Bullous pemphigoid: cov tsos mob, kev kho mob, thiab cov duab

Bullous pemphigoid - ib tug kuj ntau daim tawv nqaij kab mob uas tsa lwm ces pemphigus. Tus kab mob no tshwm sim nyob rau hauv mob daim ntawv thiab nyob rau hauv lub qhaj ntawv ntawm pab kuaj thiab kho yuav ua tau kom tsis kaj siab txim. Yog li ntawd dab tsi ua rau txoj kev loj hlob ntawm tus kab mob no? Yuav ua li cas yog cov tsos mob nws manifests nws tus kheej? Yuav ua li cas yog cov txhais tau rau cov kev kho mob ntawm niaj hnub tshuaj muaj los mus muaj? Cov lus teb rau cov lus nug no yog txaus siab rau ntau yam kev txawj nyeem ntawv.

Yuav ua li cas yog ib tug kab mob?

Bullous pemphigoid nyob rau hauv niaj hnub tshuaj yog paub los ntawm ntau lub npe - uas Qib tus kab mob, thiab ua tem toob pemphigus, dermatitis herpetiformis thiab ua tem toob. Nws yog ib tug mob autoimmune kab mob, uas yog nrog los ntawm cov tsos ntawm daim tawv nqaij liab liab sawv hlwv loj (lwm cov tsos mob tej zaum kuj zoo li muaj tseeb pemphigus).

Nws yog ib nqi sau cia hais tias lub overwhelming feem ntau ntawm cov neeg mob nrog rau qhov no mob - nws yog cov neeg uas muaj hnub nyoog 65 xyoo thiab laus dua. Lawm, tshuaj lub npe hu zam, raws li cov kab mob no yog qee zaum pom muaj nyob rau hauv cov me nyuam thiab nruab nrab-hnub nyoog cov neeg mob. Tus mob yog yus muaj los ntawm ib tug benign cov hoob kawm, tab sis nws muaj peev xwm tej zaum ua rau cov teeb meem. Cov soj ntsuam daim duab ntawm txheeb ze txoj kev vam meej alternated nrog lub sij hawm ntawm exacerbation. Ntawm cov hoob kawm, rau ntau tus neeg, cov lus nug ntawm kev txaus siab yog qhov tseeb hais tias yog ib tug bullous pemphigoid. Cov tsos mob thiab kev kho mob ntawm tus kab mob no, nws ua - cov ntaub ntawv no yuav tsum tau nyeem ntau kom zoo zoo.

Ib txhia zoo xws li cov kab mob

Nws yog ib nqi sau cia hais tias lub bullous pemphigoid yog ib feem ntawm ib pab pawg neeg ntawm thiaj li hu ua cystic dermatosis. Cov kab mob no yog txawv los ntawm qhov muaj tseeb tiag pemphigus, vim nws yog peb tsis koom nrog acantholysis. daim tawv nqaij qhov chaw mob pab pawg neeg no muaj xws li ob peb kab mob, tus soj ntsuam daim duab uas yog heev uas zoo sib xws:

• Benign pemphigus neakantoliticheskaya uas tus kab mob muaj feem xyuam rau heev dua lwm yam rau hauv lub qhov ncauj mucosa tsis tas yuav ua ua pob ua xyua rau lwm qhov chaw. Tus kab mob no kuj yus muaj los ntawm ib tug benign kawg. Los ntawm txoj kev, nws yog thawj zaug piav nyob rau hauv 1959.
• Cirrhosis pemphigoid - ib tug heev txaus ntshai tus kab mob uas muaj feem xyuam rau cov txheej membrane ntawm lub qhov muag thiab lub conjunctiva, yuav ua rau nws Atrophy. Ua pob ua xyua rau lub cev yog ua tau, tab sis tshwm sim kuj ncaw. Lub ntsiab uas yuav muaj pab pawg neeg - cov poj niam 50 xyoo ntawm lub hnub nyoog, txawm hais tias tej zaum tus kab mob no yog kaw cov txiv neej cov neeg mob.

