Pemphigus vulgaris: ua, cov tsos mob, kev kho mob, tshuaj noj. cov kab mob autoimmune

Yuav ua li cas puas xws li ib tug kab mob, xws li pemphigus? Kev kho mob thiab cov tsos mob ntawm tus kab mob no yuav sib tham txog hauv qab no. Koj kuj yuav kawm txog cov ua ntawm tus kab mob thiab yuav ua li cas nws mob.

cov ntaub ntawv

Pemphigus, yees duab uas yog nyob rau hauv no tsab xov xwm, - ib pab pawg neeg ntawm tsawg tab sis tsis tshua loj heev, ceev nrooj thiab cov uas tuag vesiculobullous autoimmune cov kab mob uas cuam tshuam rau daim tawv nqaij thiab qog ua kua week.

Kws txawj qhia nram qab no hom ntawm tus kab mob:

• pemphigus vulgaris;
• vegetans daim ntawv;
• daim nplooj;
• seborrhoeic (tej zaum yuav muaj cov npe xws li Shenir-Usher syndrome, los yog erythematous).

General cov yam ntxwv ntawm tus kab mob no

Pemphigus vulgaris nruab nrab yog ib pab pawg ntawm cov kab mob ntawm daim tawv nqaij thiab subcutaneous cov ntaub so ntswg, uas ntws nyob rau hauv lub mob hauv daim ntawv, uas nquag rov.

Tus kab mob no yog yam tshuaj nyob. Nws yog yus muaj los ntawm hnyav kawg, raws li zoo raws li lub tsim ntawm intraepidermal hlwv.

Feem ntau cov feem ntau, pemphigus vulgaris muaj feem xyuam rau cov neeg muaj hnub nyoog 50 xyoo los yog ntau tshaj.

Yog vim li cas yog tus kab mob no tshwm sim? Yog vim li cas rau txoj kev loj hlob ntawm tus kab mob no, muaj tsuas yog hypotheses.

Pemphigus: lub feem ntau yuav yog vim li cas

Ua ntej kev kho mob, tus kab mob no nyob rau hauv lo lus nug yog ib qho tseem ceeb heev kom paub seb vim li cas nws yog ib qho kab mob autoimmune sawv los ntawm ib tug kev mob. Tu siab, nrhiav qhov ua rau ntawm pemphigus yog ib qhov nyuaj. Kws txawj yog tawm tsam nrog qhov teeb meem no rau ntau xyoo lawm. Thaum lub sij hawm lub sij hawm no lawv tau muab tso rau pem hauv ntej ib tug hypothesis:

• Exogenous yam, xws li noj tshuaj, xws li penicillin thiab nws cov derivatives, thiab ntau yam interferons thiab lwm yam.
• Endogenous yam, xws li kev tiv thaiv thiab kev tshuaj ntsuam genetic.
• Lub cev yam (tej zaum yuav cuam tshuam tau txais nws kim heev kev kub nyhiab thiab tawg).
• Endocrine (e.g. hormonal tsis ua hauj lwm nyob rau hauv tib neeg).
• Kab mob (Herpesviruses).
• Noj tej yam zaub mov.

Raws li tej yam, piav qhia txog cov tej zaum tshwm sim ntawm tus kab mob, peb xaus: pemphigus vulgaris yuav ua tau immunological, endocrine, mob, neurogenic, tshuaj lom, thiab lwm yam Txawm li cas los, nws yuav tsum tau muab sau tseg hais tias muaj yog tseem tsis paub hais tias seb cov kev pauv tseem ceeb heev los yog lawv hnav .. theem nrab xwm, nyob rau hauv teb mus rau lub hauv paus ua rau.

Yog li, lub cev tsis paub cov caij nyoog ua ntawm qhov suav hais tias kab mob autoimmune ho hampers nws raws sij hawm mob, li ntawd, muaj coob tus neeg feem ntau loj teeb meem.

nucleation mechanism

Yuav ua li cas yog txoj kev loj hlob ntawm tej kab mob, xws li pemphigus? Diam duab thawj zaug rau theem ntawm tus kab mob, koj yuav saib tau nyob rau hauv no tsab xov xwm. Kws txawj hais tias qhov ua rau ntawm tej pathologic autoaggressive txheej txheem yog lub tsim ntawm cov tshuaj rau cov nqaijrog teej tug mus rau lub tsev neeg ntawm desmoglein. Cov yav tas sawv cev rau ib tug tsi ntawm "cov kua nplaum" yog pub ntxiv tshaj uas nyob ib sab epidermal hlwb ntawm tshwj xeeb txuas ntsiab, uas yog hu ua desmosomes.

Ib zaug tshuab txais lymphocytes thiab autoantibodies tua cov desmogleins, epidermal hlwb yog cais los ntawm txhua lwm yam, thiab cov epidermis yuav ntxeem tau thiab "Document", li no yooj yim peeled tawm thiab raug mus rau lub allergic ntawm ntau yam fungi thiab cov kab mob. Nyob rau hauv soj ntsuam xyaum, qhov no tshwm sim yog hu ua acantholysis.

