Pemphigus ntawm tus menyuam yug tshiab yog ib yam kab mob tsawg heev thiab txaus ntshai, uas yog raws li cov txheej txheem ntawm kev tawm tsam autoimmune ntawm daim tawv nqaij integument. Raws li cov yam ntxwv tsis paub, Lub cev tiv thaiv kab mob tsim cov tshuaj tiv thaiv rau cov tshuaj uas ua kom muaj kev ncaj ncees ntawm daim tawv nqaij. Lawv ua rau cov hlwb epithelial, vim tias cov kab mob tshwm sim ntawm daim tawv nqaij, uas kis tau tus kab mob streptococcus lossis staphylococcus.
Kev piav qhia
Lub npe ntawm tus kab mob yog pemphigus, cov tsos mob uas muaj cov tshuaj tiv thaiv kab mob hauv cov ntshav.
Pemphigus tuaj yeem cuam tshuam rau tib neeg txhua hnub nyoog thiab poj niam txiv neej. Tus kab mob no txaus ntshai heev rau cov menyuam yug tshiab uas muaj kev tiv thaiv hauv zos tseem tsis tau tsim. Pemphigus yog qhov ua rau muaj kev loj hlob, thiab nrog qhov mob loj heev, lub cev poob dej sai sai. Qhov kev pheej hmoo ntawm kev kis kab mob yog qhov siab heev, vim cov kab mob thiab cov kab mob tuaj yeem ua rau muaj kab mob sepsis.
Ntau yam
rau hompemphigus ntawm cov me nyuam mos (hauv daim duab koj tuaj yeem pom tias qhov tshwm sim ntawm tus kab mob zoo li cas) suav nrog:
- Pemphigus vulgaris.
- Vegetative pemphigus.
- Nplooj-zoo li tus.
- Erythematous.
- Seborrheic.
Vulgar pemphigus suav hais tias yog qhov ntau tshaj. Nyob rau hauv cov ntaub ntawv no, vesicles tshwm nyob rau ntawm daim tawv nqaij, uas yog sau nrog serous kua. Lawv tawg yooj yim thiab kho sai sai. Thawj hlwv tshwm sim feem ntau nyob ib ncig ntawm lub qhov ncauj thiab daim di ncauj.
Cov hlwv no dhau sijhawm tshwm sim ntau dua thiab nthuav dav thoob plaws hauv lub cev, thiab tom qab lawv qhov kev tawg tseem nyob hauv cov xim liab. Yog tias tus kab mob no tsis kho, tus menyuam yuav tuag tsis pub dhau rau lub hlis.
Thaum daim ntawv cog qoob loo pib tsim cov npuas ib leeg. Tom qab lawv tawg, grey papillomas (cov nroj tsuag) nyob rau ntawm daim tawv nqaij, nquag loj hlob.
Nplooj ntawv
Daim ntawv zoo li nplooj ntawm pemphigus ntawm tus menyuam yug tshiab yog tus cwj pwm los ntawm kev tsim cov crusts uas tshwm sim tom qab rupture ntawm hlwv. Qhov peculiarity ntawm tus kab mob yog tias nws loj hlob sai. Crusts yog tsim loj heev, tom qab uas lawv pib tev tawm nyob rau hauv loj pieces zoo li nplooj. Nws tuaj yeem txuas erythematous pemphigus rau daim ntawv no. Tsis muaj qhov sib txawv tseem ceeb ntawm lawv, vim tias cov tsos mob thiab qhov tshwm sim zoo sib xws.
Seborrheic form
Seborrheic daim ntawv pib tsim los ntawm tawv taub hau, los ntawm lub ntsej muag. Tus kab mob no zuj zusqeeb heev, hlwv pib tshwm rau sab nraub qaum, ceg ceg, plab. Thaum lub crust raug tshem tawm, quaj eczema yog tsim.
Muaj lwm hom ntawv ntawm pemphigus:
- viral;
- syphilitic.
Viral pemphigus ntawm tus menyuam mos yog tshwm sim los ntawm tus kab mob Coxsackie, nrog rau 71 hom enteroviruses. Tus kab mob tuaj yeem ua rau muaj qhov loj me thiab dhau los ua kis mob. Hauv cov menyuam yaus, nws tshwm sim feem ntau ntawm ob txhais tes thiab ko taw, txawm tias hlwv tuaj yeem tshwm rau ntawm qhov chaw mos.
Syphilitic pemphigus ntawm cov menyuam yug tshiab tsim los ntawm kev kis kab mob hauv lub tsev menyuam nrog syphilis. Cov menyuam yaus tuaj yeem tsim cov hlwv uas muaj cov pob liab liab uas tawg sai sai, ua rau cov kab mob liab dawb.
