Rash thaum cev xeeb tub yog ib qho tshwm sim tshwm sim. Tau kawg, yog tias nws tshwm sim, koj yuav tsum tau qhia rau tus kws kho mob txog nws, vim nws tuaj yeem ua tus tsos mob ntawm tus kab mob sib kis. Txawm li cas los xij, feem ntau peb tab tom tham txog xws li ib pawg ntawm pathologies xws li dermatoses ntawm cov poj niam cev xeeb tub.
Cov no yog ntau yam kab mob ntawm daim tawv nqaij uas tshwm sim los ntawm cov tsos mob xws li khaus thiab pob khaus (nws tuaj yeem ua papular, pustular, urticaria thiab lwm yam) immunogram.
Dermatoses thiab kis kab mob
pob khaus thaum cev xeeb tub tuaj yeem cuam tshuam nrog cov kab mob xws li atopic dermatitis, cholestasis (kuj yam ntxwv ntawm lub sijhawm gestational), polymorphic dermatosis, pefigoid (ib hom kab mob herpes).
Tib lub sijhawm, nws tshwm sim tias ua ntej cev xeeb tub tus poj niam tsis raug mob los ntawm kev ua xua lossis lwm yam kab mob ntawm daim tawv nqaij. Tab sis feem ntau, muaj ib qho kev xav rau lawv (kwv yees txhua txhua tus neeg mob thib tsib nrog atopic dermatosis muaj cov tsos mob ntawm tus kab mob no ua ntej).
Feem ntau, kuv kuaj cov dermatoses ntawm cov poj niam cev xeeb tub hauv kwv yees li 3-5% ntawm cov poj niam, tab sis nws yuav tsum tau muab sau tseg tias nrog cov kab mob me me, tsis yog txhua tus niam uas xav mus ntsib kws kho mob, yog li nws yog qhov zoo dua. nyuaj los tsim kom tau qhov tseeb scale.
Ib pob khaus ntawm lub plab thaum cev xeeb tub feem ntau tshwm sim hauv cov poj niam uas muaj kev cuam tshuam los ntawm cov kab mob xws li autoimmune pathologies thiab kev tsis haum tshuaj. Hmoov zoo, tom qab yug me nyuam, nws dhau mus sai heev.
Nws tshwm sim tias pob khaus qhia tias kis kab mob xws li qhua pias lossis rubella. Hauv qhov no, muaj cov tsos mob ntxiv ntawm tus kab mob kis, uas tuaj yeem siv los nkag siab qhov xwm txheej ntawm tus kab mob.
Ua pob khaus
Txawm hais tias cov teeb meem ntawm qhov tshwm sim ntawm cov kab mob no tseem tsis tau kawm tiav, ntawm cov kws kho mob cov lus pom zoo tias qhov teeb meem cuam tshuam nrog kev hloov pauv hormonal thaum cev xeeb tub, nrog rau cov kev hloov pauv ntawm lub cev thaum lub sijhawm no., txij li qee cov qog hws tau qhib. Tsis tas li ntawd, ncab daim tawv nqaij ua rau khaus.
Ntau tus ntseeg tias pob khaus yog ib qho cim ntawm cev xeeb tub. Qhov tseeb, nws tsis tshwm sim hauv txhua tus poj niam.
Qhov laj thawj uas ua rau nws ua rau nws muaj raws li hauv qab no:
- Hloov pauv hauv kev tiv thaiv, uas thaum cev xeeb tub yog txhawm rau tiv thaiv kev tsis lees paub ntawm tus menyuam hauv plab.
- YGenetic predisposition. Nws yog qhov no uas yog lub luag haujlwm rau feem ntau ntawm cov txheej txheem autoimmune. Interestingly, nyob rau hauv cov ntaub ntawv no, kev tsis haum tshuaj tsis tshwm sim los ntawmntau yam stimuli sab nraud li placent antigen.
- Kev puas tsuaj rau cov ntaub so ntswg. Nws feem ntau tshwm sim tias pob liab liab thaum cev xeeb tub khaus tsis yog vim muaj kev tsis haum tshuaj classic, tab sis vim yog qhov nce ntawm qhov loj ntawm lub plab thiab qhov cuam tshuam ntawm daim tawv nqaij. Cov ntaub so ntswg sib txuas tau raug puas ntsoog, cov khoom ntawm elastin thiab collagen nkag mus rau hauv cov hlab ntsha, thiab lub cev pom lawv ua xua, yog li cov tshuaj tiv thaiv hauv daim ntawv ntawm pob khaus thiab khaus.
Qee zaum, pob khaus thiab khaus yog tshwm sim tsis yog los ntawm kev ua xua, tab sis los ntawm gestational cholestasis, uas yog, cov kua tsib uas tuaj yeem tshwm sim thaum cev xeeb tub.
kab mob dab tsi ua rau pob khaus thiab khaus?