Raws li ib tug tshwm sim ntawm cov saum toj no cov txheej txheem rau tus neeg mob muaj hlwv ntawm daim tawv nqaij, raws li zoo raws li nws cov thickness. Nyob rau tib lub sij hawm lawv tau sau nrog exudate thiab lossi fester. Thaum lub sij hawm, lub npuas yog peeled tawm los ntawm cov ntawv txheeb, raug lead lom rau cov nqaij mos thiab txoj kev ua kua paug thiab kis tau kab mob ulcers. Nyob rau hauv heev zaus, xws tsim yuav npog tshuam tag nrho saum npoo ntawm lub cev.

keeb kwm ntaub ntawv

Keeb xeeb ib tug dermatological kab mob cov kws txawj tsis paub yuav luag tsis muaj dab tsi. Lub sij hawm "pemphigus" thov rau tag nrho cov qhov txhab ntawm txheej thiab daim tawv nqaij, nrog acantholysis, tsim los ntawm cov npuas thiab detachment ntawm cov ntawv txheeb rau cov kev loj hlob ntawm suppurating tawm. Txawm li cas los, nyob rau hauv 1964 ib tsab xov xwm twb luam tawm nyob rau hauv ib tug kev kho mob phau ntawv journal, uas hloov qhov kev nkag siab ntawm cov kws kho mob rau tus kab mob nyob rau hauv lo lus nug, raws li zoo raws li nws mus kom ze rau tus mob thiab kev kho mob. Txij li thaum uas lub sij hawm, lub xub ntiag ntawm cov tshuaj nyob rau hauv cov ntshav ntshav ntawm cov neeg mob kom desmogleina ua lub ntsiab qauv tshau rau kev qhia kom paub txog pemphigus.

Los ntawm txoj kev, nyob rau hauv 1971 nws luam tawm ib tsab xov xwm nyob rau hauv uas lub autoimmune xwm ntawm lub soj ntsuam nyob rau hauv kev nthuav dav thiab lub mechanism ntawm kev loj hlob ntawm tus kab mob no.

Lub ntsiab tsos mob

Hlwv ntawm daim tawv nqaij, uas ua los ntawm txoj kev loj hlob ntawm hais lus phem los yog hom bladderwort, sawv cev rau lub thawj kos npe rau ntawm tus kab mob. Nws yuav tsum tau muab sau tseg hais tias qhov no hom ntawm tus kab mob no tshwm sim feem ntau. Raws li kws txawj, nws tso nyiaj rau 77% ntawm tag nrho cov kev kuaj ntaub ntawv ntawm pemphigus.

Txhab nyob rau hauv daim ntawv ntawm cov npuas cuam tshuam tsis tsuas daim tawv nqaij ntawm tus neeg mob, tab sis kuj cov mucosa ntawm lub qhov ncauj thiab nws lub caj pas. Tom qab ntawd lawv kis tawm nyob rau hauv ib tug povtseg, lwm genitals, lub ntsej muag thiab thiaj li nyob.

Yuav ua li cas koj yuav tsum paub txog tej no daim tawv nqaij cov kab mob? Feem ntau, pemphigus muaj mam li nco dheev. Yog li rau kev noj qab daim tawv nqaij outwardly tsim me me npuas tensions uas nrog ib tug appreciable ceev nce flaccid tsos. Lawv txheem yog pob tshab serous kua (me ntsis turbid).

Tom qab qhib lub papules tsim tej qhov nqaij nto, uas tom qab kho, tab sis tawm ib co kua nplaum ntawm pigmentation ntawm xim av.

Rau xws li ib tug kab mob autoimmune yus mob loj heev mob txaus nyob rau hauv daim ntawv no. Nws yuav tsum tau muab sau tseg tias nyob rau hauv ib co neeg tsis muaj kev kho mob muaj cai txawj kev txhim kho, uas twb hloov los ntawm cov aggravation.

Heev feem ntau nrog pemphigus vulgaris theem nrab kab mob (Candidiasis).

Vim lub protein poob, kua thiab kab los raug ntawm tus kab mob no loj ntaub ntawv unfavorable.

Identification ntawm tus kab mob

Raws li qhia pemphigus vulgaris? Mob ntawm tus kab mob yog nqa tawm nyob rau hauv ib tug lub tsev kho mob. Lub xub ntiag ntawm tus kab mob no yog kuaj raws li kev soj ntsuam cov tsos mob thiab cov kev tshwm sim ntawm analyses.

