Bullous pemphigoid: zviratidzo, kurapwa, uye mifananidzo

Bullous pemphigoid - pazera zvakajairika ganda chirwere kuti afanane kwokunze kuratidzwa pemphigus. Hosha rinowanikwa mune chirwere chimiro uye pasina nokukurumidza nechirwere uye kurapwa zvinogona kuita kuti kuva nemigumisiro isingafadzi. Saka chii chinokonzera kukura chirwere ichi? Ndezvipi zviratidzo chinoratidza pacharo? Ndezvipi nzira pakurapa kwemazuva ano anofanira kupa? Mhinduro dzemibvunzo iyi vari ichifarirwa vaverengi vazhinji.

Chii chinonzi chirwere?

Bullous pemphigoid mu mushonga ano Anozivikanwa nemazita mazhinji - kuti chirwere Lever uye penga nokuda kokuchembera pemphigus, dermatitis herpetiformis uye penga nokuda kokuchembera. Zviri chirwere autoimmune chirwere, izvo pamwe pakuonekwa ganda mapundu ose mhoni guru (zvimwewo zviratidzo dzimwe nguva akafanana pemphigus yechokwadi).

Zvinokosha kucherechedza kuti ruzhinji varwere nechirwere ichi - ndiwo vanhu vakwegura makore 65 uye vakwegura. Sezvingatarisirwa, mushonga anozivikanwa kunze, sezvo chirwere dzimwe nguva kuwanikwa nevana uye varwere repakati. The chirwere ari dzinoratidzwa benign Chokwadi, asi dzimwe nguva kunogona kutungamirira matambudziko. The kunotoda mufananidzo hama kubudirira alternated pamwe nguva exacerbation. Chokwadi, nokuti vanhu vazhinji, mubvunzo kufarira ndechokuti ane bullous pemphigoid. Zviratidzo uye pakurapa chirwere, ayo zvinokonzera - mashoko aya anofanira kuverenga zvakawanda kunyatsoongorora.

Vamwe zvakafanana chirwere

Zvinokosha kucherechedza kuti bullous pemphigoid chikamu boka kunzi cystic dermatosis. zvirwere izvi zviri kusiyaniswa kubva pemphigus wechokwadi, nokuti haana achiperekedzwa acantholysis. ganda maronda boka rinosanganisira zvirwere zvakawanda, ari kurapwa mufananidzo uri zvikuru zvakafanana:

• Benign pemphigus neakantoliticheskaya panguva iyo chirwere chinobata chete dzaiita zvokutaurwa mucosa pasina anokonzera rashes pane dzimwe nzvimbo. The chirwere chiri dzinoratidzwa benign kosi. Nenzira, zvakanzi kutanga kurondedzerwa muna 1959.
• Scarring pemphigoid - chirwere kwazvo nengozi kunokanganisa mucous Kamudzira weziso uye conjunctiva, zvichiita kuti atrophy. Rashes pamusoro muviri zvinogoneka, asi anowanikwa nekaupenyu Kazhinji. Huru boka pangozi - vakadzi makore 50, kunyange dzimwe nguva chirwere yakanyorwa pavarwere makono.

Zvinokonzera pathogenesis pamusoro bullous pemphigoid

Zvinosuruvarisa kuti mashandiro kuti panowanikwa chirwere ichi haisi aizvinzwisisa. Zvisinei, masayendisiti vaikwanisa kuziva kuti hosha iri autoimmune zvakasikwa. Nokuti mumwe chikonzero kana mumwe pane kukundikana mubasa iri zvirwere, zvichiguma ikabereka antibodies kurwisa kwete chete vatorwa, asiwo pachake masero omuviri.

Uchapupu dzidziso iyi zviripo. Munguva serum murwere tsvakurudzo, uyewo nemvura ingabvutirwe matema, chaizvo antibodies kwakawanikwa kuparadza basal Kamudzira ganda nyama uye mucous membranes. Uyewo, akanga akawanikwa kuti zvikuru basa hosha zvikamuka, dzakanga dziri titer pamusoro antibodies izvi.

