Tus kab mob zoo li pemphigus tshwm sim li cas? Kev kho mob thiab cov tsos mob ntawm tus kab mob no yuav tham hauv qab no. Koj tseem yuav kawm txog qhov ua rau ntawm cov txheej txheem pathological no thiab yuav kuaj xyuas nws li cas.
Cov ntaub ntawv tseem ceeb
Pemphigus, duab hauv kab lus no, yog ib pab pawg tsawg tab sis hnyav heev, muaj peev xwm ua rau tuag taus thiab ua rau cov kab mob autoimmune vesiculobullous uas cuam tshuam rau daim tawv nqaij thiab cov mucous membranes.
Cov kws kho mob tshwj xeeb txheeb xyuas hom kab mob no:
- pemphigus vulgaris;
- vegetative form;
- nplooj-zoo li;
- seborrheic (tej zaum muaj cov npe xws li Senier-Uscher syndrome lossis erythematous).
yam ntxwv ntawm tus kab mob
Pemphigus vulgaris yog ib pawg ntawm cov kab mob ntawm cov nqaij mos thiab tawv nqaij, uas tshwm sim nyob rau hauv daim ntawv ntev, nrog rau kev rov qab tsis tu ncua.
Tus kab mob no yog nyob ntawm hormonally. Nws yog tus cwj pwm los ntawm cov kev kawm nce qib, nrog rau kev tsim cov hlwv hauv cov menyuam yaus.
Feem ntau, pemphigus vulgaris cuam tshuam rau cov neeg muaj hnub nyoog 50 thiab tshaj.
Vim li cas tus kab mob no tshwm sim? Oyog vim li cas rau txoj kev loj hlob ntawm tus kab mob no, tsuas muaj hypotheses.
Pemphigus: feem ntau yuav ua rau
Ua ntej pib kho tus kab mob hauv nqe lus nug, nws tseem ceeb heev kom paub seb vim li cas tus kab mob autoimmune no tau tshwm sim hauv ib tus neeg mob. Hmoov tsis zoo, nrhiav qhov laj thawj ntawm kev txhim kho pemphigus yog qhov nyuaj heev. Cov kws tshaj lij tau tawm tsam qhov teeb meem no tau ntau xyoo lawm. Thaum lub sijhawm no, lawv tsuas yog xav txog:
- Exogenous yam, uas yog, noj tshuaj, suav nrog penicillin thiab nws cov derivatives, ntau yam interferons thiab lwm yam.
- Endogenous yam, suav nrog kev tiv thaiv kab mob thiab caj ces.
- Lub cev muaj zog (tej zaum yuav cuam tshuam los ntawm qhov kub hnyiab thiab hluav taws xob tau txais).
- Endocrine (piv txwv li, hormonal tsis ua haujlwm hauv tib neeg lub cev).
- Virus (herpesviruses).
- Kev noj tej yam khoom noj.
Raws li cov xwm txheej no uas piav qhia txog qhov yuav tshwm sim ntawm tus kab mob, peb xaus lus: pemphigus vulgaris tuaj yeem ua rau lub cev tiv thaiv kab mob, endocrine, kis kab mob, neurogenic, tshuaj lom, thiab lwm yam. Txawm li cas los xij, nws yuav tsum tau muab sau tseg tias nws tseem tsis tau paub txog seb qhov no puas yog. Cov kev hloov pauv yog qhov tseem ceeb lossis lawv yog qhov xwm txheej thib ob, teb rau qhov cuam tshuam ntawm lub hauv paus ua rau.
Yog li, qhov tsis muaj peev xwm txheeb xyuas qhov tseeb ntawm tus kab mob autoimmune hauv nqe lus nug ua rau nws nyuaj rau nws qhov kev kuaj mob raws sij hawm, yog li ntau tus neeg feem ntau tsim teeb meem loj.
Nws tshwm sim li castxoj kev loj hlob ntawm tus kab mob xws li pemphigus? Koj tuaj yeem pom daim duab ntawm thawj theem ntawm tus kab mob no hauv kab lus no. Cov kws tshaj lij hais tias yog vim li cas rau txoj kev loj hlob ntawm cov txheej txheem pathological no yog tsim cov tshuaj tiv thaiv kab mob autoaggressive rau cov protein uas koom nrog tsev neeg desmoglein. Cov tom kawg yog ib hom "kua nplaum" uas txuas cov hlwb uas nyob ib sab los ntawm kev sib txuas tshwj xeeb hu ua desmosomes.
Tom qab ua kom cov lymphocytes thiab autoantibodies tua desmogleins, cov kab mob epidermal cais tawm ntawm ib leeg, thiab cov epidermis yuav ntxeem tau thiab "nplaum", vim tias nws yooj yim exfoliates thiab raug rau kev nkag mus ntawm ntau yam fungi thiab kab mob.. Hauv kev kho mob, qhov tshwm sim no feem ntau hu ua acantholysis.
