Pemphigus vulgaris: izimbangela, izimpawu, ukwelashwa, imithi. izifo sokuhlasela kwamasosha omzimba

Kanjani leso sifo, ezifana pemphigus? Ukwelashwa futhi izimpawu zalesi sifo zichaziwe ngezansi. Uyofunda ngezimbangela zokuziphendukela le nqubo isifo nokuthi uphethwe wakhe.

ulwazi oluyisisekelo

Pemphigus, isithombe okuyinto okwethulwa kulesi sihloko, - leqembu lezifo ezingavamile kodwa ogulisa ngokwedlulele, okuthena amandla futhi engase ebulalayo vesiculobullous sokuhlasela kwamasosha omzimba ezithinta isikhumba nolwelwesi lwamafinyila.

Ochwepheshe ukukhomba lezi zinhlobo ezilandelayo sifo:

• pemphigus vulgaris;
• ifomu vegetans;
• iqabunga;
• seborrhoeic (zingase zibe namagama ezifana Shenir-Usher syndrome, noma erythematous).

izici Jikelele lesi sifo

vulgaris Pemphigus limelela isigaba izifo zesikhumba kanye nezicubu ongama, yiwo ogelezela efomini ezingalapheki, ne uyahluleka uma elwa nokuphuza njalo.

Lesisifo i-hormone nasekuthengeni. It libhekene Yiqiniso lesichubekako, kanye kumiswa amanxeba okusha intraepidermal.

Ngokuvamile, pemphigus vulgaris kuthinta abantu abaneminyaka engu-50 noma ngaphezulu.

Kungani lesi sifo kwenzeka? Izizathu ukuthuthukiswa kwalesi sifo, kukhona imibono eyayisinesikhathi kuphela.

Pemphigus: izizathu okungenzeka kakhulu

Ngaphambi ukwelashwa, lesi sifo okukhulunywa kubaluleke kakhulu ukuze sithole ukuthi kungani kubalulekile kwaphakama isifo sokuhlasela kwamasosha omzimba kusuka isiguli esithile. Ngeshwa, ekutholeni imbangela pemphigus kunzima. Ochwepheshe ulwa le nkinga ukuthi sekungamashumi amaningi eminyaka. Phakathi nalesi sikhathi baye phambili umbono ocatshangelwayo:

• izici Exogenous, okusho ukuthatha imithi, kuhlanganise i-penicillin nemikhiqizo yalo, kanye interferon ahlukahlukene nezinye izinto.
• izici Endogenous, kuhlanganise amandla omzimba okuzivikela kanye zofuzo.
• izici Physical (kungase singehlela wathola ukusha okukhulu emisebeni).
• Endocrine (ukuhluleka isb hormone e abantu).
• Amagciwane (Herpesviruses).
• Ukuthatha ukudla okuthile.

Ngokusekelwe kulezi zici, echaza okuvela cishe isifo, singaphetha ngokuthini: vulgaris pemphigus kungaba immunological, endocrine, esithathelanayo, neurogenic, ezinobuthi, njll Nokho, kufanele kuphawulwe ukuthi kukhona ayikaziwa ukuthi ushintsho olunjalo ezisemqoka noma abazigqokayo .. ubunjalo yesibili, ekuphenduleni zezimbangela.

Ngakho, ukungakwazi ukuthola ukuthi kubangelwa yini esiqondile kubhekwe isifo sokuhlasela kwamasosha omzimba kakhulu uyawuthiya uphethwe kwayo okufika ngesikhathi, ngakho abantu abaningi esikhathini esinengi ithuthukisa eziyingozi.

nucleation indlela

Kangakanani ukuthuthukiswa kwezifo ezifana, ezifana pemphigus? Photo esigabeni sokuqala lesi sifo, ungabona kulesi sihloko. Ochwepheshe bathi imbangela enjalo pathologic autoaggressive nqubo kumiswa omzimba amaprotheni omndeni ka desmoglein. Lesi sakamuva ukumela noma yiluphi uhlobo "glue" abazihlanganisa eduze epidermal amaseli nge izakhi ezikhethekile yokuxhuma, ababiziweyo desmosomes.

lymphocyte Uma ocushiwe futhi autoantibodies ukuhlasela desmogleins, amaseli epidermal kuthiwa bahlukana, futhi epidermis iba ukungena nakwamanye amazwe futhi "anamatheliswe", kanjalo ehlutshiwe kalula off futhi equliswa Ukungena isikhunta ahlukahlukene namagciwane. Ngo umkhuba emtholampilo, lokhu mkhuba ubizwa ngokuthi acantholysis.