Zvinofungidzirwa kuti autoimmune zvirwere zvinokonzerwa genetics. Asi unoda zvinogona Activate chirwere. Izvi zvinogona kuva:

• Vaccination pamusoro zvimwe zvirwere;
• zvakakanganiswa kana zvakakomba ganda bundu;
• kugarotamba ultraviolet nemwaranzi (refu sunbathing, solarium kushungurudzwa, etc ...);
• Thermal hudiki kuti ganda;
• kakawanda kushandisa zvimwe mishonga, akadai "Furosemide", "captopril", "phenacetin", "amoxicillin" uye vamwe;
• Dzimwe maperembudzi kusashanda pashure kwemutemo murwere mwaranzi mishonga;
• renal nokuisazve kurambwa, nhengo transplantation inodzokororwa.

Bullous pemphigoid: Photo uye zviratidzo

Zvechokwadi, pakutanga kwezvose zvakakosha uzive zviratidzo, nekuti nokukurumidza murwere achacherekedza nokuvapo kutyorwa uye kutsvaka zano zvokurapa, ari nyore kurapa kwacho kutora nzvimbo. Education paganda kwakanyanya vesicular kwemakomo - huru aizoonekawo achabatsirwa bullous pemphigoid (Photo chinoratidza Zvinoonekwa zviri mapundu). Kakawanda zvarinoita ganda maoko nemakumbo uye hunde. Chimbi anogona kuitika mumunda mikuru dzinongoitika creases chiso uye ganda romusoro, asi zvinoitika kazhinji.

The chikuru zvinhu kuputika - vesicles uye Maronda akasiyana ane kusvinwa matai. Inside vakawana mvura, kazhinji segirazi, asi dzimwe nguva ungaona ropa. Kazhinji, ganda akapoteredza tsvuku matema.

Shoko rokuti "upenyu" pamusoro idzodzo imwe mashoma. Pashure paizvozvo, ivo nomuzvarirwo akazarurwa. At nzvimbo maronda vakaumba kukurwa kwevhu nzvimbo uye maronda diki. Goko panyika hadzina kuumbwa sezvo erosive nzvimbo nokukurumidza epiteliziruyutsya.

Nzendo rokutanga chirwere muna 20% wevarwere kutange chimiro matema pamusoro nemumuromo mucosa, uye ipapo anopinda ganda nekumhanyirira. Maronda akasiyana pamusoro mucous membranes mhino, huro, sikarudzi, maziso kuonekwa chaizvo kashoma.

Varwere vanotsutsumwa yakafunuka, uye pashure nokuvhura matema uye vamwe soreness. Zvichida kuwedzera tembiricha, kunyange zvazvo izvi kushoma. In varwere vakwegura, muviri kuti kwezvinoshandiswa nokuda kakawanda zvazvo, ari vakacherechedzawo vasanyanye kudya, uremu, mberi simba.

Histogenesis, histopathology uye patomorfologija

Zvokurwara bullous pemphigoid unofadza zvikuru. cytoplasmic pezvakaitwa pakati masero basal akatanga kuumbwa vakawanda vacuoles. Zvishoma nezvishoma idzodzo aya akabatanidzwa pamwechete kuumbika kurei zvivako. Pamwe izvi, pane unopinza uye edema pakati dermis munyama.

Tire dundira - ndiko epidermal tishu. Masero dzayo rwakatambanudzwa, asi mazambuko pakati pavo hakuna kukuvadzwa. Sezvo chirwere iri zvishoma nezvishoma unooma pamusoro epidermal masero. Panguva iyoyowo, itsva epidermal rinenge kusvika pamwe sefuro micheto, andobata Musana - saka vesicles runoita nechomukati ari Epiderme e dzimwe nguva podrogovoy rukoko.

Inside the dhudhumira pane mvura ine lymphocytes ane admixture pamusoro neutrophils. Kune tambo zviri fibrin, puroteni mamorekuru uye dzimwe yeimwe.