Txawm hais tias qee kis, pob liab liab thaum cev xeeb tub yog tshwm sim los ntawm cov kab mob sib kis. Thiab tom qab ntawd lawv tau nrog cov cim qhia ntawm kev qaug cawv. Yeej, tom qab tag nrho, peb tab tom tham txog cov kab mob ntawm daim tawv nqaij.
Atopic dermatitis ntawm cev xeeb tub
Nws suav rau ntau dua 50% ntawm cov pob khaus. Lawv feem ntau ua pob liab liab thaum cev xeeb tub. Lwm hom kab mob ntawm daim tawv nqaij tshwm sim tom qab, tab sis atopic dermatitis tuaj yeem tshwm sim ntxov li thawj peb lub hlis twg. Vim muaj kev hloov hauv kev tiv thaiv thaum cev xeeb tub.
Kev xyaum qhia tau hais tias tom qab yug menyuam hauv 80% ntawm cov neeg mob nws ploj mus thiab tus poj niam tsis thab ntxiv lawm. Xws li cov tshuaj tiv thaiv yog tshwm sim raws li pruritus, eczema thiab khaus folliculitis. Lawv tsis muaj kev phom sij.
polymorphic dermatosis ntawm cov poj niam cev xeeb tub
Tseem ib txwm muaj kab mob hauvgestational lub sij hawm. Feem ntau nws yog ntsib nyob rau hauv peb lub trimester. Cov laj thawj ua rau muaj kev xeeb tub ntau thiab hnyav dhau.
Koom nrog cov txheej txheem ntawm daim tawv nqaij ncab tau piav qhia saum toj no. Cov pob khaus yuav zoo li txawv. Tsis muaj teeb meem yug me nyuam.
YObstetric (intrahepatic) cholestasis
Tus kab mob no tshwm sim nyob rau lub peb hlis ntuj kawg, feem ntau nws yog keeb kwm. Nws cuam tshuam nrog cov nyhuv irritating ntawm cov kua tsib acids.
Tej zaum yuav ua rau muaj teeb meem txaus ntshai. Piv txwv li, postpartum hemorrhage, vim tus kab mob no cuam tshuam cov txheej txheem coagulation.
Pemphigoid cev xeeb tub
Nws yog ib qho tsis tshua muaj autoimmune pathology, thaum placental antigen ua qhov ua xua. Nws yog nrog los ntawm khaus thiab pob khaus nyob rau hauv daim ntawv ntawm vesicles. Nws feem ntau ploj mus tom qab yug me nyuam, tab sis tus me nyuam yuav ua pob liab liab.
Zoo hmoo, qhov no yog ib yam kab mob tsawg dua piv rau atopic dermatitis, vim nws ua rau muaj teeb meem xws li fetoplacental insufficiency, yug ntxov ntxov, thiab ntau dua. Yog, thiab nyob rau lub sijhawm tom qab yug me nyuam, cov teeb meem tuaj yeem pib - piv txwv li, postpartum thyroiditis tshwm sim. Tsis tas li ntawd, thaum cev xeeb tub lossis thaum noj tshuaj hormonal, tej zaum yuav muaj tus kab mob rov qab.
Txhua yam kab mob uas tau teev tseg yuav tsum tau kho, yog li koj yuav tsum sab laj nrog kws kho mob.
Symptoms nrog pob khaus
Nws yuav tsum tau sau tseg tiasCov pob khaus tuaj yeem muaj qhov sib txawv. Piv txwv li, pob khaus ntawm tes thaum cev xeeb tub yog qhov tshwm sim ntawm atopic dermatitis.
Nrog rau tus kab mob no, cov pob liab liab kuj tshwm sim ntawm lub ntsej muag thiab caj dab, thiab ntawm tes lawv nyob hauv thaj chaw feem ntau ntawm cov xib teg thiab qhov chaw flexion. Feem ntau nws tshwm sim rau cov poj niam primiparous. Nrog atopic dermatitis, pob khaus ntawm ob txhais ceg thaum cev xeeb tub kuj tsis tshua muaj tshwm sim. Xws li, nws yog localized nyob rau hauv lub hauv caug thiab ntawm lub hauv caug. Tab sis yeej tsis muaj pob khaus ntawm plab.
Thaum khaus folliculitis, pob khaus zoo li pob txuv. Nws feem ntau tshwm sim ntawm lub xub pwg nyom thiab nraub qaum, plab, caj npab. Pimples nyob ze ntawm cov hauv paus plaub hau. Lawv tuaj yeem loj heev - 2-4 mm inch.