Ngenxa yalokho yenqubo ngenhla isiguli amabhamuza esikhumbeni, kanye Uhlonze lwalo. Ngesikhathi esifanayo zisuthe ngokuhle exudate futhi njalo ibe yimbi nakakhulu. Ngokuhamba kwesikhathi, Bubbles ehlutshiwe bakhishwe amashidi, edalula izicubu futhi obumba ubomvu kanye nezilonda itheleleke. Ezimweni eziphambili, ukwakheka enjalo lisibekele kakhulu bonke ubuso umzimba.

Imininingwane zomlando

Ekuqaleni dermatological ochwepheshe isifo awazi cishe lutho. Igama elithi "pemphigus" kusetshenziswe kuwo wonke izilonda lwamafinyila kanye isikhumba, acantholysis ephelezelwa, kumiswa Bubbles kanye lamabutho ka amashidi ekuthuthukiseni Izilonda suppurating. Nokho, ngo-1964 kwase kushicilelwa isihloko encwadini yezokwelapha, ezashintsha ukuqonda odokotela isifo okukhulunywa ngakho, kanye wawusondela ukuxilongwa kanye nokwelashwa. Kusukela ngaleso sikhathi, ukuba khona kwama masosha omzimba oketshezini olungenambala lwegazi iziguli desmogleina babe nenqubomgomo esiyinhloko ukuhlonza pemphigus.

By endleleni, ngo-1971 wanyathelisa enye sihloko lapho imvelo sokuhlasela kwamasosha omzimba we uphenyo ngokuningiliziwe futhi imishini yentuthuko yalesi sifo.

Izimpawu main

Amashashaza esikhumbeni, okubangelwa ukuthuthukiswa bladderwort engahlanzekile noma ezivamile, amelela izimpawu zokuqala zokugula. Kufanele kuqashelwe ukuthi lolu hlobo isifo kwenzeka kaningi kunabo. Ngokusho kochwepheshe, okubangela 77% azo zonke izinhlobo Kutholwe ka pemphigus.

Izilonda ngesimo Bubbles zingathinti nje isikhumba esiguli, kodwa futhi le mucosa we iyiphi indawo emlonyeni nasemphinjeni yayo. Kamuva Baqhisa egatsheni, umthondo zangaphandle, ubuso nokunye.

Okufanele ukwazi ngalezi izifo zesikhumba? Ngokuvamile, pemphigus eba ngokuzumayo. Ngakho esikhunjeni okunempilo ngaphandle nibonakala kubantu nilungile kwakhiwa encane Bubbles izingxabano nge speed inzuzo ukubukeka appreciable flaccid. okuqukethwe yabo ibonakala ketshezi serous (kancane turbid).

Ngemva kokuvula papules kwakhiwa ebusweni kwaluqeda, kamuva okuphulukisa, kodwa ukushiya iminonjana lesikhumba Ngaphakathi anombala onsundu.

Ukuze uthole isifo enjalo sokuhlasela kwamasosha omzimba libhekene ezinzima ukugeleza okungalapheki fomu. Kufanele kuqashelwe ukuthi abantu abathile ngaphandle ukwelashwa laligujwa ngcono ngesikhathi osithandayo, okuyinto kwathathelwa indawo okubi kakhulu.

Kakhulu ngokuvamile kuhambisana pemphigus vulgaris zifo (candidiasis).

Ngenxa ukulahlekelwa amaprotheni, uketshezi nemiphumela ezithathelwanayo Izibikezelo yalesi sifo amafomu ezinzima okungekuhle.

Ukukhomba isifo

Njengoba kwembulwe vulgaris pemphigus? Sifo sifo kwenziwe esibhedlela. Ukuba khona isifo itholwa esekelwe izimpawu zokwelashwa kanye imiphumela cwaningo.

