IPemphigus vulgaris

I-Pemphigus vulgaris (PV) kukuphazamiseka okuzenzekelayo kolusu. Ibandakanya ukudumba kunye nezilonda (ukhukuliseko) lolusu kunye neembumba.

Amajoni omzimba avelisa izilwa-buhlungu ngokuchasene neeproteni ezithile kulusu kunye neembumba. Ezi antibodies ziqhekeza ubudlelwane phakathi kweeseli zolusu. Oku kukhokelela ekubunjweni kweblister. Oyena nobangela awaziwa.

Kwiimeko ezinqabileyo, i-pemphigus ibangelwa ngamanye amayeza, kubandakanya:

• Iyeza elibizwa ngokuba yi-penicillamine, elisusa izinto ezithile egazini (i-arhente yokukhohlisa)
• Amayeza oxinzelelo lwegazi abizwa ngokuba yi-ACE inhibitors
• Izidakamizwa ezichasayo ezichasayo (i-NSAID)

I-Pemphigus ayiqhelekanga. Ixhaphake kakhulu kubantu abadala okanye abadala.

Phantse iipesenti ezingama-50 zabantu abanale meko kuqala bahlakulela izilonda ezibuhlungu kunye nezilonda emlonyeni. Oku kulandelwa ngamadyungudyungu kulusu. Izilonda zolusu zinokuza zidlule.

Izilonda zesikhumba zinokuchazwa njenge:

• Ukucoca amanzi
• Iyakhuphela
• Ukuqokelela
• Ukuxobuka okanye ukufunyanwa ngokulula

Banokubakho:

• Emlonyeni nasemazantsi emqaleni
• Kwi-scalp, trunk, okanye ezinye iindawo zolusu

Ulusu lohlukana ngokulula xa umphezulu wolusu olungachaphazelekiyo ukhukululwa ecaleni nge-swab yomqhaphu okanye ngomnwe. Oku kubizwa ngokuba ngumqondiso oqinisekileyo weNikolsky.

Uvavanyo lwesikhumba kunye novavanyo lwegazi zihlala zisenziwa ukuqinisekisa isifo.

Iimeko ezinzima zepemphigus zisenokufuna ukulawulwa kwamanxeba, ngokufanayo kunyango lokutsha kakhulu. Abantu abane-PV banokufuna ukuhlala esibhedlele kwaye bafumane ukhathalelo kwicandelo lokutsha okanye kwiyunithi yonyango olunzulu.

Unyango lujolise ekunciphiseni iimpawu, kubandakanya iintlungu. Ikwajolise ekuthinteleni iingxaki, ngakumbi usulelo.

Unyango lunokubandakanya:

• Amayeza okubulala iintsholongwane kunye nokuthintela usulelo
• Ulwelo kunye neelectrolyte ezinikwa ngomthambo (IV) ukuba kukho izilonda zomlomo eziqatha
• Ukondla kwe-IV ukuba kukho izilonda zomlomo eziqatha
• Ukukhwabanisa (iintlungu) i-lozenges zomlomo ukunciphisa iintlungu zomlomo
• Amayeza entlungu ukuba isiqabu seentlungu sendawo akwanelanga

Unyango lwe-body-wide (systemic) luyafuneka ukulawula i-pemphigus kwaye kufuneka iqalwe kwangoko kangangoko kunokwenzeka. Unyango lwenkqubo lubandakanya:

• Iyeza lokuthintela ukudumba elibizwa ngokuba yidapsone
• ICorticosteroids
• Amayeza aqukethe igolide
• Amayeza acinezela amajoni omzimba (njenge-azathioprine, methotrexate, cyclosporine, cyclophosphamide, mycophenolate mofetil, okanye rituximab)

Amayeza okubulala iintsholongwane angasetyenziselwa ukunyanga okanye ukuthintela usulelo. I-immunoglobulin efakwa ngaphakathi (IVIg) isetyenziswa ngamanye amaxesha.

I-Plasmapheresis inokusetyenziswa kunye namayeza e-systemic ukunciphisa inani lezifo ezisegazini. I-Plasmapheresis yinkqubo apho iplasma yomzimba ene-antibody isuswa egazini kwaye endaweni yayo kufakwe ulwelo olufakwa ngaphakathi okanye iplasma enikelweyo.

Unyango lwezilonda kunye namadyungudyungu kubandakanya ukuthambisa okanye ukomisa into yokuthambisa, ukunxiba amanzi, okanye amanyathelo afanayo.

Ngaphandle konyango, le meko inokusongela ubomi. Usulelo olomeleleyo ngoyena nobangela wokufa.

Ngonyango, ingxaki ihlala ihlala ingapheliyo. Iziphumo ebezingalindelekanga zonyango zinokuba nzima okanye zikhubaze.

Iingxaki ze-PV zibandakanya:

• Usulelo lwesibini lwesikhumba
• Ukuphelelwa ngamandla emzimbeni
• Iziphumo ebezingalindelekanga zamayeza
• Ukusasazeka kosulelo kwigazi (sepsis)

Umboneleli wakho wokhathalelo lwempilo kufuneka aqwalasele nayiphi na iblisters engachazwanga.

Fowunela umnikezeli wakho ukuba unyangelwe i-PV kwaye uvelisa ezi mpawu zilandelayo:

• Ukugodola
• Ifiva
• Imvakalelo yokugula ngokubanzi
• Iintlungu ezidibeneyo
• Ubuhlungu bemisipha
• Amadyungudyungu amatsha okanye izilonda

• I-Pemphigus vulgaris ngasemva
• I-Pemphigus vulgaris - izilonda emlonyeni

Amagai M. Pemphigus. Ku: I-Bolognia JL, uSchaffer JV, uCerroni L, ii-eds. Dermatology. Ngomhla we-4. IPhiladelphia, PA: Elsevier; I-2018: isahluko 29.

IDinulos JGH. Izifo ezingaqhelekanga kunye nezibi. Ku: I-Dinulos JGH, ed. Ugqirha wezonyango waseHabif. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2021: isahluko 16.

UJames WD, u-Elston DM, nyanga i-JR, i-Rosenbach MA, i-IM ye-Neuhaus. Ukudakumba okungapheliyo kwesikhumba. Ku: James WD, Elston DM, Phatha uJR, Rosenbach MA, Neuhaus IM, ii-eds. Izifo zika-Andrew zoLusu. Umhla we-13. IPhiladelphia, PA: Elsevier; 2020: Isahluko 21.

IPatterson JW. Ipateni yokuphendula ye-vesiculobullous. Ku: Patterson JW, ed. Weedon's Ulusu lwezifo. Umhla we-5. IPhiladelphia, PA: Elsevier; 2021: isahluko 7.