Nrog polymorphic dermatosis, cov pob khaus khaus liab papules. Lawv feem ntau tshwm sim ntawm lub plab, tom qab ntawd kis mus rau tus ncej puab thiab pob tw. Feem ntau, cov pob khaus tshwm sim tshaj cov qhab nia. Nws tsis tshwm sim ntawm mucous daim nyias nyias. Cov tawv nqaij nyob ze ntawm lub dab teg thiab ntawm lub ntsej muag kuj tseem huv. Txawm hais tias ib qho me me yog 1-3 hli hauv txoj kab uas hla, lawv zoo li sib koom ua ke rau hauv qhov chaw loj.
Nws tshwm sim tias muaj pob liab liab ntawm lub ntsej muag thaum cev xeeb tub. Nws hais txog qhov muaj kev tsis haum tshuaj, tuaj yeem nrog tsis yog khaus xwb, tab sis kuj los ntawm kev tsim kua muag, ua kua ntswg thiab lwm yam tsos mob.
Thaum pemphigoid pob khaus feem ntau tshwm sim ntawm 4-7 lub hlis. Nws yog tsuas yog nyob rau ntawm daim tawv nqaij nyob ib ncig ntawm lub plab, tab sis kuj tuaj yeem tshwm sim ntawm lub hauv siab lossis nraub qaum. Cov pob khaus zoo li npuas. Yog hais tias lawv puas lawm, erosion tshwm nyob rau hauv lawv qhov chaw, thiab thaum lub crust dries.
Intrahepatic cholestasis yog tus cwj pwm los ntawm daj ntawm daim tawv nqaij thiab khaus, tshwj xeeb tshaj yog mob ntawm xib teg thiab ob txhais taw. Cov pob liab liab feem ntau yog qhov thib ob hauv qhov no. Feem ntau, tus poj niam txhuam nws, vim qhov khaus yuav luag tsis tuaj yeem.
Diagnosis
Yuav kom kuaj tau kom raug, tus kws kho mob yuav sau ib qho kev kawm ntxiv. Tom qab tag nrho, nws yuav tsum tsis suav nrog kev kis kab mob, kev puas tsuaj microbial, thiab lwm yam pathologies.
Ib qho kev tshawb fawb tshaj plaws los ntawm qhov kev pom no yog kev kuaj ntshav biochemical. Nws tso cai rau koj txheeb xyuas lub xub ntiag ntawm obstetric cholestasis, txij li tus kab mob no hauv cov ntshav nce qib ntawm cov kua tsib acids, nyob rau hauv kwv yees li 20% ntawm cov niam uas muaj kev cia siab tau ntsib teeb meem nrog pob liab liab, qib ntawm bilirubin kuj nce.
Thiab nyob rau hauv feem ntau ntawm cov neeg mob, qhov kev tshuaj ntsuam qhia tau hais tias muaj kev nce ntxiv hauv kev ua haujlwm ntawm daim siab enzymes. Rau lwm cov kab mob uas tshwm sim los ntawm pob liab liab, cov cim qhia hauv biochemical tsom xam nyob hauv qhov qub.
Txhawm rau tshem tawm cov kab mob microbial lossis cov kab mob fungal, kev tshuaj xyuas ntawm khawb lossis cov ntsiab lus ntawm vesicles-rhiab rau microflora yog ua tiav, thiab kev kuaj pom luminescent kuj tau ua. Thaum kuaj mob, nws yog ib qho tseem ceeb heev kom tsis txhob muaj kab mob, seborrhea, kab mob folliculitis, kab mob siab thiab lwm yam kab mob, vim lawv xav tau lwm txoj kev kho.
Rau atopic dermatitis thiab herpes, ib qho kev soj ntsuam yog ua raws li kev txiav txim siab cov ntsiab lus ntawm IgG4 antibodies (nrog herpes, qhov taw qhia nce)thiab IgE (qhov ntsuas no qhia txog qhov kev ua xua).
Thaum kawg, yog xav tias pemphigoid thiab polymorphic dermatosis, kuaj histological ntawm daim tawv nqaij biopsy ua tiav.
Kev kho pob khaus: cov hau kev yooj yim
Khaub thuas thiab pob khaus thaum cev xeeb tub yuav tsum tau kho kom zoo, suav nrog kev tshem tawm qhov ua rau ntawm lawv qhov tsos, nyob ntawm seb cov xwm txheej zoo li cas cuam tshuam nrog.
Piv txwv li, tshuaj tiv thaiv kab mob yog siv rau atopic dermatitis thiab lwm yam kev ua xua. Lawv tuaj yeem cuam tshuam rau tus menyuam hauv plab, yog li lawv tau sau tseg nrog ceev faj hauv thawj peb lub hlis twg yog tias qhov txiaj ntsig rau leej niam tshaj qhov kev pheej hmoo rau tus menyuam. Nyob rau hauv tas li ntawd, 2-3 tiam antihistamines yog siv - Histafen, Claritin, Zirtek, Cetirizine.