Raws li cov txheej txheem piav qhia, tus neeg mob muaj hlwv ntawm daim tawv nqaij, nrog rau nws cov tuab. Nyob rau tib lub sijhawm, lawv tau ntim nrog exudate thiab tsis tu ncua fester. Thaum lub sij hawm, cov npuas exfoliate los ntawm integument, nthuav tawm cov ntaub so ntswg thiab tsim purulent thiab kis kab mob. Nyob rau hauv cov ntaub ntawv siab heev, xws li formations yuav npog yuav luag tag nrho saum npoo ntawm tib neeg lub cev.
keeb kwm keeb kwm
Thaum pib, cov kws tshaj lij paub yuav luag tsis muaj dab tsi txog cov kab mob dermatological. Nyob rau tib lub sijhawm, lo lus "pemphigus" tau siv rau txhua qhov mob ntawm cov mucous daim nyias nyias thiab daim tawv nqaij, uas tau nrog acantholysis, tsim cov vesicles thiab detachment ntawm integument nrog kev loj hlob ntawm suppurating ulcers. Txawm li cas los xij, xyoo 1964, hauv ib phau ntawv kho mob,ib tsab xov xwm uas hloov kev nkag siab ntawm cov kws kho mob txog tus kab mob hauv nqe lus nug, nrog rau txoj hauv kev rau nws qhov kev kuaj mob thiab kev kho mob. Txij thaum ntawd los, muaj cov tshuaj tiv thaiv rau desmogleins hauv cov ntshav plasma ntawm cov neeg mob tau dhau los ua qhov tseem ceeb rau kev kuaj pom pemphigus.
Los ntawm txoj kev, lwm tsab xov xwm tau luam tawm xyoo 1971, uas tau tshuaj xyuas kom meej txog cov kab mob autoimmune thiab cov txheej txheem ntawm kev txhim kho tus kab mob no.
Cov tsos mob tseem ceeb
Cov pob khaus ntawm daim tawv nqaij, uas tshwm sim los ntawm kev txhim kho ntawm vulgaris lossis pemphigus zoo tib yam, yog thawj qhov cim ntawm kev txhim kho ntawm tus kab mob. Nws yuav tsum raug sau tseg tias hom kab mob no feem ntau tshwm sim. Raws li cov kws tshaj lij, nws suav txog li 77% ntawm tag nrho cov ntaub ntawv pom ntawm pemphigus.
Cov kab mob hauv daim ntawv hlwv cuam tshuam tsis yog rau tus neeg mob daim tawv nqaij xwb, tab sis kuj yog cov mucous ntawm nws lub qhov ncauj thiab caj pas. Tom qab ntawd, lawv kis mus rau cov ceg, sab nraud ntawm qhov chaw mos, ntsej muag, thiab lwm yam.
Koj yuav tsum paub dab tsi txog cov kab mob dermatological no? Raws li txoj cai, pemphigus tsim dheev. Nyob rau tib lub sijhawm, cov pob khaus ntawm qhov me me yog tsim rau ntawm daim tawv nqaij noj qab haus huv, uas ua rau qeeb qeeb nrog ceev ceev. Lawv cov ntsiab lus yog cov kua ntshiab ntshiab (me ntsis cloudy).
Tom qab qhib cov papules, eroded nto daim ntawv, uas tom qab ntawd kho, tab sis cia cov kab ntawm xim av pigmentation.
Tus kab mob autoimmune no yog tus cwj pwm los ntawm kev mob hnyav. Qhov twgNws yuav tsum raug sau tseg tias qee cov neeg uas tsis muaj kev kho mob tau ntsib kev txhim kho ntawm tus kheej, ua raws li qhov exacerbation.
Ntau zaus, pemphigus vulgaris yog nrog los ntawm tus kab mob thib ob (candidiasis).
Vim vim qhov poob ntawm cov protein, kua dej thiab kis kab mob, qhov tshwm sim ntawm tus kab mob no hauv cov ntaub ntawv hnyav yog qhov tsis zoo.
kuaj kab mob
Pomphigus vulgaris kuaj tau li cas? Kev kuaj mob ntawm tus kab mob no yog nqa tawm hauv tsev kho mob. Nyob rau hauv rooj plaub no, kuaj pom muaj tus kab mob nyob rau hauv lub hauv paus ntawm cov tsos mob thiab kev soj ntsuam kuaj.
thawj suav nrog:
- Asboh-Hansen cov tsos mob. Qhov kos npe no tau tshwm sim los ntawm nias tus ntiv tes lossis daim npog npog ntawm tag nrho (uas yog, tseem tsis tau qhib) npuas. Cov txheej txheem no pab txhawb rau exfoliation ntawm cov epidermis hauv cheeb tsam uas nyob ib sab ntawm papule, nrog rau kev nce hauv nws cheeb tsam vim yog lub siab ntawm cov kua dej sab hauv.