Cov ua thiab pathogenesis ntawm bullous pemphigoid

Tu siab, lub mechanism ntawm tshwm sim ntawm tus kab mob no yog tseem tsis to taub. Txawm li cas los, zaum twb tau mus ascertain tias tus kab mob no yog autoimmune nyob rau hauv cov xwm. Rau ib tug yog vim li cas los yog lwm muaj swb nyob rau hauv lub chaw ua hauj lwm ntawm lub cev, uas ua nyob rau hauv lub ua tshuaj yog zuj tsis tau tsuas yog txawv teb chaws, tab sis kuj lub cev tus kheej hlwb.

Pov thawj ntawm no ziag no muaj nyob. Thaum lub sij hawm lub ntshiab ntawm tus neeg mob kev tshawb fawb, raws li zoo raws li nyob rau hauv cov kua coj los ntawm cov npuas, tej tshuaj tau pom rau puas basal membrane ntawm daim tawv nqaij ntaub so ntswg thiab qog ua kua week. Tsis tas li ntawd, nws twb pom hais tias cov ntau yam ntawm tus kab mob muaj, ntau dua qhov lub titer ntawm cov tshuaj.

Nws yog ntseeg hais tias cov kab mob autoimmune yog tshwm sim los ntawm noob caj noob ces. Txawm li cas los koj xav kom zauv faib uas yuav qhib tus kab mob no. Qhov no yuav ua tau:

• Txhaj tshuaj tiv thaiv tiv thaiv kab mob;
• kev puas tsuaj los yog mob tawv nqaij voos;
• raug ultraviolet tawg (ntev sunbathing, solarium kev tsim txom, thiab lwm yam ...);
• Thermal kub nyhiab rau ntawm daim tawv nqaij;
• nquag siv ntawm tej yam tshuaj, xws li "Furosemide", "captopril", "phenacetin", "amoxicillin" thiab ib co lwm yam;
• Tej zaum tus kab mob no yog tshuab txais tom qab cov zaj ntawm tus neeg mob tawg txoj kev kho;
• raum hloov rejection, hloov hloov rov qab.

Bullous pemphigoid: yees duab thiab cov tsos mob

Ntawm cov hoob kawm, ua ntej ntawm tag nrho nws yog ib qho tseem ceeb kom koj nrog cov tsos mob, vim hais tias cov ua ntej tus neeg mob yuav tau them nyiaj mloog mus rau lub hav zoov ntawm ua txhaum cai thiab nrhiav kev kho tswv yim, qhov yooj yim dua cov kev kho mob coj qhov chaw. Kev kawm ntawv nyob rau hauv daim tawv nqaij khaus vesicular eruptions - lub ntsiab feature uas yog nrog bullous pemphigoid (Photo qhia tau hais tias qhov zoo ntawm cov pob). Feem ntau cov feem ntau muaj feem xyuam rau ntawm daim tawv nqaij ntawm lub ceg ntoo thiab lub cev. Ntse yuav tshwm sim nyob rau hauv lub teb ntawm loj tej yam ntuj tso creases ntawm lub ntsej muag thiab tawv taub hau, tab sis nws tshwm sim tsis tshua.

Lub ntsiab ntsiab ntawm uas - hlwv thiab hlwv nrog ib tug strained log tsheb. Hauv lawv pom ib tug ua kua, feem ntau yog pob tshab, tab sis tej zaum koj yuav pom cov ntshav. Feem ntau, ntawm daim tawv nqaij ib ncig ntawm lub liab npuas.

Lub sij hawm ntawm "lub neej" ntawm formations ntawm ib tug ob peb hnub. Tom qab hais tias, lawv nthawv qhib. Ntawm qhov chaw ntawm txhab tsim yaig chaw thiab me me ulcers. Kaub puab rau ntawm qhov chaw yog tsis tsim li erosive chaw sai sai epiteliziruyutsya.

Tus thawj theem ntawm tus kab mob nyob rau hauv 20% ntawm cov neeg mob pib nrog lub tsos ntawm bubbles rau lub qhov ncauj mucosa, thiab ces nkag mus rau hauv daim tawv nqaij ua pob liab vog. Hlwv rau hauv txheej nyias nyias ntawm lub qhov ntswg, caj pas, genitals, ob lub qhov muag tshwm sim heev tsis tshua muaj.

