I-Pemphigoid Gestationis Ngexesha lokukhulelwa

Umxholo

• Imifanekiso yepemphigoid gestationis
• Iimpawu zePemphigoid zokukhulelwa
• Ukukhulelwa kwePemphigoid kubangela
• I-Pemphigoid gestationis vs PUPPP
• Ukuxilongwa kwePemphigoid gestationis
• Unyango lwe-Pemphigoid lokukhulelwa
• Unyango lwasekhaya
• Amatyala amandundu ngakumbi
• Ukuphathwa kakubi kwePemphigoid
• Imbonakalo

Ushwankathelo

I-Pemphigoid gestationis (PG) yinto enqabileyo, erhawuzayo yokuqhuma kolusu okuhlala kwenzeka kwikota yesibini okanye yesithathu yokukhulelwa. Ihlala iqala ngokubonakala kwamaqhuma abomvu abomvu okanye i-blisters esiswini sakho nasetrunk, nangona inokubonakala kwamanye amalungu omzimba wakho.

I-PG ibangelwa kukuba amajoni akho omzimba ahlasela ngempazamo ulusu lwakho. Ihlala ihamba yodwa ngaphakathi kweentsuku okanye iiveki emva kokuhanjiswa. Kwiimeko ezinqabileyo, inokuhlala ixesha elide.

I-PG iqikelelwa ukuba yenzeke kwi-1 nganye kuma-40,000 ukuya kuma-50,000 okukhulelwa.

I-Pemphigoid gestationis eyayisaziwa ngokuba yi-herpes gestationis, kodwa ngoku iyaqondakala ukuba ayinalo ntsholongwane ye-herpes. Kukho nezinye iintlobo zeempuphu ze-pemphigus okanye ze-pemphigoid, ezingahambelani nokukhulelwa.

IPemphigus ibhekisa kwiblister okanye pustule, kwaye ukumitha lithetha "ukukhulelwa" ngesiLatini.

Imifanekiso yepemphigoid gestationis

Iimpawu zePemphigoid zokukhulelwa

Nge-PG, amaqhuma abomvu abonakala ejikeleze iqhosha lesisu kwaye asasazeka kwamanye amalungu omzimba kwiintsuku okanye iiveki ezimbalwa. Ubuso bakho, isikhumba sekhanda, iintende, kunye neenyawo zihlala zingachaphazeleki.

Emva kweeveki ezimbini ukuya kwezine, amaqhuma ajika abe ngamadyungudyungu amakhulu, abomvu, azele lulwelo. La maqhuqhuva anokubizwa ngokuba yi-bulla. Banokungonwabi kwaphela.

Endaweni yamadyungudyungu okanye i-bulla, abanye abantu bakhulisa amabala abomvu abizwa ngokuba ngamacwecwe.

I-blisters ze-PG zinokuncipha okanye zihambe zodwa ngasekupheleni kokukhulelwa kwakho, kodwa ama-75 ukuya kuma-80 eepesenti yabasetyhini abane-PG banamava okujikeleza ngexesha lokuhanjiswa.

I-PG inokuphinda ibuye ngexesha lokuya exesheni okanye ekukhulelweni okulandelayo. Ukusetyenziswa kwezicwangcisi zomlomo kunokuzisa olunye uhlaselo.

Kwiimeko ezinqabileyo-malunga-i-PG inokuvela kwiintsana.

Ukukhulelwa kwePemphigoid kubangela

I-Pemphigoid gestationis ngoku iqondwa ukuba isisifo esizimele. Oko kuthetha ukuba amajoni akho omzimba aqala ukuhlasela amalungu omzimba wakho. Kwi-PG, iiseli eziza kuhlaselwa zezo zeplasenta.

Izicubu zeplacental ziqulathe iiseli kubo bobabini abazali. Iiseli ezivela kutata zinokuqulatha iimolekyuli ezamkelwa njengezangaphandle ngumzimba womama. Oku kubangela ukuba amajoni omzimba omama ahlangane ngokuchasene nabo.

Iiseli zoomama zibakhona kuko konke ukukhulelwa, kodwa izifo ezizimela njenge-PG zenzeka kuphela kwezinye iimeko. Akuqondwa ngokupheleleyo ukuba kutheni amajoni omama asabela ngale ndlela kwezinye iimeko, hayi kwezinye.

