I-Pemphigoid Gestationis Ngesikhathi Sokukhulelwa

-Delile

• Izithombe ze-pemphigoid gestationis
• Izimpawu zokukhulelwa kwe-Pemphigoid
• I-Pemphigoid gestationis ibangela
• I-Pemphigoid gestationis vs. PUPPP
• Ukuxilongwa kwe-Pemphigoid gestationis
• Ukwelashwa kwe-Pemphigoid gestationis
• Amakhambi asekhaya
• Amacala abucayi kakhulu
• Izinkinga zokukhulelwa kwePemphigoid
• Umbono

Ukubuka konke

I-Pemphigoid gestationis (PG) ukuqhuma kwesikhumba okungajwayelekile, okulimazayo okuvame ukwenzeka ku-trimester yesibili noma yesithathu yokukhulelwa. Imvamisa kuqala ngokuvela kwamaqhubu abomvu alumayo kakhulu noma amabhamuza esiswini nasesigodlweni sakho, yize kungabonakala kwezinye izingxenye zomzimba wakho.

I-PG ibangelwa amasosha akho omzimba ahlasela ngephutha isikhumba sakho. Imvamisa iyazihambela yodwa zingakapheli izinsuku noma amasonto ngemuva kokubeletha. Ezimweni ezingavamile, ingahlala isikhathi eside.

I-PG ilinganiselwa ukuthi yenzeke koku-1 kokunye kokukhulelwa okungu-40,000 kuya ku-50,000.

I-Pemphigoid gestationis yayaziwa ngokuthi i-herpes gestationis, kodwa manje sekuqondwa ukuthi ayinakho ukuxhumana negciwane le-herpes. Kukhona nezinye izinhlobo zokuqubuka kwesikhumba se-pemphigus noma se-pemphigoid, esingahlobene nokukhulelwa.

I-Pemphigus kubhekisa ku-blister noma pustule, futhi ukukhulelwa kusho ukuthi "kokukhulelwa" ngesiLatini.

Izithombe ze-pemphigoid gestationis

Izimpawu zokukhulelwa kwe-Pemphigoid

Nge-PG, kuvela izigaxa ezibomvu ezungeze inkinobho yesisu bese zisabalalela kwezinye izingxenye zomzimba ezinsukwini noma emasontweni ambalwa. Ubuso bakho, isikhumba sasekhanda, izintende zezandla, namathe ezinyawo akuvamile kuthinteke.

Ngemuva kwamasonto amabili kuya kwamane, izigaxa ziphenduka zibe ngamabhamuza amakhulu, abomvu, agcwele uketshezi. La maqhuqhuva angabizwa nangokuthi i-bulla. Bangangakhululeki neze.

Esikhundleni samabhamuza noma i-bulla, abanye abantu bakhulisa amabala abomvu abizwa ngokuthi ama-plaque.

Ama-blisters e-PG angancipha noma ahambe ngokwawo ngasekupheleni kokukhulelwa kwakho, kepha amaphesenti angama-75 kuye kwangama-80 abesifazane abane-PG bahlangabezana nokuqubuka ngesikhathi sokubeletha.

I-PG ingabuya ngesikhathi sokuya esikhathini noma ekukhulelweni okulandelayo. Ukusetshenziswa kwezindlela zokuvimbela inzalo ngomlomo nakho kungaletha okunye ukuhlaselwa.

Ezimweni ezingavamile - cishe - i-PG ingavela ezinganeni ezisanda kuzalwa.

I-Pemphigoid gestationis ibangela

I-Pemphigoid gestationis manje isiqondwa njengesifo esizimele. Lokho kusho ukuthi amasosha akho omzimba aqala ukuhlasela izingxenye zomzimba wakho. Ku-PG, amaseli ahlaselwayo yilawo we-placenta.

Izicubu zomzimba ziqukethe amaseli avela kubo bobabili abazali. Amaseli athathwe kubaba angaqukatha ama-molecule abonwa njengangaphandle ngesimiso somama sokuzivikela. Lokhu kudala ukuthi amasosha omama ahlangane nawo.

Amaseli obaba akhona kukho konke ukukhulelwa, kepha izifo ezizimele njenge-PG zenzeka kwezinye izimo. Akuqondakali ngokuphelele ukuthi kungani amasosha omama omama esabela ngale ndlela kwezinye izimo, hhayi kwamanye.

