Bullous pemphigoid: zizindikiro, chithandizo, ndipo zithunzi

Bullous pemphigoid - ndi zimakhalanso wamba khungu matenda chokhala mawonetseredwe kunja pemphigus. Matendawa amapezeka mu mawonekedwe aakulu, pakalibe matenda Usacedwa ndi mankhwala ndi zotsatira zosasangalatsa. Choncho chimene chimachititsa chitukuko cha matenda? ndi zizindikiro izo kumaonekera chiyani? ndi njira zochizira mankhwala amakono limapereka chiyani? Mayankho a mafunso amenewa ndi chidwi owerenga ambiri.

Kodi matenda?

Bullous pemphigoid mankhwala amakono amadziwika ndi mayina ambiri - kuti matenda chokhethemulira, ndipo pemphigus senile, dermatitis herpetiformis ndi senile. Ndi aakulu autoimmune matenda, amene anatsagana ndi maonekedwe a zotupa pa khungu la chithuza lalikulu (zizindikiro kunja zina amafanana pemphigus oona).

Dziwani kuti namtindi wa odwala matenda izi - ndi anthu achikulire zaka 65 ndi kuposerapo. Mwachibadwa, mankhwala odziwika kuchotserapo, ngati nthendayo Nthawi zina ana ndi odwala usinkhu wapakati. matendawo amakhala ndi mtima wabwino ndithu, koma nthawi zina kungachititse kuti zosokonezeka. Chithunzi matenda a chitukuko wachibale alternated ndi nyengo exacerbation. N'zoona kuti anthu ambiri, funso chidwi n'chakuti, ndi bullous pemphigoid. Zizindikiro ndi mankhwala a matenda, zimayambitsa - zimenezi ayenera kuwerenga mosamala kwambiri.

Ena matenda ofanana

Dziwani kuti pemphigoid bullous ndi mbali ya gulu la otchedwa enaake dermatosis. matenda awa siyanitsa pemphigus woona, chifukwa si limodzi ndi acantholysis. zotupa Gulu zikuphatikizapo matenda angapo, matenda chithunzi omwe ndi ofanana kwambiri:

• Chosaopsa pemphigus neakantoliticheskaya limene matenda amakhudza yekha ndi mucosa m'kamwa pasanabuke totupa pa malo ena. Matendawa komanso yodziwika ndi mtima wabwino zedi. Mwa njira, iwo anafotokozedwa koyamba mu 1959.
• Amamuyambitsa timabala pemphigoid - matenda oopsa kwambiri zokhudza Kakhungu mucous wa diso ndi conjunctiva, moti manja. Totupa thupi ndi zotheka, koma zimachitika ndi infrequently. Waukulu ngozi gulu - akazi ndi zaka 50, ngakhale kuti nthawi zina matenda zinalembedwa pakati pa odwala wamwamuna.

Zimayambitsa ndi pathogenesis wa pemphigoid bullous

Mwatsoka, limagwirira wa zosayembekezereka ya matenda akadali asanamvetsetse. Komabe, asayansi anatha kudziwa kuti matenda ndi autoimmune m'chilengedwe. Chifukwa ina pali zolephera mu ntchito ya chitetezo cha m'thupi, chifukwa mu chitetezo amapanga pomenyana si yachilendo kokha, komanso thupi maselo yekha.

Umboni wa mfundo imeneyi zilipo. Pa seramu wa kufufuza mtima, komanso mu madzi otengedwa thovu, chitetezo yeniyeni apezeka kuwononga Kakhungu woyambira wa zimakhala khungu ndipo zimagwira ntchito zosiyanasiyana mucous. Komanso, chinapezeka kuti yogwira matenda akufotokozera, ndi apamwamba a titer a chitetezo izi.

Akukhulupirira kuti matenda autoimmune chifukwa cha chibadwa. Komabe mukufuna amaganiza kuti akhoza yambitsa matenda. Zimenezi zingakhale:

• Katemera ndi matenda ena,
• kuwonongeka kapena khungu likuyabwa;
• kukhudzana ndi cheza ultraviolet (sunbathing yaitali, kumwa solarium, etc ...);
• Matenthedwe amayaka khungu;
• kawirikawiri mankhwala ena, monga "Furosemide", "captopril", "phenacetin", "amoxicillin" ndi zina;
• Nthawi zina matenda ndi adamulowetsa pambuyo ndimeyi wodwalayo cheza mankhwala;
• aimpso kumuika kukanidwa, limba kupatsidwa zina mobwerezabwereza.

Bullous pemphigoid: chithunzi ndi zizindikiro

Kumene, poyamba pa zonse n'kofunika mutidziwe bwino zizindikiro zake, chifukwa mwamsanga wodwala adzamvetsera kuli kuyan'anila ndipo pitani kuchipatala, kosavuta ndondomeko chithandizo chichitike. Maphunziro pa khungu kwambiri kuphulika vesicular - chochitika chofunika chimene limodzi ndi pemphigoid bullous (Photo zikusonyeza Kuyang'ana kwa zotupa za). Nthawi zambiri zimakhudza khungu la miyendo ndi thunthu. Totupa kumachitika m'munda wa creases akuluakulu achilengedwe pa nkhope ndi khungu, koma zimachitika kawirikawiri.