Kodwa iimolekyuli ezithile ezaziwa ngokuba yi-MHC II ezingabikhoyo kwi-placenta zifunyenwe kubafazi abane-PG. Xa amajoni omzimba akhulelweyo aqonda ezi molekyuli, ihlasela.

Iimolekyuli zodidi lwe-MHC II linoxanduva lokuncamathela kulusu lwakho lolusu. Nje ukuba amajoni akho omzimba aqale ukubahlasela, kunokubangela iblister kunye ne-plaque olona phawu lwe-PG.

Elinye inyathelo lokuphendula okuzenzekelayo kukubakho kweprotein ngoku eyaziwa ngokuba yiCollagen XVII (eyayibizwa ngokuba yiBP180).

I-Pemphigoid gestationis vs PUPPP

Olunye ulusu oluqhambukayo olubizwa ngokuba yi-PUPPP (iipuruli ze-urticarial papules kunye namacwecwe okukhulelwa) anokufana ne-pemphigoid gestationis. Njengoko igama lisitsho, i-PUPPP iyarhawuzelela (pruritic) kwaye injengomtsalane (urticarial).

I-PUPPP yenzeka rhoqo kwikota yesithathu, ekwalixesha eliqhelekileyo lokuba i-PG ivele. Kwaye njenge-PG, ihlala iqala ukubonakala esiswini njengamaqhuma abomvu alumkileyo okanye iipleyiti.

Kodwa i-PUPPP ayihlali iqhubela phambili kwiiblister ezinkulu, ezigcwele ulwelo njengePG. Kwaye ngokungafaniyo ne-PG, ihlala isasazeka ukuya emilenzeni kwaye ngamanye amaxesha ibe ngaphantsi.

I-PUPPP inyangwa nge-anti-itch creams kunye ne-ointments, kwaye ngamanye amaxesha ngamacwecwe e-antihistamine. Irhashalala lidla ngokunyamalala lodwa zingaphelanga iiveki ezintandathu emva kokuziswa.

I-PUPPP yenzeka malunga ne-1 kuyo yonke into yokukhulelwa eyi-150, iyenza ukuba ixhaphake kakhulu kune-PG. I-PUPPP ikwaxhaphake kakhulu ekukhulelweni kokuqala, nakwabasetyhini abathwele amawele, abathathu, okanye ukuphindaphinda okuphezulu.

Ukuxilongwa kwePemphigoid gestationis

Ukuba ugqirha wakho urhanela i-PG, banokukuthumela kugqirha wesikhumba kwi-biopsy yolusu. Oku kubandakanya ukufaka iyeza lokuphelisa iintlungu okanye lokuqandisa kwindawo encinci yolusu kunye nokusika isampulu encinci ukuba ithunyelwe elebhu.

Ukuba ilebhu ifumana imiqondiso yepemphigoid phantsi kwemicroscope, bayakwenza olunye uvavanyo olwaziwa ngokuba luhlalutyo lwe-immunofluorescence olunokuqinisekisa i-PG.

Ugqirha wakho uya kuthatha iisampulu zegazi ukumisela amanqanaba epemphigoid antigen Collagen XVII / BP180 egazini. Oku kunokubanceda ukuba bavavanye umsebenzi wesifo.

Unyango lwe-Pemphigoid lokukhulelwa

Ukuba iimpawu zakho zincinci, ugqirha wakho unokumisela i-anti-itch creams eyaziwa njenge-topical corticosteroids. Oku kuzolisa ulusu ngokunciphisa inqanaba lomsebenzi wamajoni omzimba kwindawo yamadyungudyungu.

Amachiza e-anti-anti-anti-counter (i-antihistamines) anokunceda. Oku kubandakanya iimveliso ezingezizo:

• icetirizine (iZyrtec)
• i-fexofenadine (Allegra)
• loratadine (Claritin)

I-Diphenhydramine (iBenadryl) ibangela ukozela kwaye ithathwa ngcono ebusuku. Isebenza njengesixhobo sokulala ukongeza kwiipropathi zayo njengesinciphisi sokurhawuzelela.

