau yam tshuaj rau kev kho mob psoriasis, kev kho mob ntawm tes yog qhov nyuaj. Qhov no yog vim ob peb yam:
- nyuaj nkag mus rau hauv cov tshuaj rau hauv tus ntsia thawv txaj;
- siab toxicity of systemic drug;
- xav tau kev kawm ntev.
Kev xaiv txoj kev kho yog nyob ntawm cov tsos mob thiab qhov hnyav ntawm cov kab mob. Yog tias qhov kev puas tsuaj rau cov rau tes yog qhov tsis tseem ceeb, tsuas yog siv cov neeg sawv cev sab nraud xwb. Cov tshuaj hauv lub cev tau muab tshuaj rau hauv cov xwm txheej hauv qab no:
- daim tawv nqaij ua pob khaus;
- tus ntsia thawv mob hnyav;
- psoriasis hauv daim ntawv pustular;
- tsis muaj txiaj ntsig ntawm kev kho sab nraud;
- faib cov txheej txheem psoriatic rau cov pob qij txha.
Kev npaj sab nraud
Cov tshuaj hauv qab no yog siv los ua tus neeg sawv cev sab nraud rau kev kho mob psoriasis ntawm tus ntsia thawv phaj:
- Corticosteroid tshuaj pleev, cream, tshuaj pleev ib ce nrog mometasone - "Elok" thiab "Elok-S", "Mometasone-Akrikhin", "Momat", "Uniderm". Lawv raug siv rau cov ntsia thawv txaj thiab cov chaw nyob ib sab ntawm daim tawv nqaij. Raws li kev phiv, qhov tsos ntawm kab laug sab leeg (nets), atrophy ntawm periungual ridge thiab phalanx tau sau tseg.
- Ointments, gels thiab cream uas muaj calcipotriol, ib qho analogue ntawm vitamin D (Calcipotriol, Daivonex, Daivobet, Xamiol). Cov kev tshawb fawb pom tau tias siv lawv ob zaug ib hnub rau 6 lub hlis ua rau txo qis hauv hyperkeratosis (thickening thiab deformation ntawm tus ntsia thawv phaj) hauv 70% ntawm cov neeg mob.
- Cov tshuaj pleev, tshuaj pleev thiab pleev pleev xim raws li clobetasol - Dermovate, Clobetasol, Cloveit.
- Cyclosporin tshuaj qhia kev ua tau zoo tiv thaiv hyperkeratosis thiab ntsia thawv flaking.
- Cov tshuaj npaj raws li cov retinoid tazarotene - "Zorak", "Tazorak", "Tazarotene". Lawv pab txo qis hyperkeratosis, "roj me ntsis", exfoliation ntawm tes. Kev hnov mob, kub hnyiab, lossis flaking yuav tshwm sim raws li kev phiv.
- Cream thiab tshuaj pleev uas muaj 5-fluorouracil - Belanix, Efudix, Flonida, fluorouracil ointment. Ua ntej kev kho mobNws raug pom zoo kom sim cov khoom no ntawm ib tus ntsia thawv, raws li cov tshuaj tiv thaiv kab mob, hyperpigmentation thiab kev puas tsuaj ntawm cov ntsia hlau yog ua tau.
YSystemic Therapy
Hauv qhov xwm txheej hnyav, kev kho tus ntsia thawv psoriasis yog ua los ntawm kev siv cov txheej txheem:
- Retinoids (synthetic derivatives ntawm retinoic acid) - "Etretinate", "Acitretin". Cov tshuaj no yog siv nyob rau hauv kev kho mob ntawm psoriasis nyob rau hauv ib tug pustular daim ntawv, nrog subungual hyperkeratosis, txawm li cas los xij, muaj cov kev mob tshwm sim: qhov tsos ntawm cov pob dawb ntawm cov rau tes, qhov nce hauv lawv cov fragility thiab o ntawm periungual ridge. Tsis tas li ntawd, thaum noj cov tshuaj no, yuav tsum tau saib xyuas lub siab.