Kepha ama-molecule athile aziwa nge-MHC II ngokuvamile angekho ku-placenta atholakele kwabesifazane abane-PG. Lapho amasosha omzimba abesifazane abakhulelwe ewaqaphela la ma-molecule, ahlasela.

Ama-molecule we-MHC II-class anesibopho sokunamathela ndawonye kwezingqimba zakho zesikhumba. Lapho amasosha omzimba wakho eqala ukuwahlasela, kungaholela ekushayweni kwamabhamuza noqwembe oluyimpawu enkulu ye-PG.

Isilinganiso esisodwa salokhu kusabela okuzenzakalelayo ukuba khona kweprotheni manje eyaziwa ngokuthi yi-Collagen XVII (ngaphambili eyayibizwa nge-BP180).

I-Pemphigoid gestationis vs. PUPPP

Okunye ukuqhuma kwesikhumba okwaziwa nge-PUPPP (pruritic urticarial papules kanye namacwecwe okukhulelwa) kungafana ne-pemphigoid gestationis. Njengoba igama liphakamisa, i-PUPPP iyaluma (i-pruritic) ne-hive-like (urticarial).

I-PUPPP yenzeka kaningi ku-trimester yesithathu, okuyisikhathi esivamile sokuthi i-PG ivele. Futhi njenge-PG, ivame ukuvela kuqala esiswini njengamaqhubu abomvu alumayo noma izingcwecwe.

Kepha i-PUPPP ayivame ukuqhubekela phambili kumabhamuza amakhulu, agcwele uketshezi njenge-PG. Futhi ngokungafani ne-PG, ivame ukusabalala ize ifike emilenzeni kwesinye isikhathi kube ngaphansi kwekhwapha.

I-PUPPP iphathwa ngama-anti-itch cream namafutha, futhi kwesinye isikhathi ngamaphilisi e-antihistamine. Ukuqhuma kuvame ukunyamalala ngokwakho kungakapheli amasonto ayisithupha ngemuva kokubeletha.

I-PUPPP yenzeka cishe koku-1 kokukhulelwa ngakunye okungu-150, okwenza ukuthi kuvame kakhulu kune-PG. I-PUPPP ibuye ivame kakhulu ekukhulelweni kokuqala, nakwabesifazane abaphethe amawele, ama-triplets, noma ama-multiplex oda amaningi.

Ukuxilongwa kwe-Pemphigoid gestationis

Uma udokotela wakho esola i-PG, bangakudlulisela kudokotela wesikhumba we-biopsy yesikhumba. Lokhu kubandakanya ukufaka umuthi wokubulala izinzwa endaweni noma isikhumba endaweni encane yesikhumba nokusika isampula elincane elizothunyelwa elabhorethri.

Uma i-lab ithola izimpawu ze-pemphigoid ngaphansi kwe-microscope, zizokwenza olunye uhlolo olwaziwa ngokuthi ukuhlaziywa kwe-immunofluorescence okungaqinisekisa i-PG.

Udokotela wakho uzothatha namasampula egazi ukuthola amazinga we-pemphigoid antigen Collagen XVII / BP180 egazini. Lokhu kungabasiza ukuthi bahlole umsebenzi wesifo.

Ukwelashwa kwe-Pemphigoid gestationis

Uma izimpawu zakho zimnene, udokotela wakho angakunikeza okhilimu abalwa nama-anti-itch abaziwa ngokuthi ama-topical corticosteroids. Lokhu kwehlisa isikhumba ngokunciphisa izinga lomsebenzi wamasosha omzimba endaweni yamabhamuza.

Izidakamizwa zokungezwani komzimba ezithengiswayo (antihistamines) nazo zingasiza. Lokhu kufaka phakathi imikhiqizo engezeli:

• i-cetirizine (Zyrtec)
• i-fexofenadine (Allegra)
• I-loratadine (Claritin)

IDiphenhydramine (Benadryl) ibangela ukozela futhi ithathwa kahle ebusuku. Ngemuva kwalokho isebenza njengosizo lokulala ngaphezu kwezakhiwo zayo njengesilulamisi sokulunywa.