Zinthu zazikulu za kuphulika - vesicles ndi matuza ndi matayala ndi unasokonezeka. Mkati anapeza madzi, kawirikawiri poyela, koma nthawi zina mungaone magazi. Nthawi zambiri khungu padziko thovu wofiira.

Mawu akuti "moyo" a dongosolo la masiku angapo. Kenako zokha anatsegula. Pamalo a zotupa kupangidwa m'madera kukokololoka kwa nthaka ndi zilonda kakang'ono. Kutumphuka padziko sumangoyambika monga madera erosive msanga epiteliziruyutsya.

Magawo woyamba wa matendawa 20% odwala kuyamba ndi maonekedwe a thovu pa mucosa mkamwa, kenako akulowa ziwengo. Matuza pa nembanemba mucous mphuno, pakhosi, kumaliseche, maso kuoneka kwambiri kawirikawiri.

Odwala amadandaula kuyabwa ndi pambuyo kutsegula thovu ndi ena soreness. Mwina kuchuluka kutentha, ngakhale ali osowa. Odwala achikulire thupi kuti zatha ndi musabise pafupipafupi, ndi anaonanso kuchepa kudya, kuwonda, mwapang'onopang'ono kufooka.

Histogenesis, histopathology ndi patomorfologija

Kudwala bullous pemphigoid ndi chidwi kwambiri. Choyamba njira cytoplasmic pakati pa maselo woyambira anapanga vacuoles ambiri. Pang'onopang'ono formations awa ophatikizidwa pamodzi kupanga nyumba zikuluzikulu. Pamodzi ndi ichi, pali lakuthwa ndi edema wa dermis zimakhala.

Turo chikhodzodzo - ndi minofu epidermal. Maselo ake anatambasula, koma milatho pakati pa iwo si kuonongeka. Matendawa ndi pang'onopang'ono lifotabe maselo epidermal. Pa nthawi yomweyo, latsopano epidermal minofu akuyandikira m'mbali kuwira, analanda pansi pake - motero vesicles chimachititsanso m'kati mwa khungu ndipo nthawi zina podrogovoy wosanjikiza.

Mkati kuwira pali madzimadzi kuti lili lymphocytes ndi kusakanizikana kwa neutrophils. Pali mwawo Ulimbo, mamolekyulu mapuloteni ndi ena mankhwala ena.

Ngati tikulingalira histogenesis wa pemphigoid bullous, poyamba M'pofunikanso kukumbukira kuti matenda ndi autoimmune. Mu kuphunzira matishu ndi elekitironi maso Tingaone kuti otchedwa antigens BPAg1, imatulutsidwa pa yankho ndi chitetezo zili wosanjikiza woyambira, ndicho nthawi yeniyeni poludesmosom keratinocytes. Antigen wina - BPAg2 - komanso m'dera poludesmosom. Akukhulupirira kuti aumbike mwa kolajeni mtundu XII.

Komanso pa kafukufuku izo wapezeka kuti macrophages ndi eosinophils ku matenda poyamba kudziunjikira mu Kakhungu woyambira, ndipo kenako amasamukira mwa ilo ndi kuyamba kudziunjikira mkati chikhodzodzo ndi pakati pa maselo woyambira. Komanso, pali degranulation kwambiri maselo mlongoti.

Histologically, matenda zimawonedwa pamene exfoliation wa khungu kwa dermis, ndi pakati pa amene anapanga subepidermal chithuza. Ziwiya mu zimakhala khungu komanso kukodzedwa, pali kutupa zigawo wamkati (endothelium).

njira zamakono za matenda

Monga ulamuliro, palibe mavuto ndi matenda a matenda monga pemphigoid bullous: zizindikiro ndi zenizeni kwambiri, choncho dokotala anu akhoza kuganiza matenda kale pa muyezo anayendera. Pa khungu wodwalayo thovu zolimba anapanga, ndi ndondomeko ya epithelialization wa erosions amapezeka mofulumira.

Peel mayeso zoipa khungu. Komanso, mpanda ikuchitika wa nkhani mkati mwa thovu ndi histological kupenda. Pa zasayansi mayesero angapezeke mu vacuoles madzi zinthu histiocytic, eosinophils ndi lymphocytes.

Komano, matenda masiyanidwe nthawi zina zinadzala ndi mavuto, monga chithunzi matenda ndiye pang'ono amatikumbutsa matenda ena a pakhungu kuphatikizapo multiforme exudative erythema; woona ndi pemphigus herpetiformis dermatitis Duhring.

Kodi mankhwala imatengedwa kuti azigwira?

Kodi mutadziwa bullous pemphigoid? Chithandizo Pankhaniyi amafuna kwambiri. Komanso, kusankha kukasangalala ndi mankhwala kumatengera zifukwa zambiri, monga mwamphamvu ya matenda, m'badwo ndi umoyo wa wodwalayo, pamaso pa comorbidities. Mulimonsemo, ya kamwedwe mankhwala akhale yekha ndi dokotala nawo.