Cov yav tas los muaj xws li:

• A cov tsos mob ntawm asbestos-Hansen. Qhov no feature yog kuaj tau los ntawm nias ib tug ntiv tes los yog rau ib tug cover iav (i.e., tseem tsis tau penetrated) npuas. Tej txheej txheem tswj detachment ntawm lub epidermis nyob rau hauv cov cheeb tsam uas yog nyob ib sab mus papules, raws li zoo raws li nce nws cheeb tsam vim cov kua siab nyob rau hauv lub chav tsev.
• Seb mob Nikolsky. Qhov no feature yog kuaj nyob rau hauv npuas Entrainment daim nrog ncais thiab muab tshuaj ntxuav ib tug ntiv tes feem outwardly lawm daim tawv nqaij nyob ze ntawm lub lesion site. Yog li muaj ib tug detachment ntawm lub epidermis.

Nws yuav tsum tau muab sau tseg tias hais lus phem pemphigus cov tsos mob no yog tsis yog hais, thiab diagnostics. Nws yuav tsum tau nco ntsoov hais tias hais tias xws li ces tej zaum yuav tshwm sim nyob rau hauv lwm yam kab mob.

laboratory kev ntsuam xyuas

Yuav ua li cas thiaj paub tias yog pemphigus vulgaris? Kev kho mob ntawm tus kab mob autoimmune yuav tsum tau nqa tawm tsuas yog tom qab ib tug kws kho kev xeem. Yuav kom ntes xws li ib tug kab mob no yog siv:

• Histological tsom xam, uas kev soj ntsuam ntawm smears, los yog lub thiaj li hu ua tuabneeg qhia hais tias yuav npuas acantholytic hlwb (ie, epidermal hlwb uas muaj undergone morphological kev hloov).

Nws yuav tsum tau muab sau tseg tias nyob rau hauv lub hauv paus ntawm histological tsom xam ntawm cov ntaub ntawv los xaus tias cov kev loj hlob ntawm autoimmune kab mob no yog tsis yooj yim sua. Qhov no yog vim lub fact tias muaj lwm yam kab mob nrog ib tug duab zoo sib xws.

• Immunofluorescence txoj kev mus ntes intracellular deposits ntawm immunoglobulin G thiab A, raws li zoo raws li qhia loj thiab me antigens - desmoglein 3 thiab desmoglein-1. Qhov no yog cov feem ntau muaj tseeb kuaj mob.

Yog li, tus mob "hais lus phem pemphigus 'yog muab tso rau raws li cumulative cov ntaub ntawv ntawm kev soj ntsuam cov tsos mob thiab soj ntsuam daim duab ntawm tus kab mob thiab cov kev tshwm sim ntawm immunofluorescence cov txheej txheem thiab histologic xeem.

kev kho mob

Thaum pib ntawm txoj kev loj hlob ntawm pemphigus vulgaris cov neeg mob tus kws kho glucocorticoids. Tshuaj nyob rau hauv pab pawg neeg no tau txais nyob rau hauv lub poob siab koob tshuaj. Lub sij hawm ntawm qhov kev siv yeeb tshuaj nyob rau hauv loj qhov ntau ntawm tseem ceeb heev pov thawj. Nrog kev xav txog cov contraindications thiab kev phiv, lawv yog theem nrab.

Yuav ua li cas yog hais tias tus kab mob nyob rau hauv lo lus nug muab glucocorticoids? Npaj rau kev kho mob ntawm hais lus phem puzyrchaki tej zaum yuav raws li nram no: "Prednisolone" "Dexamethasone" thiab "Triamptsinolon".

Thaum txhim kho ntawm tus neeg mob, i.e. nyob rau hauv lub qhaj ntawv ntawm tshiab npuas, lub koob tshuaj ntawm cov tshuaj yog txo maj thiab mus rau txhawb nyob rau hauv thiaj li yuav tiv thaiv kom txhob tshua mob heev. Tej kev kho mob ntawm cov neeg mob ntev txaus.

Dhau li glucocorticoids, cov neeg mob tej zaum yuav xaiv cytotoxic agents, immunosuppressants, xws li "Methotrexate", "Azathioprine" los yog "Prospidin". Lawv yog cov tsim nyog los tshem tawm cov teeb meem ntawm kev phiv tshuaj tom qab haus ntawm yooj yim tshuaj.

Lwm yam kev kho mob txoj kev

Yog hais tias muaj yog indications uas nyob rau hauv kab mob autoimmune cov neeg mob yuav tsum kho nrog tshuaj tua kab mob, thiab cov tshuaj uas pab txhawb cov hlab plawv system, regulating cov ntshav siab thiab normalize lub hauj lwm ntawm daim siab thiab ob lub raum.

Tsis tas li ntawd yuav tsum tau kom tsawg ntawm potassium-muaj kab mob, calcium thiab vitamins. Rau cov tshuaj pleev kev kho mob ntawm pemphigus anti-inflammatory siv tshuaj, infusions thiab decoctions ntawm tshuaj ntsuab yuav siv tau.

Nws yuav tsum tau muab sau tseg tias, nyob ntawm seb tus mob ntawm tus neeg mob tej zaum nws yuav raug muab tso rau xws txheej txheem raws li gemabsorbtsiya, ntshav ntawm cov ntshav thiab plasmapheresis.