Pemphigoid Bullous: izimpawu, ukwelashwa, nezithombe

pemphigoid Bullous - a ezijwayelekile esehlaselwa isifo sesikhumba esenyanyekayo ukuthi sifana ukubonakaliswa sangaphandle pemphigus. Lesi sifo kwenzeka ifomu chronic ngokungabi bikho Ukuhlonza isifo nokuselapha kungaholela nemiphumela ebuhlungu. Ngakho yini ebangela ukuthuthukiswa kwalesi sifo? Ziyini izimpawu ukuthi kuziveza? Yiziphi izindlela ekwelapheni kwezokwelapha zanamuhla kufanele anikele? Izimpendulo zale mibuzo abafundi abaningi.

Siyini isifo?

pemphigoid Bullous kwezokwelapha zanamuhla is ngamagama amaningi aziwa - ukuthi isifo Lever, futhi pemphigus senile, dermatitis herpetiformis futhi senile. Kuyinto ezingamahlalakhona isifo sokuhlasela kwamasosha omzimba, okuyinto kuhambisana ukubukeka ukuqubuka kwesikhumba ibhamuza ezinkulu (izimpawu zangaphandle ngezinye izikhathi zifane pemphigus kweqiniso).

Kuyaphawuleka ukuthi iningi labantu iziguli nale Ihlahlubo - ke abantu oneminyaka engu-65 nangaphezulu. Ngokwemvelo, imithi eyaziwa okuhlukile, njengoba lesi sifo ngezinye izikhathi lokhu kutholakala izingane kanye neziguli oseqinile. Ukugula elinesimo Yiqiniso kungavamile ukuba ingozi, kodwa kwesinye isikhathi singaholela ezinkingeni. Isithombe basemtholampilo ukuchuma isihlobo alternated nge izinkathi exacerbation. Yiqiniso, abantu abaningi, umbuzo othakazelisayo yokuthi kuyinto pemphigoid bullous. Izimpawu kanye nokwelashwa isifo, izimbangela zayo - lolu lwazi kufanele ufunde kabanzi ngokucophelela.

Ezinye isifo esifanayo

Kuyaphawuleka ukuthi pemphigoid bullous kuyingxenye iqembu okuthiwa dermatosis fibrosis. Lezi zifo zihlukaniswa kusukela pemphigus kweqiniso, njengoba hhayi ephelezelwa acantholysis. Izilonda iqembu kuhlanganisa izifo eziningana, isithombe emtholampilo okuyinto iyafana:

• Benign pemphigus neakantoliticheskaya lapho sifo kuphela le mucosa ngomlomo ngaphandle kokudala ukuqubuka kwamanye amasayithi. Lesi sifo futhi elinesimo Yiqiniso kungavamile ukuba ingozi. By the way, kwathiwa owokuqala owachaza lesi ngo-1959.
• Izibazi pemphigoid - ngempela isifo esiyingozi esithinta ulwelwesi lwamafinyila esweni futhi conjunctiva, okubangela it yoma. Ukuqubuka emzimbeni zingenzeka, kodwa zenzeka kuqhathaniswa njalo. The main ingozi iqembu - abesifazane 50 ubudala, nakuba ngezinye izikhathi lesi sifo silotshwe phakathi iziguli besilisa.

Izimbangela pathogenesis ka pemphigoid bullous

Ngeshwa, lo mshini okwenziwe ngaleli sifo akukaqondwa ngokugcwele. Nokho, ososayensi bakwazi nithole ukuthi lesi sifo sokuhlasela kwamasosha omzimba ngokwemvelo. Ukuze yezizathu ezithile kukhona ukwehluleka emsebenzini izivikeli mzimba, okuholela amasosha omzimba ekhiqizwa abamhlaselayo hhayi kuphela zakwamanye amazwe, kodwa futhi amangqamuzana omzimba siqu.

Ubufakazi balokhu theory ayatholakala. Phakathi serum zocwaningo nesineke, kanye ketshezi othathwe Bubbles, omzimba athile kuye kwatholakala ukuthi kungalimaza ulwelwesi basal ka kwezicubu isikhumba kanye nolwelwesi lwamafinyila. Futhi, kwatholakala ukuthi kulapho asebenzayo isifo eba, ayanda titer of la masosha omzimba.

