Pemphigus vulgaris

Pemphigus vulgaris (PV) yog qhov ua haujlwm autoimmune ntawm daim tawv nqaij. Nws cuam tshuam cov hlwv thiab hlwv (ntawm tej tawv nqaij) ntawm daim tawv nqaij thiab cov qog ua kua.

Cov tshuaj tiv thaiv kab mob ua rau cov tshuaj tiv thaiv tawm tsam cov protein tshwj xeeb hauv daim tawv nqaij thiab cov qog ua kua. Cov tshuaj tiv thaiv no ua kom puas cov pob ntawm cov hlwb nqaij. Qhov no ua rau qhov tsim cov hlwv dej. Vim li cas tiag tsis muaj neeg paub.

Muaj qee zaus, pemphigus tshwm sim los ntawm qee yam tshuaj, suav nrog:

• Ib yam tshuaj hu ua penicillamine, uas tshem qee yam khoom hauv cov ntshav (tus neeg saib xyuas chelating)
• Cov tshuaj ntshav siab hu ua ACE inhibitors
• Nonsteroidal anti-inflammatory tshuaj (NSAIDs)

Pemphigus yog qhov tsis tshua muaj tshwm sim. Feem ntau nws tshwm sim hauv cov laus lossis cov neeg laus.

Kwv yees li 50% ntawm cov neeg uas muaj tus mob no yuav pib ua mob khaus thiab mob hauv qhov ncauj. Qhov no yog ua raws los ntawm daim tawv nqaij ua hlwv. Cov tawv nqaij tawm tuaj yeem mus thiab mus.

Cov tawv nqaij ua paug yuav piav raws li:

• Qhov txhuav
• Oozing
• Neeg puab
• Tshuav lossis ua kom yooj yim

Lawv yuav nyob:

• Hauv qhov ncauj thiab hauv caj pas
• Ntawm tawv taub hau, pob tw, lossis lwm qhov chaw tawv nqaij

Daim tawv nqaij sib cais yooj yim thaum lub ntsej muag ntawm daim tawv tsis muaj qhov cuam tshuam yog txhuam sab nrog daim ntaub qhwv los yog ntiv tes ntiv taw. Qhov no yog hu ua muaj npe Nikolsky zoo.

Kev kuaj nqaij ntawm daim tawv nqaij thiab kuaj ntshav ntau zaus kom paub meej tias txoj kev kuaj mob.

Cov mob hnyav ntawm pemphigus tuaj yeem xav tau kev tswj qhov txhab, zoo ib yam li kev kho mob kub nyhiab loj. Cov neeg uas muaj PV yuav tsum tau nyob hauv tsev kho mob thiab txais kev pab hauv lub tsev kub hnyiab lossis chav saib xyuas mob hnyav.

Txoj kev kho yog txhawm rau txo cov tsos mob, nrog rau mob. Nws tseem lub hom phiaj txhawm rau tiv thaiv teeb meem, tshwj xeeb yog kev kis mob.

Kev kho mob yuav suav nrog:

• Cov tshuaj tua kab mob thiab tshuaj tua kab mob los tiv thaiv lossis tiv thaiv kev kis kab mob
• Cov kua thiab electrolytes muab los ntawm txoj hlab ntshav (IV) yog tias muaj qhov ncauj mob heev
• Tso pub mis IV yog tias muaj qhov ncauj mob hnyav
• Pob qhov ncauj (mob ua kom loog) qhov ncauj lozenges kom txo qhov ncauj mob
• Tshuaj mob yog tias qhov mob kom zoo rau hauv zos tsis txaus

Kev kho thoob plaws lub cev (mob system) yog xav tau los tswj cov pemphigus thiab yuav tsum tau pib thaum ntxov li sai tau. Cov kab ke kho mob suav nrog:

• Ib qho tshuaj tiv thaiv kab mob hu ua dapsone
• Corticosteroids
• Cov tshuaj muaj kub
• Cov tshuaj uas ua rau lub cev tiv thaiv kab mob tsis muaj zog (xws li azathioprine, methotrexate, cyclosporine, cyclophosphamide, mycophenolate mofetil, lossis rituximab)

Tshuaj tua kab mob tuaj yeem siv los kho lossis tiv thaiv kev kis mob. Qee cov tshuaj immunoglobulin (IVIg) Qee zaum siv.

Plasmapheresis tuaj yeem siv nrog rau cov tshuaj kho mob hauv lub cev kom txo qis cov tshuaj tiv thaiv hauv cov ntshav. Plasmapheresis yog txheej txheem uas cov ntshav muaj ntshav los ntshav tawm hauv ntshav mus thiab hloov ntshav los ntawm cov ntshav ntshav lossis ntshav ntshav pub dawb.

Kev kho mob ua paug thiab hlwv nrog rau kev pleev kom qhuav lossis ziab pleev, hnav ris tsho ntub dej, lossis ntsuas zoo ib yam.

Yog tias tsis kho, tus mob no yuav ua tau lub neej tsis zoo. Kev kis mob hnyav yog qhov ua kom ploj mus.

Nrog txoj kev kho mob, txoj kev tsis zoo yuav mob nyhav. Kev phiv los ntawm kev kho mob tej zaum yuav hnyav lossis xiam oob khab.

Teeb meem ntawm PV suav nrog:

• Tus kab mob zaum ob
• Lub cev qhuav dej kom hnyav
• Sab sij huam tshuaj
• Kev kis mob ntawm cov hlab ntshav (sepsis)

Koj tus kws kho mob yuav tsum kuaj xyuas txhua qhov ua kom muaj cov hlwv uas tsis pom tseeb.

Hu rau koj tus kws kho mob yog koj tau raug kho rau PV thiab koj tau tsim muaj cov tsos mob li nram no:

• Ua daus no
• Ua npaws
• General mob siab
• Mob ua ke
• Mob ib ce
• Tshiab hlwv lossis mob rau

• Pemphigus vulgaris nyob tom qab
• Pemphigus vulgaris - mob txhab hauv qhov ncauj

Amagai M. Pemphigus. Hauv: Bolognia JL, Schaffer JV, Cerroni L, eds. Lub cev ntaj ntsug. 4 tug ed. Philadelphia, PA: Elsevier; 2018: chap 29.

Dinulos JGH. Vesicular thiab bullous kab mob. Hauv: Dinulos JGH, ed. Habif Qhov Chaw Kho Mob Dermatology. 7 tus ed. Philadelphia, PA: Elsevier; 2021: chap 16.

James WD, Elston DM, Kho JR, Rosenbach MA, Neuhaus IM. Mob duav pes tsawg. Hauv: James WD, Elston DM, Kho JR, Rosenbach MA, Neuhaus IM, eds. Andrew Cov Kab Mob Ntawm Cov Tawv. 13th ed. Philadelphia, PA: Elsevier; 2020: chap 21.

Patterson JW. Cov qauv tshuaj tiv thaiv vesiculobullous. Hauv: Patterson JW, ed. Weedon's Cov Khoom Siv Tawv Tawv. Thib 5 ed. Philadelphia, PA: Elsevier; 2021: chap 7.