Cov neeg mob tsis txaus siab ntawm khaus, thiab tom qab qhib lub npuas thiab ib co hnov mob. Tej zaum qhov kev nce rau hauv kub, txawm hais tias qhov no yog tsis tshua muaj. Nyob rau hauv cov neeg laus cov neeg mob, lub cev uas yog depleted los ntawm heev rov, yog tseem pom txo nyob rau hauv qab los noj mov, poob phaus, hnyav tsis muaj zog.

Histogenesis, histopathology thiab patomorfologija

Pathology bullous pemphigoid yog heev nthuav. Thawj cytoplasmic dab ntawm basal hlwb tsim heev heev vacuoles. Maj mam cov formations yog merged ua ke rau daim loj lug. Nrog rau no, muaj ib tug ntse thiab edema ntawm lub dermis ntaub so ntswg.

Tire zais zis - yog epidermal cov ntaub so ntswg. Hlwb nws ncav us txog, tab sis lub cov txuas hniav nruab nrab ntawm lawv yog tsis puas. Raws li tus kab mob no yog ib tug gradual withering deb ntawm epidermal hlwb. Nyob rau tib lub sij hawm, tshiab epidermal cov ntaub so ntswg cuag nrog npuas npoo, kev ntes nws qab - yog li hlwv tsiv inwardly ntawm lub epidermis thiab tej zaum nyob rau hauv podrogovoy txheej.

Hauv lub npuas muaj ib tug dej uas muaj lymphocytes nrog ib tug admixture ntawm qe. Muaj strands ntawm fibrin, lub protein molecules thiab ib co lwm yam sib txuas.

Yog hais tias peb xav txog qhov histogenesis ntawm bullous pemphigoid, xub thawj nws yog ib nqi nco ntsoov hais tias tus kab mob no yog autoimmune. Nyob rau hauv txoj kev tshawb no ntawm ntaub so ntswg los electron tshuab kuaj kab mob yuav tsum tau muab sau tias yog li ntawd-hu ua antigens BPAg1, uas yog tso tawm thaum lub sij hawm ib lub cev tsis teb nyob rau hauv lub basal txheej, namely ntawm kho poludesmosom keratinocytes. Lwm antigen - BPAg2 - kuj muaj nyob rau hauv lub cheeb tsam poludesmosom. Nws yog ntseeg hais tias nws yog tsim los ntawm collagen hom XII.

Tsis tas li ntawd thaum lub sij hawm cov kev tshawb fawb nws tau raug pom tias macrophages thiab eosinophils nyob rau hauv tus kab mob no chiv noog nyob rau hauv lub basal membrane, thiab ces mus los ntawm nws thiab pib noog nyob rau hauv lub zais zis thiab nruab nrab ntawm cov basal hlwb. Tsis tas li ntawd, muaj yog ib tug tseem ceeb degranulation ntawm mast hlwb.

Histologically, tus kab mob no yog cai thaum exfoliation ntawm lub epidermis los ntawm lub dermis, thiab ntawm uas yog tsim nyob rau subepidermal sawv hlwv. Hlab ntsha nyob rau hauv daim tawv nqaij ntaub so ntswg kuj txhab, muaj yog o ntawm lub puab khaubncaws sab nraud povtseg (endothelium).

Niaj hnub nimno txoj kev mob

Raws li txoj cai, yog tsis muaj teeb meem nrog qhov mob ntawm xws kab mob raws li bullous pemphigoid: cov tsos mob yog heev txog, thiab yog li ntawd koj tus kws kho mob tej zaum yuav xav tias tus kab mob no twb thaum lub sij hawm tus txheej txheem soj ntsuam. Nyob rau ntawm tus neeg mob daim tawv nqaij nruj npuas yog tsim, thiab cov txheej txheem ntawm epithelialization ntawm erosions tshwm sim sai heev.