Kukholakala ukuthi izifo sokuhlasela kwamasosha omzimba zibangelwa izici zofuzo. Nokho ufuna uphumelele ezingaba kusebenze isifo. Lokhu kungaba:

• Ukugonywa ezifweni ezithile;
• umonakalo noma okunzima isikhumba ukucasuka;
• ukuchayeka emisebeni ultraviolet (bethamele ilanga eside, ukuhlukunyezwa solarium, njll ...);
• ukusha Thermal kwesikhumba;
• ukusetshenziswa njalo imithi ethile, njengokuthi "Furosemide", "captopril", "phenacetin", "amoxicillin" namanye;
• Ngezinye izikhathi lesi sifo icushiwe ngemva ukudlula isiguli ukwelashwa ngemisebe;
• kwezinso ukufakelwa kwenqatshwa, isitho ukufakelwa okuphindaphindiwe.

Bullous pemphigoid: isithombe kanye nezimpawu

Yiqiniso, okokuqala kubalulekile uzijwayeze izimpawu, ngoba ngokushesha isiguli ozonaka ukuba khona ukwephulwa futhi bafune iseluleko yezokwelapha, kulula inqubo yokwelapha zenzeke. Ezemfundo esikhumbeni okukhulu nokuqhuma vesicular - isici esiyinhloko okuyinto kuhambisana pemphigoid bullous (Photo libonisa ukubukeka ukuqubuka). Ngokuvamile zithinta isikhumba we izitho zomzimba isiqu. Ukuqubuka kungenzeka emkhakheni ezinkulu creases zemvelo ebusweni ekhanda, kodwa kwenzeka akuvamile.

Izakhi eyinhloko kuqhuma - vesicles shashaza nge amathayi buhle. Ngaphakathi bathola uketshezi, ngokuvamile esobala, kodwa ngezinye izikhathi ungase uphawule igazi. Ngokuvamile, esikhumbeni azungeze Bubbles abomvu.

Igama elithi 'wokuphila "indlela okwakheke ngayo ka kwezinsuku ezimbalwa. Ngemva kwalokho, baqala angesabi ivulekile. Endaweni izilonda kwakhiwa ukuguguleka izindawo kanye nezilonda ezincane. Uqweqwe phezu abumane njengoba izindawo erosive ngokushesha epiteliziruyutsya.

Izigaba lokuqala isifo 20% eziguli siqale ukubonakala Bubbles mucosa ngomlomo, bese engena ukuqubuka kwesikhumba. Anamabhamuza nolwelwesi lwamafinyila we ekhaleni, emphinjeni, umthondo, amehlo avele kakhulu kuyaqabukela.

Iziguli esekhala ukulunywa, futhi ngemva kokuvula Bubbles futhi abanye soreness. Mhlawumbe ukwanda lokushisa, nakuba lokhu ezingavamile. Ezigulini esezikhulile, umzimba ukuthi Akukho lutho olusele ngu uyahluleka uma elwa nokuphuza njalo, is yaphawula ukwehla esesuthi, ukuncipha emzibeni, ubuthakathaka ezithuthukayo.

Histogenesis, histopathology futhi patomorfologija

Pathology bullous pemphigoid kuyinto ngempela ezithakazelisayo. izinqubo Okokuqala cytoplasmic phakathi amaseli basal kwakhiwa vacuoles eziningi. Kancane kancane lezi zokwakheka iyahlanganiswa ndawonye ukuze zakhe ubuzalwane izakhiwo ezinkudlwana. Njengoba sihambisana nale, kukhona abukhali futhi edema ka dermis kwezicubu.

ITire esinyeni - kuyinto epidermal izicubu. Amaseli welulela yayo, kodwa amabhuloho phakathi kwabo alilinyaziwe. Njengoba lesi sifo singumbulali esiqedayo kancane kancane kude kwamaseli epidermal. Ngesikhathi esifanayo, epidermal yakhe izicubu ezintsha abasondela nge bubble imiphetho, uthwebule iphansi lalo - ngaleyo ndlela vesicles uhamba ngaphakathi the epidermis futhi ngezinye izikhathi e podrogovoy ungqimba.

Ngaphakathi the bubble kukhona uketshezi equkethe lymphocyte nge admixture we neutrophil. Kukhona zingu fibrin, amangqamuzana amaprotheni namanye compounds.