Chifukwa cha mankhwala - steroid odana ndi yotupa mankhwala okhala ndi mankhwala. Nthawi zambiri ntchito Mwaichi "Prednisolone". Mankhwala chikuyendetsedwera m'nsinga ndi mlingo pang'ono ndi pang'ono utachepa monga mofulumira zizindikiro.

Komanso, umapangitsa ndi kuperekedwa cytostatics ndi wothandizila immunosuppressive zothandiza matenda kugwira ntchito kwa chitetezo cha m'thupi. Nthawi zambiri, odwala Kwalamulidwa mankhwala monga 'Cyclosporin A "," Cyclophosphamide "," Azathioprine ".

Kumene, mfundo zofunika ndi mankhwala a zotupa, erosions ndi zilonda pa khungu. M'pofunika kusunga khungu loyera. Odwala kutumikiridwa njira ndi utoto aniline (mwachitsanzo, "Furkotsin") yomwe zinthu monga antiseptics kapena kuumitsa kunja khungu. Zikavuta kwambiri amafuna mafuta ndi mankhwala.

Chithandizo ndi mankhwala wowerengeka

Bullous pemphigoid, kapena matenda ndalezo - ndi kudwala yofuna woyenera, mankhwala oyenerera. Kugwiritsa ntchito mankhwala osiyanasiyana amene amamwa zotheka, koma ndi chilolezo cha katswiri. Musanayambe angagwiritse ntchito njira iliyonse muyenera kukaonana ndi dokotala. Mankhwala wowerengeka ntchito zosiyanasiyana mankhwala osiyana.

• Akukhulupirira kuti boma zabwino thanzi la wodwalayo bwanji tincture wa Eleutherococcus. Landira ayenera kawiri patsiku, 30 madontho.
• Pakuti panja ntchito totupa madzi processing wa masamba a Aloe, amene amathandiza kuti kuthetsa kuyabwa ndi soreness, kumathandiza chitukuko cha kutupa, Iyamba kusinthika. madzi muyenera moisten ndi bandeji, ndiye ntchito kwa zinkakhala m'dera khungu ndi kukonza bandeji. Pakuti zotsatira pazipita, mukhoza kuphimba Manga Manga pulasitiki.
• Ndi cholinga chomwecho, madzi abwino kapena decoction masamba nettle angagwiritsidwe ntchito. Ntchintchi anapanga chiwembu pamwambapa anafotokoza.
• Bullous pemphigoid, kapena yeniyeni, zizindikiro zake Mungathe kuchepetsa kuvutitsana ndi wapadera mankhwala decoction. Kuti pamafunika ndalama ofanana (50 g) wa masamba bulugamu, rhizomes koyilo zipatso Sophora japonica, masamba birch, yarrow, chikwama mbusa ndi lunguzi. supuni awiri osakaniza okonzeka ku zitsamba madzulo, kutsanulira kapu ya madzi otentha ndi kusiya usiku. M'mawa wa kulowetsedwa n'kofunika kukhetsa muchigawane mwa magawo atatu - kuwatengera masana.

Iwo ankadziwa kuti mankhwala azitsamba kwa wodwala aliyense akhoza kuchita mosiyana. Ngakhale wothandizila ali ndi ubwino, Mulimonsemo musataye mankhwala.

Kuti madokotala ananena zawo kwa odwala

Pemphigoid - mtima wabwino matenda a khungu, choncho zimachitika nthawi zambiri si zovuta. Komanso, pafupifupi aliyense waukulu kuchipatala anachita chithandizo bwino kwa matenda ndi dzina choncho zovuta - bullous pemphigoid. Mu Orenburg, Moscow, ndi mzinda wina uliwonse, inu ndinu wotsimikiza kupeza katswiri wabwino. Malo okhala kudzadalira kupatula mtengo wa chithandizo, kuyambira mitengo ya mankhwala ena mwa zinthu zosiyana mankhwala zosiyanasiyana.

Pamene imachitika bwino mankhwala kukwaniritsa chikhululukiro khola. Nthawi pali ena odwala muyambirenso, zomwe, ndithudi, wosasangalala, koma osati oopsa. Komano, pamene palibe mankhwala malo mapangidwe zotupa akhoza kukhala pachipata cha matenda, motero Wamaliza kutupa unyinji wochuluka, suppuration mabala, kusalola tizilombo toyambitsa matenda mu zigawo zakuya khungu.

Kodi pali njira iliyonse zopewera?

Mwatsoka, palibe njira yeniyeni kapewedwe ka matenda monga bullous pemphigoid ndalezo. Mwachibadwa, tiyenera kufunafuna thandizo nthawi, ndipo monga matenda, ngakhale mu nthawi ya wachibale bwino ayenera mosamala kuyan'ana ukupeza.

Musaiwale kuti matenda mankhwala amaonedwa kuti angathe chikhomo khansa. N'chifukwa chake pamaso pa matenda wodwala ayenera kukumana ndi kufufuza mabuku kutsimikiza kapena akatsimikizire matenda a Khansa. Kumbukirani kuti ndi matenda aliwonse ndi zosavuta kupirira mukayamba chithandizo mwamsanga.