Kana tikafunga histogenesis pamusoro bullous pemphigoid, kutanga zvinokosha kuyeuka kuti chirwere chacho autoimmune. Kudzidza munyama nokuda Erekitironi maikorosikopu zvinogona kucherechedzwa kuti dzinonzi maantigen BPAg1, izvo vanosunungurwa panguva zvirwere mhinduro dziri mune basal layer kureva panguva kugadzirira poludesmosom keratinocytes. Chimwe antigen - BPAg2 - uyewo iri munharaunda poludesmosom. Zvinonzi vaidavira kuti chakaumbwa collagen mhando XII.

Uyewo panguva kutsvakurudza zvave kuwanikwa kuti macrophages uye eosinophils mune chirwere ichi pakutanga uchingounganidza ari basal Kamudzira, uye zvino tama kubudikidza uye kutanga kuunganidza mukati dundira uye pakati basal masero. Uyewo, pane chinokosha degranulation pamusoro pedanda rechikepe masero.

Histologically, maperembudzi kuchengetwa apo exfoliation pakati Epiderme e kubva dermis, uye pakati iyo kuumbwa subepidermal mhoni. Midziyo paganda munyama uyewo rakawedzerwa, pane ari kuzvimba yomukati akaturikidzana (endothelium).

Modern nzira nechirwere

Kazhinji, hapana aiomerwa nechirwere kwezvirwere zvakadai bullous pemphigoid: zviratidzo zviri chaizvo zvakananga, uye naizvozvo chiremba wako anogona chifungidziro chirwere kare panguva mureza kuongorora. On ganda murwere zvakasimba matema vari kuumbwa, uye chirongwa epithelialization pamusoro erosions kunoitika nokukurumidza.

Peel bvunzo akaipa Epiderme e. Mukuwedzera, fenzi rinoitwa kubva munyika zviri matema mimwe histological kuzviongorora. Panguva Murabhoritari miedzo inogona kuwanikwa nemvura vacuoles histiocytic okunze, eosinophils uye lymphocytes.

Ukuwo, zviri differential zvokuongorora dzimwe nguva hwakazara nezvinetso, sezvo chiremba mufananidzo uri zvishoma nowenyika zvimwe zvirwere ganda, kusanganisira multiforme exudative erythema, wechokwadi uye pemphigus herpetiformis dermatitis Duhring.

Chii kurapwa anoonekwa kuti ubudirire?

Zvakadini kana iwe wakawana bullous pemphigoid? Treatment muchiitiko ichi kunoda kunzwisisa. Uyezve, kusarudzwa yenhandaro nemishonga anoenderana zvinhu zvakawanda, kusanganisira kwokuomerwa hosha, zera uye utano hwakanaka murwere, kuvapo comorbidities. Chero zvazvingava, mishonga zvaiitwa anogona kuitwa chete kupinda chiremba.

Hwaro yokurapa - steroid Anti-anogumbura zvinodhaka ane steroids. Most inowanzoshandiswa nokuda ichi chinangwa "Prednisolone". The mushonga chinotarisirwa nomutsinga uye chipimo chemushonga iri zvishoma nezvishoma yakaderera sezvo kunyangarika zviratidzo.

Uyewo, munhu wakanaka nezvinozoitika apa cytostatics uye immunosuppressive yomuchipatara inobatsira normalize kushanda zvirwere. Kazhinji, varwere ushandiswe mishonga yakadai se "Cyclosporin A", "Cyclophosphamide", "Azathioprine".

Chokwadi, kukosha ndezvokuti pakurapa maronda, erosions uye maronda paganda. Zvakakodzera kuchengeta ganda yakachena. Varwere raitongwa zvingaitwa ne aniline madhayi (semuenzaniso, "Furkotsin") iro vave antiseptics kana kupwa kunze ganda. Muzviitiko zvakaipisisa dzinodawo mafuta pamwe steroids.