Uma sicabangela histogenesis ka pemphigoid bullous, okokuqala Kuhle ukukhumbula ukuthi lesi sifo sokuhlasela kwamasosha omzimba. Esifundweni kwezicubu nge-electron microscope kungenziwa kuphawulwe ukuthi okuthiwa antigen BPAg1, awo adedelwa ngesikhathi amasosha omzimba atholakala ungqimba basal, okungukuthi ngesikhathi ukulungisa poludesmosom keratinocytes. Enye antigen - BPAg2 - futhi ise poludesmosom ndawo. Kukholakala ukuthi kwakhiwa it is by collagen uhlobo XII.

Futhi ngesikhathi ucwaningo kuye kwatholakala ukuthi macrophage kanye eosinophils kule isifo ekuqaleni buthelela ulwelwesi basal, bese uthuthe ngokusebenzisa ke futhi baqala buthelela ngaphakathi esinyeni futhi phakathi amaseli basal. Futhi, kukhona degranulation abalulekile insika amaseli.

Histologically, lesi sifo abona othile ewunikela ngesikhathi eliphathisa we epidermis kusukela dermis, futhi obakhiwa okuyinto ibhamuza subepidermal. Imikhumbi emisipheni isikhumba futhi lanwetshwa, kukhona ukuvuvukala izingqimba kwangaphakathi (endothelium).

izindlela zesimanje uphethwe

Njengomthetho, azikho izinkinga esinazo izifo ezifana pemphigoid bullous: izimpawu ezithile kakhulu, futhi ngenxa yalokho udokotela wakho angase usola isifo kakade ngesikhathi sokuhlolwa ejwayelekile. On isikhumba lesiguli Bubbles Friend akhiwa, futhi inqubo epithelialization ka erosions kwenzeka ngokushesha.

Ikhasi test epidermis ezimbi. Ngaphezu kwalokho, kocingo Kwenziwa okuqukethwe sangaphakathi Bubbles nge enye esizoyihlola histological. Phakathi laboratory ukuhlolwa zingatholakala ku vacuoles ketshezi histiocytic izakhi, eosinophils nama-lymphocyte.

Ngakolunye uhlangothi, uphethwe umehluko ngezinye izikhathi kubabangele nobunzima, njengoba ubona esithombeni sokucindezeleka kancane okusikhumbuza nezinye izifo zesikhumba, kuhlanganise multiforme erythema exudative, kuyiqiniso futhi pemphigus herpetiformis dermatitis Duhring.

Yini ukwelashwa ubhekwa ngempumelelo?

Kuthiwani uma uthola ukuthi pemphigoid bullous? Ukwelashwa kulokhu kudinga eziyinkimbinkimbi. Ngaphezu kwalokho, ukukhethwa zokuzijabulisa kanye nemithi kuxhomeke ezicini eziningi, kuhlanganise kobukhulu lesi sifo, ubudala noma impilo yabo jikelele isiguli, khona comorbidities. Kunoma ikuphi, le mishanguzo ukwelashwa singenziwa kuphela udokotela ukuba khona.

Ngesisekelo yokwelapha - izidakamizwa eqeda ukuvuvukala steroid equkethe ama. Ngokuvamile asetshenziselwe le nhloso "Prednisolone". Umuthi iqondiswa ngemithambo yegazi kanye Isikali is kancane kancane sehle njengoba ukunyamalala izimpawu.

Futhi, ukusebenza ezinhle cytostatics enikeziwe ejenti immunosuppressive ezisiza kulesetayelekile ukusebenza izivikeli mzimba. Kaningi, iziguli ebekiwe izidakamizwa ezifana "Cyclosporin A", "Cyclophosphamide", "Azathioprine".

Yiqiniso, iphuzu elibaluleke kuyinto ekwelapheni izilonda, erosions kanye nezilonda esikhumbeni. Kuyadingeka ukugcina isikhumba ahlanzekile. Iziguli iqondiswa izixazululo nge aniline udayi (isb, "Furkotsin") lapho ukwenza njenge antiseptics noma iphele ukuphuma isikhumba. Ezimweni ezimbi kakhulu futhi zidinga yokugcoba nge steroid.

Ukwelashwa nge amakhambi abantu

pemphigoid Bullous, noma isifo Lever - a zokugula edinga, impatho abanekhono oqeqeshiwe. Ukusetshenziswa kwemithi ahlukahlukene okuzenzela kungenzeka, kodwa kuphela kwemvume uchwepheshe. Ngaphambi kokuthi usebenzise noma yiziphi izindlela kufanele uxhumane nodokotela wakho. Ngo Folk imithi esetshenziswa ezihlukahlukene izidakamizwa ezahlukene.

