Pemphigus vulgaris

Pemphigus vulgaris (PV) ndi vuto lokhalitsa la khungu. Zimaphatikizapo kuphulika ndi zilonda (zotupa) za khungu ndi mamina.

Chitetezo cha mthupi chimapanga ma antibodies motsutsana ndi mapuloteni ena pakhungu ndi mamina. Ma antibodies awa amathetsa kulumikizana pakati pama cell khungu. Izi zimapangitsa kuti pakhale blister. Zomwe zimayambitsa sizikudziwika.

Nthawi zambiri, pemphigus imayambitsidwa ndi mankhwala ena, kuphatikiza:

• Mankhwala otchedwa penicillamine, omwe amachotsa zinthu zina m'magazi (wonyenga)
• Mankhwala a kuthamanga kwa magazi otchedwa ACE inhibitors
• Mankhwala osagwiritsidwa ntchito poletsa kutupa (NSAIDs)

Pemphigus si zachilendo. Nthawi zambiri zimachitika pakati pa okalamba kapena achikulire.

Pafupifupi 50% mwa anthu omwe ali ndi vutoli poyamba amatuluka zotupa ndi zilonda mkamwa. Izi zimatsatiridwa ndi zotupa pakhungu. Zilonda zapakhungu zimatha.

Zilonda pakhungu zimatha kufotokozedwa kuti:

• Kukhetsa
• Kutuluka
• Kuthamanga
• Kujambula kapena kusungidwa mosavuta

Atha kupezeka:

• Pakamwa ndi pakhosi
• Pamutu, pamtengo, kapena madera ena akhungu

Khungu limadzilekana mosavuta pomwe pamwamba pa khungu losakhudzidwa limasisitidwa chammbali ndi swab ya thonje kapena chala. Ichi chimatchedwa chizindikiro chabwino cha Nikolsky.

Kuyezetsa khungu ndi kuyezetsa magazi nthawi zambiri kumachitidwa kuti zitsimikizire matendawa.

Matenda owopsa a pemphigus angafunike kuyang'anira mabala, ofanana ndi chithandizo cha zilonda zamoto. Anthu omwe ali ndi PV angafunike kukhala mchipatala kuti alandire thandizo kuchipinda chowotchera kapena kuchipatala.

Chithandizo ndi cholinga chochepetsa zizindikiro, kuphatikizapo kupweteka. Imafunanso kupewa zovuta, makamaka matenda.

Chithandizo chitha kukhala:

• Maantibayotiki ndi mankhwala antifungal oletsa kapena kupewa matenda
• Zamadzimadzi ndi ma electrolyte omwe amaperekedwa kudzera mumtsempha (IV) ngati pali zilonda zam'kamwa
• Kudyetsa IV ngati kuli zilonda zam'kamwa
• Dzanzi (dzanzi) lozenges pakamwa pochepetsa zilonda zam'mkamwa
• Mankhwala opweteka ngati kupweteka kwakomweko sikokwanira

Mankhwala ofunikira (systemic) amafunikira kuti athane ndi pemphigus ndipo ayenera kuyambitsidwa mwachangu momwe angathere. Chithandizo chamachitidwe chimaphatikizapo:

• Mankhwala odana ndi zotupa otchedwa dapsone
• Corticosteroids
• Mankhwala okhala ndi golide
• Mankhwala omwe amaletsa chitetezo cha mthupi (monga azathioprine, methotrexate, cyclosporine, cyclophosphamide, mycophenolate mofetil, kapena rituximab)

Maantibayotiki amatha kugwiritsidwa ntchito pochiza kapena kupewa matenda. Intravenous immunoglobulin (IVIg) nthawi zina imagwiritsidwa ntchito.

Plasmapheresis itha kugwiritsidwa ntchito limodzi ndi mankhwala amachitidwe kuti muchepetse kuchuluka kwa ma antibodies m'magazi. Plasmapheresis ndi njira yomwe m'magazi okhala ndi anti-antibody amachotsedwa m'magazi ndikusinthidwa ndi madzi am'mitsempha kapena plasma yoperekedwa.

Zilonda zam'mimba ndi zotupa zimaphatikizapo zotsekemera kapena zowumitsa, mavalidwe onyowa, kapena njira zina zofananira.

Popanda chithandizo, vutoli limawopseza moyo. Matenda owopsa ndi omwe amafa kwambiri nthawi zambiri.

Ndi chithandizo, matendawa amakhala osadwaladwala. Zotsatira zoyipa zamankhwala zitha kukhala zovuta kapena zolemetsa.

Mavuto a PV ndi awa:

• Matenda apakhungu lachiwiri
• Kutaya madzi m'thupi kwambiri
• Zotsatira zoyipa za mankhwala
• Kufalikira kwa matenda kudzera m'magazi (sepsis)

Wothandizira zaumoyo wanu ayenera kuwona matuza aliwonse osadziwika.

Itanani omwe akukuthandizani ngati mwalandira chithandizo cha PV ndipo mukukhala ndi izi:

• Kuzizira
• Malungo
• Kumva kudandaula
• Kupweteka kofanana
• Kupweteka kwa minofu
• Matuza atsopano kapena zilonda

• Pemphigus vulgaris kumbuyo
• Pemphigus vulgaris - zotupa pakamwa

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Dinulos JGH. Matenda opatsirana komanso oopsa. Mu: Dinulos JGH, mkonzi. Chipatala cha Habif's Dermatology. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2021: mutu 16.

James WD, Elston DM, Chitani JR, Rosenbach MA, Neuhaus IM. Matenda otupa kwambiri. Mu: James WD, Elston DM, Tsatirani JR, Rosenbach MA, Neuhaus IM, eds. Matenda a Andrew a Khungu. Wolemba 13. Philadelphia, PA: Elsevier; 2020: mutu 21.

Patterson JW. Mitundu ya vesiculobullous reaction. Mu: Patterson JW, mkonzi. Matenda a Khungu la Weedon. 5th ed. Philadelphia, PA: Elsevier; 2021: mutu 7.