Erythema yog nrog los ntawm kev nce hauv capillaries, vim cov ntshav ntws mus rau lawv. Nplhaib erythema (Erythema annulare) yog suav tias yog ib qho ntawm cov cim qhia ntawm rheumatism nyob rau theem nquag, piv txwv li, nrog polyarthritis, nrog rau kev tshwm sim ntawm lwm yam kab mob hauv lub cev. Tus kab mob no feem ntau cuam tshuam rau cov menyuam yaus thiab cov tub ntxhais hluas hnub nyoog qis dua 30 xyoo. Nyob rau hauv lub xyoo pua xeem, cov kws txawj tau soj ntsuam erythema annulare raws li ib tug kab mob nrog ib tug tsis zoo prognosis. Niaj hnub no, nrog rau kev muaj cov txheej txheem tshiab zoo rau kev kho mob rheumatic, qhov kev tshwm sim hauv kev tawm tsam erythema yog qhov zoo heev.
Erythema keeb kwm
Cov tsos mob ntawm tus kab mob tau pom los ntawm kws kho mob thaum pib ntawm lub xyoo pua xeem. Thawj tus piav txog erythema annulare thiab ntaus nqi rau cov kab mob ntawm daim tawv nqaij yog cov kws kho mob ntawm Austria G. Lendorff thiab H. Leiner hauv xyoo 1922. Nws yog lawv tus yam ntxwv tus kab mob ua ib qho ntawm cov tsos mob ntawm rheumatism. Yog li, tus kab mob no tseem hu ua Lendorff-Leiner rheumatic erythema. Ib tug kws kho mob los ntawm Fabkis Besnier thaum lub sij hawm ntawd hu ua erythema annulare erytheme margine en plaques, yog li nyob rau hauv txawv teb chaws qhov chaw koj yuav nrhiav tau lub npe erythema marginatum.
Xyoo 1975, H. Stollerman tau txheeb xyuas ib daim ntawv ntawm erythema annulare uastsis yog ib qho kev tshwm sim ntawm rheumatism. Ntau cov kev tshawb fawb histological hauv thaj tsam ntawm cov pob liab liab tau tso cai rau cov kws kho mob tshwj xeeb los txheeb xyuas cov kab mob tshwm sim tsis yog los ntawm cov kab mob rheumatic, tab sis los ntawm kev ua txhaum txoj cai tswj hwm ntawm cov phab ntsa ntawm cov hlab ntsha, nrog rau ntau yam kab mob thiab kab mob hauv lub cev.
Erythema annulare tsos mob
Erythema annulus manifests nws tus kheej nyob rau hauv daim ntawv ntawm liab los yog liab kaw rings uas tshwm rau ntawm daim tawv nqaij. Feem ntau, cov pob yog puag ncig los yog oval nyob rau hauv cov duab, nrog ib tug daj ntseg nruab nrab thiab feem ntau edematous. Cov cheeb tsam cuam tshuam tsis yog flaky thiab tsis mob. Cov neeg mob yuav hnov qhov khaus thiab kub hnyiab hauv qhov chaw cuam tshuam.
Nplhaib nce qhov loj, tsim cov voj voog tshiab feem ntau pom hauv lawv. Raws li cov pob ntawm erythema loj tuaj, lawv tuaj yeem sib koom ua ke, tsim cov duab ntawm ntau yam duab. Tus kab mob no tshwm sim hauv nthwv dej, thiab yog tias qee lub nplhaib ploj, tom qab ib ntus tshiab redness tshwm es tsis txhob ntawm lawv. Ib qho kev tawm tsam ua raws lwm qhov hauv peb lub lis piam. Cov tsos mob ntawm cov pob khaus ntawm cov mucous daim nyias nyias, daim tawv nqaij ntawm cov xib teg thiab cov pob qij txha tsis raug rau cov kab mob xws li erythema nplhaib. Daim duab no qhia meej txog qhov xwm txheej ntawm daim tawv nqaij erythema.
Erythema annulare yog thaj chaw ntawm lub hauv siab, lub xub pwg nyom, ntsej muag thiab caj dab, qee zaum ntawm nraub qaum, caj npab thiab ceg. Qhov kev siv ntawm qhov chaw feem ntau nce nyob rau hauv kev cuam tshuam ntawm qee yam. Ntawm lawv, qhov cuam tshuam ntawm qhov kub thiab txias, ob qho tib si qis thiab siab,lub siab lub ntsws, hloov endocrine (mob khaub thuas, noj tshuaj hormonal contraceptives lossis tshuaj steroid), thiab lwm yam. Qee zaum, erythema manifests nws tus kheej atypically, nrog rau cov pob liab liab thiab tsim cov vesicles. Yog tias, nrog rau cov nplhaib, cov nodules tshwm rau ntawm daim tawv nqaij, cov kws kho mob xav tias qhov no yog ib qho tsos mob uas qhia txog kev txhim kho tsis zoo ntawm rheumatism. Nyob rau tib lub sijhawm, erythema annulare kuj pom nyob rau hauv cov neeg mob nyob rau theem ntawm kev rov qab los tom qab ploj ntawm qhov tshwm sim tseem ceeb ntawm tus kab mob rheumatoid.