• Kukholakala ukuthi isimo esihle sempilo isiguli kuthinte tincture Eleutherococcus. Take it kufanele kube usuku kabili, 30 amathonsi.
• Ukuze ongaphandle ukusetshenziswa ukuqubuka ukucutshungulwa juice kusuka amaqabunga enhlaba, okuyinto Kusiza ekudambiseni ukulunywa futhi soreness, kuvimbela ukuthuthukiswa ukuvuvukala, ngesivinini ukuvuselelwa. I juice udinga moisten ibhandishi ke silisebenzise kulowo ethintekile isikhumba endaweni uphinde ulungise ibhandishi. Ukuze umphumela esiphezulu, ungafunda ukugoqa nge ukugoqa plastic.
• Ngenhloso efanayo, ijusi fresh noma decoction amaqabunga sembabazane ingasetshenziswa. Poultice eyenziwe isikimu ngenhla echazwe.
• pemphigoid Bullous, noma ngaphezulu ngokunembile, izimpawu zayo zingancishiswa nge decoction ekhethekile ngezindleko zemithi engamakhambi. Ukuze kuthathe inani elilingana (50 g) amaqabunga kagamthilini, rhizomes ikhoyili izithelo Sophora japonica birch efihlekile, Yarrow, esikhwameni zikamalusi izimbabazane. Ababili wezipuni ingxube lelungiselelwe kule amakhambi kusihlwa, uthele ingilazi yamanzi abilayo futhi ushiye ubusuku. Ekuseni le ukumnika kuyadingeka sokukhipha wahlukanise izingxenye ezintathu - uzithatha emini.

Kuyaqondakala ukuthi imithi engamakhambi isiguli ngasinye bangase benze ngendlela ehlukile. Ngisho noma i-ejenti, kuba nemiphumela lemihle, noma kunjalo, ungadikibali yokwelashwa.

Onalesi sifo ngoba iziguli

Pemphigoid - isifo ingozi kwesikhumba, futhi ngenxa yalokho okwenzeka ezimweni eziningi kakhulu kangangokuba angabi naso kanzima. Ngaphezu kwalokho, cishe zonke esibhedlela esikhulu edolobheni wenza yokwelashwa okuphumelelayo lesi sifo igama eziyinkimbinkimbi kangaka - pemphigoid bullous. Ngo Orenburg, eMoscow, futhi imuphi omunye umuzi, uqiniseka ukuthola onguchwepheshe omuhle. Indawo yokuhlala kuzoncika ngaphandle izindleko zokwelapha, ngoba amanani entengo yemithi ethile e ezahlukene ekhemisi izinto ziyahlukahluka.

Lapho uphenyo olwenziwe kahle ukwelashwa ingafinyelela ukuthethelelwa esitebeleni. Ngezikhathi ezithile kukhona ezinye iziguli ngiwela ogibeni lwezidakamizwa, okuyinto Yiqiniso, ezingemnandi, kodwa hhayi ebulalayo. Ngakolunye uhlangothi, uma kungekho indawo ekwelapheni kumiswa izilonda angase abe esangweni for ukutheleleka, ngokulandelana eqeda ukuvuvukala okukhulu ngaphezulu, suppuration amanxeba, kokuziphatha namagciwane abangela izifo angena izingqimba ezijulile isikhumba.

Ingabe kukhona izindlela lokuvikela?

Ngeshwa, ayikho indlela ethize ekuvimbeleni izifo ezifana bullous Lever pemphigoid. Ngokwemvelo, kubalulekile ukufuna usizo ngesikhathi, futhi njengoba isifo esingelapheki, ngisho ngezikhathi isihlobo inhlalakahle kudingeka ukuqapha ngokucophelela isimo sempilo.

Ungakhohlwa ukuthi lesi sifo imithi ibhekwa njengongase abe umdlavuza umaka. Yingakho ukuba khona isifo isiguli kumele ahlolwe oluphelele ukuqinisekisa noma siqambe sitholakele Cancer. Khumbula ukuthi nanoma yimuphi isifo kuba lula kakhulu ukubhekana nesimo uma uqala ukwelashwa.