Zonke ezi ziyafumaneka ekhawuntarini. Iinguqulelo zeGeneric ziyalingana kwimisebenzi kumagama eebrendi, kwaye zihlala zingabizi kakhulu.

Soloko uthetha nogqirha wakho ngaphambi kokuba uthathe naliphi na iyeza, nokuba ungathengisa iimveliso, xa ukhulelwe.

Unyango lwasekhaya

Ugqirha wakho unokucebisa ngoncedo lwasekhaya ukulwa ukulunywa kunye nokungonwabi kwimeko encinci ye-PG. Oku kunokubandakanya:

• ukugcina ulusu lupholile ngumkhenkce okanye ingqele ebandayo
• ukuhlala kwindawo epholileyo okanye enomoya-moya
• Ukuhlamba ityuwa ye-Epsom okanye amalungiselelo e-oatmeal
• unxibe iimpahla zomqhaphu ezipholileyo

Amatyala amandundu ngakumbi

Xa ukurhawuzelela kunye nokucaphuka kunzima kakhulu, ugqirha wakho uya kumisela i-corticosteroids yomlomo. Njengoko la machiza esebenza ngokunciphisa umsebenzi wamajoni omzimba, kufuneka kusetyenziswe idosi encinci esebenzayo.

Ugqirha wakho uya kuthathela ingqalelo iimpembelelo kuwe nakumntwana wakho, kwaye ugcine idosi kunye nexesha lonyango ubuncinci.

Amachiza e-immunosuppressive anje nge-azathioprine okanye i-cyclosporine inokusetyenziselwa ukunceda ukunciphisa ukurhawuzelela nokungonwabi. Ukujonga ngononophelo iziphumo ebezingalindelekanga kuyafuneka. Oku kunokubandakanya:

• Ukujonga uxinzelelo lwegazi kube kanye okanye kabini ngeveki kwinyanga yokuqala yokusetyenziswa
• Ukujonga ukusebenza kwezintso ngovavanyo lwegazi kunye nomchamo
• Ukujonga ukusebenza kwesibindi, i-uric acid, kunye nokuzila kwamanqanaba eepidid

Ukuphathwa kakubi kwePemphigoid

Uhlolisiso olwenziwe ngo-2009 lwafumanisa ukuba ukuqhambuka kwamadyungudyungu e-PG kwikota yokuqala okanye yesibini kunokukhokelela kwiziphumo zokukhulelwa.

Olu phononongo luvavanye iirekhodi zamatyala amakhosikazi angama-61 akhulelweyo ane-PG evela e-United Kingdom naseTaiwan. Iziphumo ezibi ezifunyenwe kwabasetyhini abanokuqala kwangoko (ikota yokuqala okanye yesibini) i-PG ibandakanyiwe:

• ukuzalwa kwangaphambi kokuzalwa
• ubunzima bokuzalwa obuphantsi
• encinci ngexesha lokukhulelwa

Kuqheleke ngakumbi ukuba i-PG ivele kamva ekukhulelweni. Xa isenzeka kwikota yokuqala okanye yesibini, ababhali abafundayo bacebisa ukuyiphatha njengokukhulelwa okuphezulu komngcipheko ngokujonga ngononophelo kunye nokujonga.

Kwicala elifanelekileyo, uphononongo lufumanise ukuba unyango lwe-systemic (yomlomo) yecorticosteroids ayichaphazeli kakhulu iziphumo zokukhulelwa.

Imbonakalo

I-Pemphigoid gestationis sisifo esinqabileyo sesikhumba esidla ngokwenzeka emva kwexesha lokukhulelwa. Kuyarhawuzelela kwaye kungonwabisi, kodwa hayi ukusongela ubomi kuwe okanye kusana lwakho.

Xa kusenzeka kwangethuba ekukhulelweni kukho ukwanda okuncinci kumathuba okuzalwa kwangaphambi kokuzalwa okanye usana olunesisindo esiphantsi. Ukujonga ngokusondeleyo ugqirha wakho we-OB-GYN kunye nokulungelelanisa unyango kunye nedermatologist yakho kuyacetyiswa.

Unokufuna ukunxibelelana ne-International Pemphigus kunye ne-Pemphigoid Foundation, enamaqela eengxoxo kunye nabaqeqeshi boontanga babantu abane-PG.