Kev txhim kho kab mob
Qhov ua rau rheumatoid erythema yog rheumatism nyob rau hauv lub active theem, thiab cov tsos ntawm rings ntawm daim tawv nqaij feem ntau yog ib tug harbinger ntawm exacerbation ntawm rheumatic mob plawv thiab polyarthritis. Rau cov kws kho mob, feem ntau, erythema annulare yog ib qho kev pom zoo ntawm kev kuaj mob rheumatism.
Cov ntaub ntawv ntawm cov tsis-rheumatoid annular erythema tsim vim qee qhov laj thawj. Ntawm lawv:
- kab mob fungal xws li kis las ko taw thiab candidiasis;
- ua haujlwm tsis zoo ntawm endocrine system;
- teeb meem tiv thaiv kab mob;
- kev npam;
- kab mob focal (osteomyelitis, tonsillitis, cholecystitis thiab lwm yam);
- dysproteinemia, lossis ua txhaum ntawm cov protein muaj pes tsawg leeg ntawm cov ntshav;
- tshuaj tsis haum tshuaj;
- leukemia, lymphoma, adenocarcinoma;
- sepsis;
- Yglomerulonephritis;
Erythema annulare kho
Hais txog kev tawm tsam xws li kab mob xws li annular erythema, kev kho mob yog tsom rau kev tshem tawm qhov ua rau,ua rau daim tawv nqaij mob. Yog hais tias tus kab mob yog nrog los ntawm lub xub ntiag ntawm tus kab mob nyob rau hauv lub cev, tshuaj tua kab mob yog muab. Tsis tas li ntawd, nyob rau hauv kev sib ntaus tawm tsam erythema annulare, vitamin therapy, kev siv cov immunostimulating, antihistamines, calcium npaj thiab sodium thiosulfate yog dav siv. Cov khoom noj khoom haus ntawm tus neeg mob muab kev noj haus uas tsis muaj allergens hauv cov zaub mov. Kev kho mob ntawm erythema tshwm sim los ntawm rheumatism feem ntau yog tsom rau kev tawm tsam cov kab mob hauv qab.
Erythema migrans
Yog ib lub nplhaib tshwm rau ntawm daim tawv nqaij nrog cov cim tom hauv nruab nrab, ces peb tab tom tham txog qhov mob xws li migrating annular erythema. Nws tau raug tsim los hais tias hom kab mob no tuaj yeem tshwm sim vim qhov tom ntawm ixodid zuam thiab lwm yam kab.
Erythema migrans yog tshwm sim los ntawm tus kab mob, feem ntau yog kab mob los yog kab mob. Tus kab mob no nyuaj heev, feem ntau ua mob ntev. Nws yog tsim nyog sau cia tias erythema migrans nyiam kis los ntawm niam mus rau fetus. Thawj cov tsos mob yog daim tawv nqaij hyperemia, o thiab tev. Cov kab mob maj mam nce hauv qhov loj thiab tsim ib hom ciam teb. Cov theem ntxiv yog tus cwj pwm los ntawm kev loj hlob ntawm exocytosis, uas tshwm sim nws tus kheej raws li kev tiv thaiv kev ua haujlwm, thaum lub hlwb ntawm cov ntaub so ntswg tshem tawm cov tshuaj lom los ntawm daim nyias nyias mus rau saum npoo. Leukocyte infiltration muaj nyob rau hauv cov ntaub so ntswg. Lub infiltrate yog raug rau kev soj ntsuam kom meej, uas tso cai rau kev kuaj mob kom raug.
yam ntxwv,hais tias tom cov zuam, muv, hornets thiab lwm yam kab ua rau kev loj hlob ntawm mob erythema migrans. Ib hom kab mob ntau dua thiab insidious yog nws daim ntawv mob ntev, lub hauv paus chiv keeb uas feem ntau tseem tsis paub. Thiab erythema nws tus kheej yog tus cwj pwm los ntawm qhov mob hnyav, mob thiab khaus tas li thiab kub hnyiab. Txhawm rau kuaj mob erythema, ib qho kev ntsuam xyuas dav dav, suav nrog kev kuaj ntshav thiab zis, kuaj xyuas cov infiltrate thiab epidermis.
Erythema migrans kho
Kev kho yog ua tiav nrog cov tshuaj tua kab mob dav dav. Tus kws kho mob xaiv cov tshuaj nyob ntawm daim ntawv thiab theem ntawm tus kab mob. Piv txwv li, nyob rau thawj theem, kev siv tshuaj "Doxycycline" rau ib mus rau ob lub lis piam muab cov txiaj ntsig zoo. Yog tias tus kab mob hnyav heev, tus kws kho mob yuav muab tshuaj Cetriaxone ntsiav tshuaj thiab Benzylpenicillin intramuscularly rau 14-21 hnub. Kev kho ntxiv muaj xws li noj cov vitamins. Qhov kev xaiv kho mob zoo tshaj plaws rau cov mob xws li erythema migrans, feem ntau, pab txhawb kom rov zoo sai.
