Ib qho ntawm cov kab mob insidious tshaj plaws yog Dubrey's melanosis. ICD-10 cais nws raws li hom mob qog noj ntshav ua ntej. Ib tug cais code nyob rau hauv lub classifier tsis yog muab rau tus kab mob, tab sis nws yog feem ntau yog cais raws li D22 (melanoform nevus) los yog C43 (malignant melanoma ntawm daim tawv nqaij). Lub pathology nws tus kheej yog qhov nyuaj rau kev kuaj mob, thiab txawm tias tus kws kho mob oncologist tsis tuaj yeem ua qhov kev kuaj mob. Tias yog vim li cas nws tseem ceeb heev kom paub txog nws cov tsos mob thaum ntxov.
daim ntawv pov thawj kho mob
Dubrey's melanosis yog kab mob ntawm daim tawv nqaij. Nws yog tus cwj pwm los ntawm cov kab mob pigmented uas ntes cov epidermis thiab dermis. Cov qog nws tus kheej muaj feem ntau ntawm atypical melanocytes.
Thawj zaug, cov lus piav qhia ntxaws ntxaws ntawm cov kab mob tau nthuav tawm los ntawm kws kho mob dermatologist Hutchinson. Tom qab ntawd nws tuaj txog ntawm tus kws kho mob Fab Kis Dubreuil, tom qab uas nws tau hu ua.
Ib yam tshwj xeeb ntawm cov qog yog suav tias yog kev loj hlob qeeb. Feem ntau nws yog localized ntawm lub ntsej muag nyob rau hauv cov poj niam laus. Ntawm cov neeg sawv cev ntawm kev sib deev muaj zog, xws li kev kuaj mob tshwm sim hauv qhov tshwj xeeb. Chawntev heev, nws yuav tsis tshwm sim los ntawm sab nraud deformations. Txawm li cas los xij, nyob rau hauv kev cuam tshuam ntawm qee yam, nws pib loj tuaj. Maj mam, daim duab kho mob tau ntxiv los ntawm lwm cov cim qhia ntawm malignancy.
Qhov laj thawj tseem ceeb
Qhov laj thawj ntawm Dubreu's melanosis tseem tsis tau paub. Cov kws kho mob txheeb xyuas ib pab pawg ntawm qee yam, qhov muaj nyob ntawm qhov uas ua rau muaj kev pheej hmoo ntawm pathology. Ntawm lawv, feem ntau yog cov hauv qab no:
- daim tawv nqaij;
- hnub nyoog tshaj 50;
- raug tshav ntuj ncaj qha;
- tanning txaj txaj txaj muag;
- kev raug mob rau qhov chaw pigment.
Nrog cov neeg sawv cev ntawm haiv neeg dub, Dubrey's melanosis yog xyaum tsis pom.
daim duab kho mob
Lub ntsiab tshwm sim ntawm pathology yog xim av. Raws li txoj cai, nws yog flabby thiab dim. Cov duab ntawm neoplasm yog qhov tsis sib xws, tab sis cov ciam teb yog qhov tseeb heev. Nws cov xim yuav luag ib txwm tsis sib xws. Cov ntxoov ntxoo tuaj yeem sib txawv ntawm xim av mus rau xim dub. Qee lub sij hawm tus kab mob yuav siv daim ntawv ntawm lub blob dub ntawm keeb kwm xim av.
Cov pob nrog Dubreu's melanosis feem ntau nyob hauv thaj chaw qhib ntawm daim tawv nqaij, piv txwv li, ntawm lub ntsej muag. Lawv qhov loj tuaj yeem sib txawv ntawm ob peb millimeters mus rau ob peb centimeters. Qhov chaw loj hlob qeeb. Txawm li cas los xij, txoj kev pheej hmoo ntawm kev loj hlob ntsug yog qhov siab heev. Hauv qhov no, raws li txoj cai, kev hloov pauv ntawm melanosis rau hauv melanoma tshwm sim. Lwm cov tsos mob ntawm malignancy muaj xws litseem ceeb:
- pom thaj chaw tsaus;
- muag ciam teb ntawm neoplasm;
- hloov qhov loj thiab cov duab;
- pom thaj chaw ntawm cicatricial atrophy.
Qee zaum melanosis cuam tshuam rau ntawm daim tawv nqaij nyob ib ncig ntawm daim tawv muag thiab txawm tias lub qhov muag ntawm qhov muag. Lub cornea tsis tshua muaj kev cuam tshuam.
theem kev txhim kho
Hauv nws txoj kev loj hlob, melanosis muaj npe tom qab Dubrey mus txog 3 theem. Nyob rau theem pib, qhov nce ntawm cov melanocytes tau pom. Qhov thib ob theem yog tus cwj pwm los ntawm pronounced proliferation, nrog rau manifestations ntawm athymia ntawm methanocytes. Nyob rau theem thib peb, cov ntsiab lus atypical pib loj tuaj rau hauv daim tawv nqaij.