- Nikolsky cov tsos mob. Cov tsos mob no tau kuaj pom nyob rau hauv tus txheej txheem ntawm kev ntes cov zais zis nrog tweezers thiab rub ib ntu ntawm daim tawv nqaij zoo nkauj nyob ze ntawm qhov chaw ntawm qhov txhab nrog tus ntiv tes. Hauv qhov no, detachment ntawm epidermis tshwm sim.
Nws yuav tsum tau muab sau tseg tias cov tsos mob ntawm pemphigus vulgaris tsis yog tshwj xeeb, tab sis kev kuaj mob. Tib lub sijhawm, nws yuav tsum nco ntsoov tias qhov tshwm sim tuaj yeem tshwm sim nrog lwm yam kab mob.
Lab tests
Pemphigus vulgaris kuaj mob li cas? Kev kho mob rau qhov noCov kab mob autoimmune yuav tsum tau siv tsuas yog tom qab kuaj mob. Txhawm rau kuaj pom tus kab mob no, siv:
Histological tsom xam nrog rau kev tshuaj xyuas ntawm smears lossis hu ua blistering impressions los txheeb xyuas cov hlwb acantholytic (uas yog, cov hlwb epidermal uas tau hloov pauv morphological)
Nws yuav tsum tau sau tseg tshwj xeeb tshaj yog raws li cov ntaub ntawv ntawm kev tshuaj xyuas histological, nws tsis tuaj yeem kos cov lus xaus txog kev txhim kho tus kab mob autoimmune. Qhov no yog vim muaj lwm yam kab mob uas muaj cov duab zoo sib xws.
Immunofluorescent txoj kev txhawm rau txhawm rau txhawm rau txhawm rau hauv cellular ntawm immunoglobulin G thiab A, nrog rau kev txiav txim siab lub ntsiab thiab theem nrab antigens - desmoglein-3 thiab desmoglein-1. Txoj kev kuaj mob no yog qhov tseeb tshaj plaws
Yog li, kev kuaj mob ntawm pemphigus vulgaris yog tsim los ntawm cov ntaub ntawv sib xyaw ntawm cov tsos mob thiab cov duab kho mob ntawm tus kab mob, nrog rau cov txiaj ntsig ntawm immunofluorescent thiab cov txheej txheem kuaj histological.
Kev kho mob
Thaum pib ntawm kev txhim kho pemphigus vulgaris, tus neeg mob tau muab tshuaj glucocorticoids. Cov tshuaj ntawm pab pawg no yog noj nyob rau hauv loading koob tshuaj. Kev teem caij ntawm cov tshuaj zoo li no hauv qhov ntau muaj qhov qhia tseem ceeb. Raws li rau contraindications thiab phiv, lawv yog theem nrab.
Dab tsi yog glucocorticoids raug tshuaj rau tus kab mob raws li kev txiav txim siab? Cov tshuaj rau kev kho mob ntawm cov hlab ntsha tsis zoo tuaj yeem ua tau raws li hauv qab no: Prednisolone, Dexamethasone thiab Triampcinolone.
Tom qab kev txhim kho ntawm tus neeg mob tus mob, cesyog nyob rau hauv qhov tsis muaj cov hlwv tshiab, koob tshuaj maj mam txo thiab hloov mus rau kev saib xyuas txhawm rau tiv thaiv kev rov qab los. Cov kev kho mob ntawm cov neeg mob no ntev heev.
Ntxiv rau cov glucocorticoids, cov neeg mob yuav raug tshuaj cytostatic immunosuppressants, suav nrog Methotrexate, Azathioprine, lossis Prospidin. Lawv tsim nyog los daws cov kev tsis zoo uas tshwm sim tom qab noj cov tshuaj tseem ceeb.
Lwm Txoj Kev Kho Mob
Yog tias muaj cov cim qhia, yog tias muaj kab mob autoimmune, tus neeg mob tuaj yeem muab tshuaj tua kab mob, nrog rau cov tshuaj uas txhawb nqa cov hlab plawv, tswj cov ntshav siab thiab ua kom lub siab thiab lub raum normalizes.
Nws tseem yuav tsum tau noj cov khoom uas muaj cov poov tshuaj, calcium thiab vitamins. Rau kev kho sab nraud ntawm pemphigus, tshuaj tiv thaiv kab mob, tshuaj ntsuab tinctures thiab decoctions tuaj yeem siv.
Nws tseem yuav tsum tau sau tseg tias nyob ntawm tus neeg mob tus mob, cov txheej txheem xws li haemasorption, kev hloov ntshav thiab plasmapheresis tuaj yeem raug tshuaj.