Erythema toxic
hom kab mob no tshwm sim hauv cov menyuam mos thiab tshwm sim los ntawm cov pob liab liab ntawm tus menyuam lub cev. Tus kab mob no cuam tshuam 20-40% ntawm cov menyuam mos. Raws li qhov hnyav ntawm chav kawm, tshuaj lom erythema tau muab faib ua cov ntawv tsis qhia thiab nthuav tawm (lossis dav dav). Nyob rau hauv thawj rooj plaub, cov pob liab liab yog me me thiab yog nyob rau sab nraub qaum thiab sab hauv folds ntawm caj dab. Tus mob ntawm tus me nyuam yog ntsuas raws litxaus siab.
Nyob rau hauv generalized toxic erythema, cov pob liab liab muaj ntau yam, lawv feem ntau sib koom ua ke, tsim vesicles. Qhov kub thiab txias yog siab, thiab tus me nyuam tsis xis nyob. Hauv cov ntshav ntawm tus menyuam mos, pom muaj cov ntsiab lus ntxiv ntawm eosinophils. Qhov no yog ib hom leukocytes uas ua haujlwm tiv thaiv thaum tsis haum rau hauv lub cev, nrog rau helminthic invasions.
Ntawm cov kev pheej hmoo rau cov tshuaj lom erythema yog cov hauv qab no:
- lub nra hnyav;
- cev xeeb tub toxicosis, tshwj xeeb tshaj yog hnyav;
- kev ua haujlwm ntawm niam yav tom ntej hauv kev ua haujlwm txaus ntshai;
- kab mob hauv lub cev;
- muaj nyob rau hauv kev noj zaub mov ntawm tus poj niam cev xeeb tub los yog lactating poj niam ntawm cov khoom noj tsis haum, xws li citrus txiv hmab txiv ntoo, qe qaib, chocolate, zib ntab, currants, raspberries thiab lwm yam;
- mob ntshav qab zib, thyroid teeb meem lossis kev rog niam txiv.
Yog erythema ntawm tus menyuam yug tshiab yog qhov tshwm sim ntawm qhov muaj cov tshuaj tsis haum hauv cov kua mis los yog cov mis rau kev pub mis, ces tus kab mob no ploj mus ntawm nws tus kheej 4-5 hnub tom qab hloov kho cov khoom noj. Nyob rau hauv cov ntaub ntawv hnyav erythema, tshuaj kho tshwj xeeb yog sau.
Kev kho mob rau cov menyuam yaus erythema
Daim ntawv tshuaj lom ntawm erythema yuav tsum tau kho nyob rau hauv nws cov ntaub ntawv hnyav. Tus kws kho mob tau sau cov tshuaj tiv thaiv kab mob thiab cov tshuaj pleev tshwj xeeb lossis cov tshuaj pleev kom zoo. Nws yog ib qho tseem ceeb nyob rau theem ntawm kev kho mob kom tshem tawmnoj cov allergens nyob rau hauv lub cev ntawm leej niam thiab tus me nyuam. Raws li kev pab kho mob, calcium gluconate, cov vitamins, Rutin yog siv. Cov pob khaus thiab cov hlwv yuav tsum tau kho ob peb zaug hauv ib hnub nrog ci ntsuab lossis tsis muaj zog 4-5% daws ntawm poov tshuaj permanganate, thiab tom qab ua tiav, siv cov hmoov me me rau ntawm daim tawv nqaij ntawm tus menyuam.
Erythema multiforme
Qhov no yog ib qho mob ntawm daim tawv nqaij thiab cov mucous daim nyias nyias, uas yog raws li kev ua xua ntawm lub cev. Erythema multiforme cuam tshuam rau cov extremities, mucous daim nyias nyias ntawm lub qhov ncauj, qhov chaw mos thiab qhov ntswg. Tus kab mob no tshwm sim rau cov menyuam yaus thiab cov laus.
Qee cov tshuaj thiab qee yam kab mob ua rau muaj kev loj hlob ntawm exudative erythema multiforme. Hom kab mob no tshwm sim los ntawm cov tshuaj tua kab mob ntawm penicillin series, barbiturates, sulfonamides thiab lwm yam tshuaj. Ntawm cov kab mob, feem ntau ua rau erythema multiforme yog mycoplasmosis thiab herpes. Cov kab mob loj tshaj plaws yog erythema, tshwm sim los ntawm cov tshuaj tiv thaiv. Piv txwv li, Stevens-Johnson syndrome.
Erythema multiforme kho
Yuav tiv thaiv tus kab mob, siv ob qho tib si thiab hauv zos txoj kev kho mob. Cov qub suav nrog kev siv tshuaj tua kab mob thiab tshuaj tiv thaiv kab mob, kev siv cov tshuaj immunostimulants. Nyob rau tib lub sijhawm, tus neeg mob cov kab mob ntev tau kho. Kev kho mob hauv cheeb tsam tau qhia txog kev siv tshuaj tua kab mob thiab tshuaj tua kab mob, xws li "Chlorhexidine" lossis "Furacilin", tshuaj pleev uas muaj prednisolone thiab hydrocortisone. Kev tu lub qhov ncauj zoo thiab lwm yammucous daim nyias nyias.