Konke lokhu kuyatholakala ngaphezu kwekhawunta. Izinhlobo zama-generic ziyalingana emsebenzini kumagama womkhiqizo, futhi imvamisa zibiza kakhulu.

Njalo khuluma nodokotela wakho ngaphambi kokuthatha noma imiphi imithi, ngisho nemikhiqizo engaphezulu kwekhawunta, ngesikhathi sokukhulelwa.

Amakhambi asekhaya

Udokotela wakho futhi angaphakamisa amakhambi asekhaya ukulwa nokushaywa nokungahambi kahle kwecala elincane le-PG. Lokhu kungafaka:

• ukugcina isikhumba sipholile ngeqhwa noma ukucindezela okubandayo
• ukuhlala endaweni epholile noma enomoya opholile
• ukugeza ngosawoti we-Epsom noma amalungiselelo e-oatmeal
• egqoke izingubo ezipholile zikakotini

Amacala abucayi kakhulu

Lapho ukulunywa nokucasuka kunzima kakhulu, udokotela wakho cishe uzokunika i-corticosteroids yomlomo. Njengoba le mithi isebenza ngokunciphisa ukusebenza kwamasosha omzimba, umthamo omncane osebenzayo kufanele usetshenziswe njalo.

Udokotela wakho uzobheka imiphumela yakho nobabili nengane yakho, futhi ugcine umthamo nobude besikhathi sokwelashwa buncane.

Izidakamizwa ze-immunosuppressive ezifana ne-azathioprine noma i-cyclosporine nazo zingasetshenziswa ukusiza ukunciphisa ukulunywa nokungahambi kahle. Ukuqapha ngokucophelela imiphumela emibi kuyadingeka. Lokhu kungafaka:

• ukuhlola umfutho wegazi kanye noma kabili ngesonto ngenyanga yokuqala yokusetshenziswa
• ukuqapha ukusebenza kwezinso ngokuhlolwa kwegazi nomchamo
• ukuqapha ukusebenza kwesibindi, i-uric acid, namazinga we-lipid azila ukudla

Izinkinga zokukhulelwa kwePemphigoid

Ucwaningo lwango-2009 lwathola ukuthi ukuqubuka kwamabhamuza e-PG ku-trimester yokuqala noma yesibili kungaholela emiphumeleni emibi yokukhulelwa.

Ucwaningo luhlolisise amarekhodi amacala abesifazane abangu-61 abakhulelwe abane-PG abavela e-United Kingdom naseTaiwan. Imiphumela emibi etholakala kwabesifazane abanokuqala kokuqala (i-trimester yokuqala noma yesibili) i-PG ifakiwe:

• ukuzalwa kwangaphambi kokubeletha
• isisindo sokuzalwa esiphansi
• encane yobudala bokukhulelwa

Kuvame kakhulu ukuthi i-PG ivele ngokuhamba kwesikhathi ekukhulelweni. Uma kwenzeka ku-trimester yokuqala noma yesibili, ababhali abacwaningayo bancoma ukuthi bakuthathe njengokukhulelwa okuyingozi enkulu ngokuqapha nokuqapha okuningiliziwe.

Ngasohlangothini oluhle, isifundo sathola nokuthi ukwelashwa nge-systemic (ngomlomo) i-corticosteroids ayithinti kakhulu imiphumela yokukhulelwa.

Umbono

I-Pemphigoid gestationis ukuqubuka kwesikhumba okungajwayelekile kuvame ukwenzeka sekwedlule isikhathi sokukhulelwa. Kuyaluma futhi akujabulisi, kepha hhayi okusongela impilo kuwe noma enganeni yakho.

Uma kwenzeka ekuqaleni kokukhulelwa kunokwanda okuncane kwamathuba okuzalwa ngaphambi kwesikhathi noma usana olunesisindo esiphansi. Ukuqapha okusondele kakhulu kukadokotela wakho we-OB-GYN nokuxhumanisa ukwelashwa nodokotela wakho wesikhumba kunconywa.

Ungahle uthande ukuxhumana ne-International Pemphigus ne-Pemphigoid Foundation, enamaqembu ezingxoxo nabaqeqeshi bontanga babantu abane-PG.