Pemphigus vulgaris

Pemphigus vulgaris (PV) chirwere chemuviri cheganda. Inosanganisira kuputika uye maronda (erosions) eganda uye mucous membranes.

Iyo immune system inoburitsa masoja anorwisa akasarudzika mapuroteni muganda uye mucous membranes. Aya ma antibodies anodambura zvisungo pakati pemasero eganda. Izvi zvinotungamira mukuumbwa kweblister. Chikonzero chaicho hachizivikanwi.

Muzviitiko zvisingawanzoitika, pemphigus inokonzerwa nemimwe mishonga, inosanganisira:

• Mushonga unonzi penicillamine, unobvisa zvimwe zvinhu muropa (chelating agent)
• Ropa rekumanikidza mishonga inonzi ACE inhibitors
• Nonsteroidal anti-anogumbura zvinodhaka (NSAIDs)

Pemphigus haina kujairika. Inowanzoitika kune vane zera repakati kana vanhu vakuru.

Vanoda kusvika makumi mashanu kubva muzana yevanhu vane chirwere ichi vanotanga kukura maronda anorwadza uye maronda mumuromo. Izvi zvinoteverwa nemabhuru eganda. Maronda eganda anogona kuuya oenda.

Maronda eganda anogona kutsanangurwa se:

• Kudhonza
• Kufema
• Kukanda
• Kubaya kana kusununguka zviri nyore

Vanogona kunge varipo:

• Mumuromo uye pasi pehuro
• Pamusoro peganda, trunk, kana dzimwe nzvimbo dzeganda

Ganda rinoparadzanisa zviri nyore kana iyo yepamusoro yeganda risingabatwe ichikwizwa padivi nedonje swab kana chigunwe. Ichi chinonzi chiratidzo chakanakidza chaNikolsky.

Ganda biopsy uye kuongororwa kweropa zvinowanzoitwa kusimbisa kuongororwa.

Makesi akakura epemphigus angangoda manejimendi manejimendi, akafanana nekurapa kwekutsva kwakanyanya. Vanhu vane PV vangangoda kugara muchipatara uye nekuchengetwa muchikamu chinopisa kana chevanorwarisa.

Kurapa kunoitirwa kudzikisa zviratidzo, kusanganisira kurwadziwa. Izvo zvakare zvine chinangwa chekudzivirira matambudziko, kunyanya hutachiona.

Kurapa kunogona kusanganisira:

• Mishonga inorwisa mabhakitiriya uye mishonga yekudzivirira kubata kana kudzivirira hutachiona
• Mvura nemagetsi zvinopihwa kuburikidza netsinga (IV) kana paine maronda akakomba emumuromo
• IV kudyisa kana paine maronda akakomba emumuromo
• Kuburitsa (anesthetic) muromo lozenges yekudzora maronda emuromo
• Mishonga yemarwadzo kana zororo remuno risingakwani

Muviri-wakapamhama (systemic) kurapa kunodiwa kudzora pemphigus uye inofanira kutangwa nekukurumidza sezvazvinogona. Kurapa kwakarongeka kunosanganisira:

• Mushonga unorwisa-kuzvimba unonzi dapsone
• Corticosteroids
• Mishonga ine goridhe
• Mishonga inodzvinyirira immune system (senge azathioprine, methotrexate, cyclosporine, cyclophosphamide, mycophenolate mofetil, kana rituximab)

Mishonga inorwisa mabhakitiriya inogona kushandiswa kurapa kana kudzivirira hutachiona. Intravenous immunoglobulin (IVIg) inowanzo shandiswa.

Plasmapheresis inogona kushandiswa pamwe chete nehurongwa hwemishonga yekuderedza huwandu hwezvirwere muropa. Plasmapheresis inzira inobvisa plasma-ine-antibody muropa uye inotsiviwa nemvura inopinza kana plasma yakapihwa.

Ulcer uye blister kurapwa kunosanganisira kunyaradza kana kuomesa lotions, kunyorova kupfeka, kana zvakafanana matanho.

Pasina kurapwa, mamiriro aya anogona kutyisidzira hupenyu. Utachiona hwakanyanya ndicho chinonyanya kukonzera rufu.

Nekurapa, kusagadzikana kunowanzo kuve kusingaperi. Mhedzisiro yemhedzisiro yekurapa inogona kuve yakaoma kana kuremadza.

Zvinetso zvePV zvinosanganisira:

• Zvirwere zvechipiri zveganda
• Kunyanya kupera mvura mumuviri
• Migumisiro yechirwere yemishonga
• Kupararira kwehutachiona kuburikidza neropa (sepsis)

Wehutano wako mupi anofanira kuongorora chero asina kutsanangurwa mablisters.

Fonera mupiki wako kana iwe wakarapwa PV uye iwe unovandudza chero cheanotevera zviratidzo:

• Kutonhora
• Kupindwa nechando
• Kazhinji kurwara kunzwa
• Joint aches
• Tsvina inorwadza
• Maronda matsva kana maronda

• Pemphigus vulgaris kumusana
• Pemphigus vulgaris - maronda mumuromo

Amagai M. Pemphigus. Mune: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018: chitsiko 29.

Dinulos JGH. Zvirwere uye zvinotyisa. Muna: Dinulos JGH, ed. Habif's Clinical Dermatology. 7th ed. Philadelphia, PA: Elsevier; 2021: chitsauko 16.

James WD, Elston DM, Bata JR, Rosenbach MA, Neuhaus IM. Chirwere blistering dermatoses. Muna: James WD, Elston DM, Bata JR, Rosenbach MA, Neuhaus IM, eds. Andrew's Zvirwere zveGanda. 13 ed. Philadelphia, PA: Elsevier; 2020: chitsiko 21.

Patterson JW. Iyo vesiculobullous reaction pateni. Mune: Patterson JW, ed. Weedon's Ganda Pathology. 5 ed. Philadelphia, PA: Elsevier; 2021: chits. 7.