Kev txiav txim siab ntawm theem tseeb ntawm cov txheej txheem pathological tso cai rau koj xaiv txoj kev kho mob zoo tshaj plaws, muab qhov kev kuaj mob kom rov zoo.
Txoj kev kuaj mob
Thaum neoplasms tshwm sim ntawm daim tawv nqaij ntawm ib qho etiology, nws yog ib qho tsim nyog mus ntsib kws kho mob dermatologist. Nyob rau hauv cov ntaub ntawv ntawm kev ua xyem xyav ntawm oncology, tus kws kho mob yuav xa koj mus rau ib tug tshwj xeeb kws kho mob - ib tug oncologist.
Kev kuaj mob ntawm Dubrey's melanosis pib nrog kev kuaj mob, kev kawm txog tus neeg mob keeb kwm. Nws yog ib qho tseem ceeb rau tus kws kho mob kom paub nyob rau hauv cov xwm txheej dab tsi neoplasm tshwm sim, dab tsi ua ntej tus txheej txheem no. Tom qab ntawd, teem caij kuaj xyuas kom ntxaws. Nws feem ntau muaj cov haujlwm hauv qab no:
- Dermatoscopy. Siv los ntsuas cov duab, pigmentation thiab qauv ntawm neoplasm.
- Kev tshuaj ntsuam morphological ntawm cov ntaub so ntswg. Siv los txiav tximtus naj npawb ntawm melanocytes, kev hloov pauv hauv cov epidermis. Thaum lub sij hawm soj ntsuam, qee cov tawv nqaij raug coj los ntawm tus neeg mob.
- Testing rau qog markers. Nws yog nqa tawm kom tshem tawm qhov malignancy ntawm pathology.
- Scintigraphy. Thaum lub sijhawm txheej txheem, daim tawv nqaij raug tshuaj xyuas siv xov tooj cua phosphorus.
Nws tsim nyog sau cia tias qhov kev kuaj ntshav tsis tau ua raws li txoj kev kuaj mob. Qhov tseeb yog tias nrog txoj kev kuaj no, qhov kev pheej hmoo ntawm cov kab mob kis tau siab dhau lawm.
Differential Diagnosis
Raws li tuaj yeem pom los ntawm cov duab tau nthuav tawm hauv peb tsab xov xwm, Dubrey's melanosis tuaj yeem ua yuam kev rau lwm yam kab mob ntawm daim tawv nqaij. Qhov yuam kev tshaj plaws ntawm cov kws kho mob thaum kuaj mob yog kev piav qhia txog pathology rau senile keratosis. Qhov no kuj yog ib qho mob precancerous, uas sai sai hloov mus rau hauv cov txheej txheem malignant. Rau tus neeg mob, ob yam kab mob no txaus ntshai heev thiab xav tau kev kho mob tsim nyog, saib xyuas tas li los ntawm tus kws kho mob tshwj xeeb.
Lwm qhov yuam kev yog ua yuam kev melanosis rau basalioma pigmentosa. Qhov sib txawv ntawm qhov no tseem ceeb heev. Piv txwv li, basalioma loj hlob tshwj xeeb hauv cov ntaub so ntswg, thiab melanosis tuaj yeem cuam tshuam rau tag nrho lub cev. Cov tom kawg yog yooj yim tsis meej pem nrog txhoj puab heev melanoma. Tias yog vim li cas kev kuaj mob sib txawv ua lub luag haujlwm tseem ceeb hauv kev lees paub tus kab mob hauv qab.
Txoj Kev Kho Mob
Kev Kho Mob Dubreu's melanosis yuav tsum muaj kev tsim nyog tshwj xeeb. Txoj kev tseem ceeb ntawm kev cuam tshuampathology suav hais tias yog kev cuam tshuam kev phais. Thaum lub sijhawm txheej txheem, tus kws tshaj lij txiav tawm cov neoplasm nrog rau cov ntaub so ntswg subcutaneous.
Cov khoom siv excised yuav tsum raug xa mus rau kev tshawb fawb. Cov neeg mob nrog Dubrey's melanosis uas tau txais histology tau txais cov lus teb txog qhov muaj lossis tsis muaj cov qog nqaij hlav cancer. Txoj hauv kev no tso cai rau ncua sij hawm ncua ntawm cov txheej txheem malignant.
Qee zaum yuav tsum tau txiav txim siab dav ntawm neoplasm. Nyob rau hauv cov ntaub ntawv no, lub lag luam yog nqa tawm nyob rau hauv cov theem thiab ib txwm nrog kev siv cov yas kho ntawm daim tawv nqaij. Qhov kev cuam tshuam ntawm kev cuam tshuam kuj nthuav dav yog tias cov kab mob "sawv", cov metastases tshwm sim hauv cov qog ntshav.