Treatment pamwe zvavo mishonga

Bullous pemphigoid, kana Lever chirwere - a zvokurwara rinoda nomazvo, anokwanisa kurapwa. Kushandisa mishonga siyana mukaravhani zvichibvira, asi chete pamwe mvumo nyanzvi. Usati unogona kushandisa chero nzira yaunofanira bvunza chiremba wako. In the folk mushonga dzakasiyana-siyana zvinodhaka zvakasiyana.

• Zvinofungidzirwa kuti zvakanaka mamiriro eutano murwere kukanganisa tincture pakati Eleutherococcus. Tora zvinofanira kuva kaviri pazuva, 30 madonhwe.
• Nokuti kunze kushandiswa mapundu kubudiswa muto kubva Mashizha Aloe, izvo kunobatsira kuderedza kuvaviwa uye soreness, kunotadzisa kukura kuzvimba, Inowedzera patsva. The muto unofanira inyorovese bhandeji, ipapo yoashandisa njodzi ganda nzvimbo uye kugadzirisa bhandiji. For kunonyanyisa chaizvoizvo unogona kufukidza wrap pamwe epurasitiki wrap.
• Tiine chinangwa ichocho, mumwe muto kana decoction kuti yorukato mashizha zvinogona kushandiswa. Poultice rakagadzirwa zano-pamusoro apa.
• Bullous pemphigoid, kana kupfuura zvazviri, zviratidzo zvayo inogona kuderedzwa ane mishonga decoction chaiyo. Kuti zviite kutora mari yakaenzana (50 g) kuti Eucalyptus mashizha, rhizomes Coil muchero Sophora japonica, Birch atwo, yarrow, romufudzi chikwama uye porukato. Two spoon of akagadzirira musanganiswa manheru miriwo, ndidire girazi kufashaira mvura uye siya husiku. On mangwanani ose aizomupa zvinokosha kuti wopedza uye ive migove mitatu - kuvatora masikati.

Zvinonzwisiswa kuti yemakwenzi mishonga mumwe murwere anogona kuita zvakasiyana. Kunyange kana pomutumwa kunobatsirawo, chero zvazvingava musarega kurapwa.

The fungidziro varwere

Pemphigoid - a benign chirwere ganda, uye saka kunoitika kakawanda hazvina kuoma. Uyezve, chero guru guta chipatara akaita inobudirira chirwere zvakadaro yakaoma zita - bullous pemphigoid. In Orenburg, Moscow, uye chero mumwe guta, imi muri chokwadi kuwana nyanzvi akanaka. Nzvimbo dzokugara achavaponesa kunze mutengo kurapwa, sezvo mitengo dzezvimwe nemishonga yakasiyana chemishonga zvinhu zvinosiyana.

Kana zvakakodzera kuitwa kunokwanisa kuzadzisa yakagadzikana kanganwiro. Kubva nguva nenguva pane varwere kuitazve, izvo, chokwadi, kusingafadzi, asi kwete zvinouraya. Ukuwo, kana pasina nzvimbo Mabatirwo inotungamirwa maronda anogona kuva pasuo nokuda chirwere ukuwo apedza zvakawanda muhombe kuzvimba, suppuration kuti maronda, infiltration pamusoro pathogenic utachiona kupinda zvakadzama ganda akaturikidzana.

Pane nzira muzvidzivirire?

Sezvineiwo, hapana nzira chaiyo yokudzivisa zvirwere zvakadai bullous pemphigoid Lever. Sezvingatarisirwa, zvinokosha kuti titsvake rubatsiro nenguva, uye sezvo chirwere chirwere, kunyange nguva hama zvakanaka vanofanira kunyatsoongorora kuongorora mamiriro utano.

Usakanganwa kuti hosha iri mushonga anoonekwa somunhu anotarisira kenza zvechinguvana. Ndokusaka pamberi chirwere murwere aifanira misoro kuongororwa kuti asimbise kana ushe kubva nechirwere kenza. Yeuka kuti chero chirwere nyore zvikuru kutsungirira kana ukatanga kurapwa mangwanani.