Peel xeem tsis zoo epidermis. Nyob rau hauv tas li ntawd, lub laj kab yog nqa tawm ntawm lub internal txheem ntawm lub npuas nrog ntxiv histological xeem. Thaum lub sij hawm kuaj kev kuaj yuav pom nyob rau hauv cov kua vacuoles histiocytic hais, eosinophils thiab lymphocytes.

Nyob rau lwm cov tes, differential mob no tej zaum kuj fraught nrog teeb meem, raws li cov kev soj ntsuam daim duab no yog me ntsis reminiscent ntawm lwm daim tawv nqaij cov kab mob, xws li multiforme exudative erythema, yeej muaj tseeb thiab pemphigus herpetiformis dermatitis Duhring.

Yuav ua li cas kho mob yog pom tias yuav tau zoo?

Yuav ua li cas yog tias koj pom bullous pemphigoid? Kev kho mob nyob rau hauv cov ntaub ntawv no yuav tsum tau ib tug complex. Ntxiv mus, cov kev xaiv ntawm kev ua si ua ub no thiab tshuaj nyob ntawm ntau yam, xws li cov mob ntawm tus kab mob, lub hnub nyoog thiab kev noj qab haus huv ntawm tus neeg mob, muaj cov comorbidities. Nyob rau hauv txhua rooj plaub, cov kev kho mob regimen yuav tsum yog los ntawm lub mus kawm tus kws kho mob.

Lub hauv paus ntawm txoj kev kho - steroid anti-inflammatory siv tshuaj uas muaj steroids. Feem ntau cov feem ntau siv rau lub hom phiaj no "Prednisolone". Lub tshuaj no yog muab intravenously thiab ntau npaum lub yog maj poob raws li lub disappearance ntawm cov tsos mob.

Tsis tas li ntawd, ib tug zoo zoo yog muab cytostatics thiab immunosuppressive neeg uas pab rau normalize lub hauj lwm ntawm lub cev. Heev feem ntau, cov neeg mob tshuaj tshuaj xws li "Cyclosporin A", "Cyclophosphamide", "Azathioprine".

Ntawm cov hoob kawm, qhov tseem ceeb point yog cov kev kho mob ntawm txhab, erosions thiab ulcers nyob rau hauv daim tawv nqaij. Nws yog tsim nyog kom daim tawv nqaij kom huv si. Cov neeg mob muab cov ntsiab nrog aniline dyes (e.g., "Furkotsin") uas ua raws li antiseptics los yog so tawm ntawm daim tawv nqaij. Nyob rau hauv ntau loj heev zaum kuj yuav tsum tau tshuaj pleev nrog steroids.

Kev kho mob nrog pej xeem tshuaj

Bullous pemphigoid, los yog Qib kab mob - ib tug pathology uas yuav tsum tau ib tug competent, tsim nyog kho mob. Cov kev siv ntawm ntau yam tshuaj qhob tau, tab sis tsuas nrog kev tso cai los ntawm cov kws muaj txuj. Ua ntej koj yuav siv cov lus txhais tau tias koj yuav tsum sab laj nrog koj tus kws kho mob. Nyob rau hauv pej xeem cov tshuaj siv ib tug ntau yam sib txawv ntawm cov tshuaj.