Lub paratumoral pemphigus muaj cov tsos mob tshwm sim tshaj plaws. Raws li txoj cai, nws feem ntau nrog cov kab mob xws li leukemia lossis lymphoma, thiab tej zaum yuav qhia txog qhov pib ntawm cov txheej txheem malignant.
Cia saib cov laj thawj tseem ceeb ntawm pemphigus hauv cov menyuam yug tshiab.
Ua rau pathology hauv menyuam mos
Qhov pib ntawm tus kab mob coincides nrog kev tsim cov tshuaj tiv thaiv kab mob autoimmune rau desmoglein proteins, uas yog lub hauv paus rau kev sib txuas ntawm cov hlwb epidermal. Proteins tau tawg thiab kev ncaj ncees ntawm daim tawv nqaij raug kev txom nyem, thiab cov kab mob, thaum lawv nkag rau ntawm daim tawv nqaij, ua rau tsim cov hlwv.
Cov laj thawj uas tuaj yeem ua rau cov txheej txheem pathological no tseem tsis paub txog kev tshawb fawb. Lub ntsiab yog vim li cas yog noob caj noob ces thiab keeb kwm predisposition rau xws li ib tug txheej txheem autoimmune. Kev cuam tshuam hauv kev ua haujlwm ntawm lub hauv nruab nrab lub paj hlwb kuj suav tias yog qhov ua tau ua rau muaj kev loj hlob ntawm pemphigus. Kab mob, kab mob lossis lwm yam kab mob tuaj yeem ua rau muaj tus kab mob.
Txoj kev sib cav
Cov hauv qab no kuj tau qhia raws li qhov ua tau rau qhov tshwm sim ntawm pathology:
- Kev noj tshuaj thiol pab pawg.
- Burns.
- YHerpesviruses.
- Tau nrog tshuaj tua kab.
- kev nyuaj siab.
Pemphigus thaum ntxov tsis ua rau muaj kev txhawj xeeb. Cov menyuam yaus hnov zoo thiab sib nrug ntawm ob peb lub hlwv ntawm daim tawv nqaij, tsis muaj lwm yam kev hloov pauv. Deterioration ntawm tus mob tshwm sim raws li qhov nce nyob rau hauv lub cheeb tsam ntawm cov cheeb tsam ntawm daim tawv nqaij. Qhov chaw ntawm qhov txhab loj hlob thaum cov kab mob nkag mus rau ntawm daim tawv nqaij, thiab kev loj hlob ntawm cov suppurations hauv zos thiab loj inflammatory foci pib. Tus kab mob no tshwm sim los ntawm qhov tsis muaj cov ntaub so ntswg epithelialization tom qab rupture ntawm lub zais zis. Erosions maj mam nthuav thiab sib koom ua ke. Neonatal pemphigus kuaj tau li cas?
Diagnosis
Tus kab mob no tsawg heev, yog li cov kws kho mob feem ntau pom tias nws nyuaj rau kev txiav txim siab qhov kev kuaj mob. Ua ntej tshaj plaws, nws raug pom zoo kom paub qhov txawv ntawm tus kab mob los ntawm lwm cov kab mob dermatological uas tuaj yeem nrog cov tsos mob zoo sib xws.
Rau qhov no, Nikolsky xeem yog siv. Tus kws kho mob rub tus menyuam daim tawv nqaij nyob zenrog lub npuas thiab deb ntawm nws, nias rau ntawm lub hlwv. Qhov kev ntsuam xyuas zoo yog tias muaj cov cim qhia ntawm daim tawv nqaij exfoliation:
- Thaum nias, cov kua nkag mus rau hauv cov txheej txheem ntawm daim tawv nqaij.
- Yog koj nias rau ntawm daim tawv nqaij hla lub hlwv, nws tev tawm zoo li ib daim kab xev.
- Nyob hauv thaj chaw noj qab haus huv, kev sib xyaw ntawm cov txheej txheej sab saud ntawm cov epidermis tau pom.
Ib qho kev tshuaj ntsuam kuj tau sau tseg rau cov ntsiab lus ntawm cov tshuaj tiv thaiv rau desmoglein proteins hauv cov ntshav. Yog tias pom cov tshuaj tiv thaiv zoo li no, qhov no qhia tias muaj pemphigus. Qee lub sij hawm kuaj cov kua dej los ntawm cov hlwv thiab ntxiv cov kev tshawb fawb dav dav lossis cytological raug txiav txim.