- YCyclosporin. Kev npaj raws li nws ("Ekoral", "Cyclosporin", "Panimun Bioral" thiab lwm yam) yog cov muaj zog tiv thaiv kab mob. Kev kho mob feem ntau ua ke nrog cov tshuaj pleev ib ce uas muaj calcipotriol. Kev siv sijhawm ntev tuaj yeem ua rau lub raum tsis ua haujlwm thiab hloov ntshav siab. Yog li, cov tshuaj no ua haujlwm raws li cov tshuaj thib ob hauv kev kho mob psoriasis.
Means of biological action
Hauv kev tshawb fawb txog kev kho mob niaj hnub no, txoj kev tshiab tab tom nrhiav los kho tus ntsia thawv psoriasis. Ib qho ntawm cov kev txhim kho tsis ntev los no yog immunomodulators Alefacept thiab Infliximab. Lawv muaj peev xwm inhibit qhov txawv txav ntawm T-lymphocytes nyob rau hauv cov tawv nqaij cuam tshuam, thaum tsis cuam tshuam rau tus so ntawm lub cev tiv thaiv kab mob.
Tshuaj sawv cevib qho lyophilisate rau kev npaj cov tshuaj. "Alefasept" yog muab intramuscularly, thiab "Infliximab" - intravenously. Tom qab 12-22 lub lis piam txij thaum pib kho, cov tsos mob ntawm tus ntsia thawv psoriasis ploj tag nrho hauv 50% ntawm cov neeg mob. Cov kev mob tshwm sim ntawm cov tshuaj no muaj tsawg dua li cov neeg ua haujlwm hauv lub cev tau piav qhia saum toj no. Qhov tsis zoo ntawm kev kho mob xws li nws tus nqi siab.
Physiotherapy
Ntawm txoj kev kho lub cev, PUVA thiab X-ray irradiation yog siv. PUVA kev kho mob pab tshem tawm cov ntsia thawv exfoliation, tshem tawm cov subungual hyperkeratosis, "roj me ntsis", txo cov o ntawm daim tawv nqaij thiab txo qhov ntev ntawm cov ntsia thawv phaj. Qhov tseem ceeb ntawm kev kho mob yog noj psoralen, ib tsob nroj-derived tshuaj uas muaj cov nyhuv photosensitizing.
Cov tawv nqaij ua ntau dua rau lub teeb, thiab photochemistry pab ua kom puas T-helper cov hlwb hauv daim tawv nqaij thiab txo cov txheej txheem ntawm kev faib cell. Irradiation nrog ultraviolet lub teeb tshwm sim nyob rau hauv tshwj xeeb cabins, reminiscent ntawm solarium khoom. Kuj tseem muaj cov khoom siv nqa tau yooj yim rau kev cuam tshuam rau thaj chaw me me ntawm daim tawv nqaij thaum kho tus ntsia thawv psoriasis (duab hauv qab).
Kev kho mob nrog xoo hluav taws xob tsis muaj zog tau thov los ntawm cov kws kho mob German thiab Swiss. Lawv pom tias irradiation ntawm cov ntiv tes nrog peb koob tshuaj ntawm 150 kGy pab txo qis ntawm cov ntsia hlau tuab thiab txo cov txheej txheem kev puas tsuaj hauv nws. Txawm li cas los xij, ntxiv rau cov koob tshuaj ntau ntxivX-ray raug, txoj kev no tsuas muaj ib ntus xwb.