• Nws yog ntseeg hais tias ib tug zoo lub xeev ntawm kev kho mob ntawm tus neeg mob muaj kev cuam tshuam lub tincture ntawm Eleutherococcus. Siv nws yuav tsum tau ib hnub ob zaug, 30 ncos.
• Rau siv sab nraum zoov tawm pob ua kua txiv los ntawm cov nplooj ntawm aloe, uas yuav pab kom txo tau khaus thiab hnov mob, tiv thaiv cov kev loj hlob ntawm o, accelerates lwm. Cov kua txiv koj yuav tsum moisten lub ntaub qhwv, ces thov nws rau cov tawv nqaij cheeb tsam thiab txhim kho ntaub qhwv. Rau siab tshaj plaws ua hauj lwm, koj muaj peev xwm them qhwv nrog yas qhwv.
• Nrog rau tib lub hom phiaj, ib tug tshiab kua txiv los sis ib tug decoction ntawm nettle nplooj yuav siv tau. Poultice ua los ntawm cov saum toj no-piav tswvyim.
• Bullous pemphigoid, los yog ntau tshaj precisely, nws cov tsos mob yuav alleviated nrog ib tug tshwj xeeb herbal decoction. Kom nws coj ib tug sib npaug zos npaum li cas (50 g) ntawm eucalyptus nplooj, rhizomes kauj txiv hmab txiv ntoo Sophora japonica, birch buds, yarrow, tus tswv yug yaj lub hnab thiab nettles. Ob dia ntawm qhov sib tov npaj nyob rau hauv lub yav tsaus ntuj tshuaj ntsuab, ncuav ib lub khob ntawm boiling dej thiab tawm dhau ib hmo. Nyob rau thaum sawv ntxov ntawm Txoj kev lis ntshav yog tsim nyog los ntws thiab faib mus rau hauv peb feem - coj lawv thaum nruab hnub.

Nws yog to taub hais tias herbal tshuaj rau txhua tus neeg mob tej zaum yuav ua txawv. Txawm yog hais tias tus neeg sawv cev muaj ib tug zoo ua hauj lwm, nyob rau hauv txhua rooj plaub tsis muab kev kho mob kev kho mob.

Cov raug rau cov neeg mob

Pemphigoid - ib tug benign kab mob ntawm daim tawv nqaij, thiab yog li ntawd yuav siv sij hawm qhov chaw nyob rau hauv feem ntau tus neeg mob tsis yog ib qho nyuaj heev. Ntxiv mus, yuav luag txhua lub nroog loj lub tsev kho mob ua ib tug muaj kev vam meej kev kho mob rau cov kab mob no yog li ntawd, tham lub npe - bullous pemphigoid. Nyob rau hauv Orenburg, Moscow, thiab lwm yam nroog, koj yeej paub hais tias mus nrhiav tau ib tug zoo tshwj xeeb. Qhov chaw ntawm qhov chaw nyob yuav nyob ntawm seb tsuas yog tus nqi ntawm kev kho mob, vim tus nqi ntawm tej yam tshuaj nyob rau hauv txawv qhov chaw muag tshuaj cov khoom sib txawv.

Thaum zoo ua kev kho mob muaj peev xwm ua tau ib tug ruaj khov kev so ib pliag. Los ntawm lub sij hawm rau lub sij hawm muaj ib co neeg mob relapse, uas, ntawm chav kawm, tsis kaj siab, tab sis tsis tuag. Nyob rau lwm cov tes, thaum tsis muaj kev kho mob qhov chaw ntawm tsim ntawm txhab yuav ua ib lub rooj vag rau tus kab mob, feem finishes ntau loj heev o, suppuration ntawm wounds, infiltration ntawm pathogenic cov kab mob mus rau hauv lub tob daim tawv nqaij khaubncaws sab nraud povtseg.

Puas muaj kev txhais tau tias ntawm kev tiv thaiv?

Tu siab, muaj yog tsis muaj cov txhais tau tias rau kev tiv thaiv xws kab mob raws li bullous pemphigoid Qib. Lawm, nws yog ib qho tseem ceeb mus nrhiav kev pab nyob rau hauv lub sij hawm, thiab raws li ib tug kab mob, txawm nyob rau hauv lub sij hawm ntawm txheeb ze zoo yuav tsum ua tib zoo saib xyuas hauv lub xeev ntawm kev noj qab nyob.

Tsis txhob hnov qab tias tus kab mob nyob rau hauv cov tshuaj yog ntshai raws li ib tug tej zaum cancer marker. Uas yog vim li cas lub xub ntiag ntawm tus kab mob ntawm tus neeg mob yuav tsum tau yauv ib tug kev xeem kom paub meej tias los yog kav tawm qhov mob ntawm Cancer. Nco ntsoov hais tias nrog tej yam kab mob yog yooj yim npaum li mus rau tiv hais tias koj pib kho mob thaum ntxov.