Yog tias pob khaus nrog mob hnyav, tom qab ntawd rau txhua hom kab mob, tshwj tsis yog khaus ntawm cov poj niam cev xeeb tub (xws li, atopic dermatitis, polymorphic dermatosis, pymphegoid), corticosteroids tuaj yeem muab tshuaj. Piv txwv li, nws tuaj yeem yog tshuaj pleev raws li hydrocortisone lossis prednisolone.
Tsis muaj kev kho tshwj xeeb rau pemphigoid, yog li cov tshuaj hormones tau piav qhia saum toj no kuj tau siv ntau tshaj plaws.
Ursodeoxycholic acid npaj tau raug sau tseg rau obstetric cholestasis. Nws txhim kho cov kua tsib muaj pes tsawg leeg, txo cov concentration ntawm cov tshuaj lom ntawm cov kua tsib acids nyob rau hauv nws, thiab txhawb lub outflow ntawm tin. Hauv cov kab mob no, cov tshuaj hepatoprotective kuj tau sau tseg los tiv thaiv daim siab, piv txwv li, Karsil, thiab cytostatics.("Methotrexate"). Nws raug nquahu kom noj cov tshuaj tiv thaiv kab mob thiab cov vitamins uas tau piav qhia saum toj no.
Thaum kawg, nws yog ib qho tseem ceeb kom ua raws li qee yam kev txwv hauv cov zaub mov, tsis kam noj ntsim, rog, qab ntsev los txhawb lub siab. Qee lub sij hawm kev kho mob los yog kev kawm tshwj xeeb ntawm lub cev yog muab.
Emollients
Cov no yog cov tshuaj pleev ib ce thiab tshuaj pleev ib ce uas siv rau hauv cov kab mob zoo li no rau kev tu tawv nqaij kom rov ua kom cov epidermis puas, moisturize thiab soften ntawm daim tawv nqaij, thiab txhawb kev tsim kho ntawm intercellular lipid lug.
Feem ntau cov emollients tsis muaj contraindications rau cov niam uas xav tau, tab sis koj yuav tsum ua tib zoo kawm lawv cov muaj pes tsawg leeg kom nws tsis suav nrog cov khoom uas tuaj yeem ua rau muaj kev fab tshuaj.
Tej zaum muaj txiv duaj lossis txiv roj roj, panthenol, thiab lwm yam ntuj tsim thiab cov tawv nqaij moisturizers.
Nrov emollients suav nrog, piv txwv li, Bepanthen cream, uas txawm pom zoo siv rau kev kho mob atopic dermatitis hauv cov menyuam mos.
Kev
Thaum cev xeeb tub, yuav tsum tau saib xyuas koj cov tawv nqaij kom zoo kom tsis txhob muaj pob khaus los ntawm kev tu cev tsis zoo.
Yog li ntawd, tsis muaj kev tiv thaiv kab mob dermatoses. Tab sis cov kws kho mob pom zoo kom tso tseg cov ris tsho hauv qab hluavtaws thiab cov khaub ncaws uas nyiam cov khoom tsim los ntawm cov ntaub ntuj tsim, nrog rau kev sib cuag nrog ntau yam tshuaj tsis haum: cov plua plav hauv tsev, tsiaj plaub hau, paj paj ntoo. Ua li no, nws raug nquahu kom tsis tu ncua ntub tu thiab ntxuav lub qhov rais mesh, thiab thaum lub sij hawm flowering lub sij hawmnyob deb ntawm qhov chaw muaj teeb meem.
Nws yog ib qho tseem ceeb heev uas yuav tsum xaiv cov hmoov ntxuav kom zoo kom tsis txhob ua rau atopic dermatitis lossis tiv tauj.
Zoo kawg
Raws thaum cev xeeb tub tuaj yeem muaj ntau yam ua rau, yog li thawj cov tsos mob koj yuav tsum nrhiav kev pab tsim nyog. Kev kho raws sij hawm yuav pab kom tsis txhob muaj kev cuam tshuam tsis zoo rau tus poj niam thiab tus menyuam hauv plab.
Nws tseem yuav tsum nco ntsoov tias kev siv tshuaj ywj pheej yog txwv nruj yam tsis muaj kev sab laj nrog tus kws kho mob ua ntej, nrog rau cov tshuaj pej xeem. Thiab nws tsis yooj yim sua kom tsis quav ntsej txog lub xeev no nyob rau hauv txhua rooj plaub.