tshuaj ntsuab
Tshuaj kho tus ntsia thawv psoriasis hauv tsev tuaj yeem ua ke nrog cov zaub mov noj tshuaj:
- Da dej nrog infusion ntawm chamomile, calendula lossis sage. Cov tshuaj no muaj cov nyhuv anti-inflammatory, nrog rau cov tsis muaj zog antiseptic. Yog tias psoriasis tau ua ke nrog cov kab mob fungus, nws raug nquahu kom ntxiv ob peb tee ntawm cov tshuaj yej tsob ntoo roj los yog hiav txwv ntsev rau qhov dej. Cov cuab yeej yog npaj raws li nram no: 2 tbsp. l. qhuav raw cov ntaub ntawv ncuav 2 tbsp. boiling dej thiab insist nyob rau hauv ib tug thermos rau ib nrab ib teev. Yog tias tsim nyog los kho cov ntiv taw, qhov twg ntawm daim tawv nqaij yog rougher thiab cov rau tes yog thicker, ces cov paj yog 2 zaug. Lub infusion yog lim thiab txias me ntsis. Cov dej kub yuav tsum yog li 40 ° C, thiab lub sijhawm kho yuav tsum yog 15 feeb. Cov txheej txheem yog nqa tawm 2-3 zaug hauv ib hnub kom txog thaum cov tsos mob raug tshem tawm. Txhawm rau txhim kho cov ntshav ncig thiab cov ntaub so ntswg, kev kho mob tuaj yeem ua ke nrog kev sib piv da dej.
- Seaweed therapy. Ua li no, siv cov nplooj tshiab los yog qhuav ntawm kelp. Nws muaj ntau ntawm micro thiab macro ntsiab, vitamins. Cov polysaccharides muaj nyob rau hauv nws cov muaj pes tsawg leeg cuam tshuam rau cellular tiv thaiv kab mob, rhuav tshem cov qog ntawm malignant hlwb thiab ua rau lawv permeable rau cytotoxic tshuaj. Laminaria hmoov yog diluted nrog dej ntawm chav tsev kub (dej kub tuaj yeem ua rau kev puas tsuaj ntawm cov as-ham), tso cai rau o rau 0.5-1 h thiab siv rau cov ntiv tes rau 15-20 feeb, ces ntxuav tawm. Hoob - 2 lub lis piam. Tom qab sab laj nrog tus kws tshaj lij, chav kawm tuaj yeem rov ua dua yog tias tsim nyog.
- Rau kev kho mob psoriasis hauv cov tshuaj ib txwm siv, decoction ntawm nplooj nplooj kuj tau siv, uas tau noj hauv qhov ncauj thiab siv da dej. Rau nws cov kev npaj 2 tbsp. l. tws nplooj ncuav boiling dej, simmer rau 10 feeb. rau lawv o. Tom qab ntawd lub broth yog lim thiab qaug dej qaug cawv thaum nruab hnub hauv 3 zaug sib faib. Lub sijhawm kho yog 1 lub lis piam.
Txhawm rau ua kom cov ntsia hlau thiab cov tawv nqaij nyob ib puag ncig nws, nws raug nquahu kom rub cov roj txhua hnub - txiv ntseej, paj noob hlis lossis ntoo thuv roj, uas muaj cov tshuaj tiv thaiv kab mob.
Vitamin Therapy & Khoom noj khoom haus
Vitamin kho yog ib qho ntawm cov khoom tsim nyog hauv kev kho mob ntawm psoriasis. Cov vitamins ntawm pab pawg B, ascorbic thiab folic acid, vitamins A, E, PP, kab kawm calcium thiab phosphorus pab khaws cov qauv ntawm tus ntsia thawv. Thaum xaiv cov tshuaj, kev nyiam yuav tsum tau muab rau cov vitamin-poov tshuaj complexes. Brewer's poov xab yog ib yam tshuaj uas txhawb kev loj hlob ntawm tus ntsia thawv phaj, thiab cov sulfur muaj nyob rau hauv nws yog tsim nyog rau tsim keratin nyob rau hauv cov rau tes thiab plaub hau.
Khoom noj khoom haus rau psoriasis yuav tsum ua kom tiav thiab muaj zog. Nws raug nquahu kom tsis suav nrog cov zaub mov noj uas ua rau mob plab hnyuv thiab cuam tshuam rau daim siab (ntsim, ntsev, kib, rog, haus luam yeeb), vim qhov no cuam tshuam kev tshem tawm cov co toxins ntawm lub cev. Nws yog ib qho tsim nyog los nce cov zaub thiab txiv hmab txiv ntoo uas txhim kho txoj hnyuv motility.