Kev kho mob pemphigus hauv cov menyuam yug tshiab
Qhov tseem ceeb hauv kev kho mob pathology yog los tiv thaiv kev tsim cov hlwv tshiab thiab ua tiav cov kev kho mob uas twb muaj lawm. Cov tshuaj tseem ceeb hauv kev kho cov txheej txheem pathological yog glucocorticosteroids. Txawm hais tias lub hnub nyoog ntawm tus me nyuam, nws raug sau rau ib chav kawm ntawm cov kab mob glucocorticosteroids, uas tau muab tshuaj ntau. Qhov no ua rau nws muaj peev xwm txo tau qhov kev siv ntawm kev tsim cov npuas tshiab thiab pib cov txheej txheem ntawm kev yaig rov qab. Txoj kev kho no tau ua tiav li ntawm ob lub lis piam, tom qab ntawd kev kho tshuaj hormonal nrog tib cov tshuaj hauv cov tshuaj me me yog qhov tsim nyog.
Prednisolone
Cov tshuaj siv tau zoo tshaj plaws hauv kev kho mob pemphigus yog Prednisolone, uas yog siv rau hauv cov koob tshuaj loj, uas tau txo qis. Hmoov tsis zoo, rau cov menyuam yaus feem ntau, cov kev kho mob zoo li no kav ntev mus rau lub neej, thiab Prednisolone tau txhaj txhua txhua.day.
Nrog rau cov tshuaj hormones, tus menyuam tau muab tshuaj calcium, vitamin D, tshuaj tiv thaiv kab mob uas cuam tshuam cov haujlwm ntawm lub cev tiv thaiv kab mob. Cov tshuaj no suav nrog:
- "Azathioprine";
- Y "Cyclophosphamide";
- Mielosan;
- YCyclophosphamide.
Nyob rau theem pib ntawm kev kho mob, tus menyuam raug pom zoo cov txheej txheem los ntxuav cov ntshav ntawm cov tshuaj tiv thaiv aggressive. Cov no suav nrog hemodialysis thiab plasmapheresis. Txhawm rau txo qhov kev pheej hmoo ntawm kev kis tus kab mob, kev kho kom zoo ntawm daim tawv nqaij nrog tshuaj pleev nrog tshuaj tua kab mob thiab corticosteroids tau sau.
Nws yuav tsum to taub kom meej tias kev kho rau pemphigus yuav nyob mus ib txhis. Nyob rau hauv tsawg zaus - nrog me me so ntawm relapses.
Kev noj qab haus huv ntawm cov menyuam yaus uas kuaj pom tus mob staphylococcal pemphigus ntawm tus menyuam mos yuav tsum tau saib xyuas tshwj xeeb thiab saib xyuas txhua hnub. Lub neej expectancy ntawm xws li ib tug me nyuam nyob ntawm qhov no. Nws tseem ceeb heev kom paub tseeb tias nws noj txhua yam tshuaj uas kws kho mob tau sau tseg.
Cov niam txiv yuav tau kawm txhaj tshuaj, vim nws yuav tau ua txhua hnub. Nws tseem yog ib qho tsim nyog los kho cov pob khaus ntawm daim tawv nqaij nrog aniline dyes ("Fukortsin", Zelenka), uas muaj txiaj ntsig zoo rau cov kab mob microbes. Corticosteroid tshuaj pleev yog pom zoo rau kev yaig thiab crusts. Raws li txoj cai, "Celestoderm", "Garamycin" thiab "Gyoksizon" raug tshuaj.
Thaum cov tsos mob tshwm sim - kua paug, o - yuav tsum tau siv tshuaj tua kab mob thaum kho -"Baneocin" los yog "Levomekol". Yog tias thaj chaw loj raug cuam tshuam, nws yog qhov zoo tshaj los tiv thaiv lawv nrog kev hnav tsis taus.
tshuaj tiv thaiv kab mob
Thaum yws qhov mob, qee zaum nws raug tso cai muab tshuaj tiv thaiv tus menyuam Ibuprofen lossis Nurofen. Yog tias tshuaj loog ua tsis tiav, koj yuav tsum sab laj nrog kws kho mob uas yuav qhia rau koj tias cov tshuaj loog twg tso cai rau siv thaum yau. Cov da dej uas koj tuaj yeem ntxiv cov tshuaj "Chlorhexidine" yuav tau txais txiaj ntsig. Nws yog ib qho tsim nyog yuav tau muab cov tshuaj vitamin thiab ntxhia rau menyuam yaus nrog folic acid, vitamin E, thiab lwm yam.