Thaum kev phais yog contraindicated los yog tsis muaj, tus neeg mob raug qhia kom mus kho hluav taws xob. Nws tau raug pov thawj tias cov kab mob pathological ntawm neoplasm yog rhiab heev rau kev tsom xam X-ray txoj kev kho.
pab tshuaj tshuaj ntsuab
Daim ntawv qhia ntawm pej xeem cov kws kho mob tsuas yog siv los ua piv txwv ntawm kev pab hauv kev tawm tsam melanosis. Tsis tas li ntawd, kev sab laj ua ntej nrog tus kws kho mob tuaj koom yog qhov yuav tsum tau ua. Qee cov tshuaj ntsuab muaj contraindications rau kev siv rau ib tus neeg mob. Lwm tus tuaj yeem ua rau qhov hnyav ntawm cov kab mob pathology, thiab lawv txoj kev siv yog nrog los ntawm cov kev mob tshwm sim loj hauv cov tawv nqaij tshwj xeeb no. Yog vim li cas cov tshuaj niaj hnub no categorically tsis pom zoo rau tus kheej noj.
Kev siv ntau yam kev kho neeg pej xeem yog qhia,ua ntej ntawm tag nrho cov, kom txo tau qhov kev siv ntawm inflammatory txheej txheem ntawm daim tawv nqaij, ntxiv dag zog rau lub cev tiv thaiv kab mob. Ntawm cov tshuaj hauv zos, cov roj flaxseed yog qhov tshwj xeeb tshaj yog siv tau. Nws yuav tsum tau tov nrog zib mu nyob rau hauv sib npaug zos proportions, thiab ces thov mus rau qhov chaw cuam tshuam ob zaug ib hnub twg.
txhawm rau txhim kho lub cev tiv thaiv kab mob, cov kws kho mob pej xeem pom zoo kom noj tincture ntawm aconite tubers. Cov tshuaj yog siv 20 tee ntawm ib lub sij hawm, tab sis peb zaug ib hnub twg. Nws yog qhov zoo dua los rov ua cov txheej txheem ua ntej noj mov loj. Koj tuaj yeem siv tincture ntawm kopechnik. Txhawm rau npaj nws, koj xav tau txog 50 g ntawm qhuav raw cov ntaub ntawv, ncuav 0.5 liv ntawm vodka. Lub tincture yuav tsum tau muab tso rau hauv qhov chaw tsaus rau 15 hnub, tom qab ntawd lim. Nws raug nquahu kom noj cov tshuaj uas tshwm sim hauv ib lub teaspoon ib hnub ib zaug.
Kev ntsuas kom rov zoo
Kev Ntsuas rau Dubreu's melanosis yog kev poob siab. Thaum tsis muaj kev kho raws sijhawm thiab ua tau zoo, kev hloov pauv ntawm pathology rau hauv kev mob qog noj ntshav tau pom hauv 40-75% ntawm cov neeg mob. Cov txheej txheem nws tus kheej siv sijhawm li 15 xyoo, tab sis qee zaum nws mus ntau zaus.
Hauv 10% ntawm cov neeg mob, neoplasm cells metastasize rau ntawm daim tawv nqaij. Cov txiaj ntsig zoo li no txaus ntshai heev thiab feem ntau ua rau tuag.
Txoj Kev Tiv Thaiv
Tom qab kev phais, tus neeg mob melanosis yuav tsum tau sau npe rau hauv lub tsev kho mob. Tsis tas li ntawd, nws yuav tsum tau mus kuaj mob los ntawm tus kws kho mob oncologist thiab kws kho mob dermatologist, thiab tau txais kev sim ntau zaus.
Puas muaj peev xwm tiv thaiv kev txhim kho ntawm Dubreu's melanosis ntawm lub ntsej muag? Cov duab ntawm cov neeg mobnrog rau kev kuaj mob zoo sib xws ua rau koj xav txog qhov teeb meem no. Kev tiv thaiv tshwj xeeb tsis tau tsim. Txawm li cas los xij, cov kws kho mob muab ntau cov lus pom zoo kom txo qis kev pheej hmoo ntawm kev tsim kab mob.
Ua ntej tshaj plaws, nws yog qhov yuav tsum tau mus rau hnub so nrog txhua lub luag haujlwm. Tus kws kho mob pom zoo kom sunbathing ua ntej noj su lossis yav tsaus ntuj. Hauv qhov no, nws yog ib qho tsim nyog yuav tsum siv cov khoom tiv thaiv tawv nqaij (creams, lotions), tsis txhob raug tshav ntuj ncaj qha. Cov neeg tawv nqaij ncaj yuav tsum zam kom tsis txhob pleev xim rau tag nrho.
Lwm txoj cai tiv thaiv tau nqis los tswj lub neej noj qab haus huv, tshem tawm kev quav tshuaj thiab cov xwm txheej ntxhov siab. Cov ntsiab cai no siv tau rau txhua yam mob qog noj ntshav.