Lo mqeqeshi owake wapheka zihlanganisa:

• A uphawu asbestos-Hansen. Lesi sici itholwa ngokucindezela umunwe noma ikhava ingilazi (ngamanye amazwi, zingakafinyeleli) bubble. inqubo enjalo kusiza lamabutho we epidermis endaweni ukuthi eyakhelene papules, kanye okwandisa endaweni yayo ngenxa ingcindezi uketshezi ngaphakathi kweyunithi.
• Uphawu Nikolsky. Lesi sici ezitholakele bubble Entrainment izicucu nge esebenzisa futhi bezihlikihla ingxenye umunwe nibonakala isikhumba yayinjalo eduze site lesion. Ngakho kukhona ihlukane we epidermis.

Kufanele kuqashelwe ukuthi pemphigus inhlamba lezi zimpawu azicacile, nokuhlola. Kufanele kukhunjulwe ukuthi ezinjalo kungenzeka kwezinye izifo.

ukuhlolwa laboratory

Kanjani ukuthi unesifo pemphigus vulgaris? Ukwelashwa kwezifo sokuhlasela kwamasosha omzimba kufanele sigcwaliswe kuphela ngemva ngihlolwa. Ukuthola enjalo isifo isetshenziswa:

• ukuhlaziywa histological, ezihilela Ukuhlola smear, noma okuthiwa zeminwe ukuhlonza abagcwele amaseli acantholytic (ie, amaseli epidermal ukuthi iye yashintshwa morphological).

Kufanele kuqashelwe ukuthi ngesisekelo ukuhlaziywa histological idatha ukuphetha ngokuthi ukuthuthukiswa isifo sokuhlasela kwamasosha omzimba akunakwenzeka. Lokhu kungenxa yokuthi kukhona nezinye izifo ne isithombe efanayo.

• Immunofluorescence indlela ukuthola ezifakwa intracellular ka immunoglobulin G no-, kanye ukuhlonza antigen ezinkulu nezincane - desmoglein 3 futhi desmoglein-1. Le ndlela yikona okunembile kakhulu.

Ngakho, uphethwe "pemphigus inhlamba 'ibekwe esekelwe idatha sezikhalazo izimpawu zokwelashwa nesithombe emitholampilo ye isifo futhi imiphumela immunofluorescence amasu kanye luhlolo histologic.

ukwelashwa

Ekuqaleni ukuthuthukiswa pemphigus vulgaris iziguli ebekiwe glucocorticoids. Izidakamizwa kuleli qembu etholwe ukushaqeka Ukweqiwa. Ukuqokwa kwesiKhulu izidakamizwa in inqwaba yobufakazi esibalulekile. Ngokuphathelene contraindications side effects, zingabantu yesibili.

Kuthiwani uma lesi sifo okukhulunywa linqume glucocorticoids? Amalungiselelo ekwelapheni puzyrchaki inhlamba kungenzeka kanje: "Prednisolone" "Dexamethasone" futhi "Triamptsinolon".

Uma ngcono nesineke, isb ngokungabi bikho Bubbles ezintsha, umthamo we izidakamizwa kuyehla kancane kancane futhi ezihamba asekelayo ukuze kuvinjelwe Ukuphinda. Ukuphathwa kanjalo iziguli isikhathi eside ngokwanele.

Ngaphandle glucocorticoids, iziguli angaqoka ejenti cytotoxic, immunosuppressants, kuhlanganise "Methotrexate", "Azathioprine" noma "Prospidin". Ziyakwazi kuyadingeka ukuze asuse izinkinga ukusabela ezingezinhle ngemva ukungenisa imithi eyisisekelo.

Ezinye izindlela ukwelashwa

Uma kunezinkomba zokuthi iziguli isifo sokuhlasela kwamasosha omzimba zingelashwa ngemithi elwa namagciwane, futhi imithi ukuthi ukusekela esimiso senhliziyo nemithambo yegazi, olawula blood pressure kanye kujwayeleke ukusebenza isibindi kanye nezinso.

Futhi kudingeka potassium-equkethe ama-ejenti, i-calcium ne amavithamini. Ngoba impatho ngezihloko ezihlukene pemphigus izidakamizwa eqeda ukuvuvukala, infusions kanye Iziphungo amakhambi angasetshenziswa.

Kufanele kuphawulwe ukuthi, kuncike ngezimo zesiguli ingase yabelwe izinqubo ezifana gemabsorbtsiya, ukumpontshelwa igazi futhi plasmapheresis.