Pemphigus vulgaris( vulgar): causes, symptoms, diagnosis, treatment

August 24, 2017 23:00 | Bullous

One of the diseases that has an autoimmune mechanism of development is considered to be vulgar vulgaris.It is typical for the appearance of vesicles on the mucous membrane, dermis.If these vials are opened, pink spots will appear in their place.

So, let's learn more about the symptoms and causes of the disease pemphigus vulgaris( vulgaris), its treatment in adults, children and newborns.

Features of the disease

Vulgar pemphigus in the medical community is known as the most popular form of pemphigus. Most often the disease occurs in older patients, whose age is within 30 - 60 years.

The first manifestations are noted on the mucosa lining the oral cavity.After some time, the disease passes to the dermis.If the vesicles appear on the female genitalia, in the mouth, they quickly burst.

About the reasons why a vulgar pemphigus can appear in the history of the disease, we will tell below.

Causes of

Usually, this disease occurs when a malfunction of immunity.In this case, the body produces

antibodies( IgG) to its own cells, which are localized in the spiny layer of the epidermis.

Desmosomes that bind epidermal cells collapse due to exposure to autoantibodies.With the loss of connections between cells, spaces appear that are filled with intercellular fluid.Thus, acantholytic bubbles are formed.

About the signs of pemphigus will tell the video below:

Symptoms

Often the development of pemphigus begins with the mucous membranes( mouth, pharynx).To find them in time is very difficult, because these bubbles burst very quickly.After their accidental opening, only erosions remain, which are painful and have a distinctive bright red color.If you do not start treatment, there is growth, the fusion of the vesicles.At this stage of the development of the disease, the following symptoms are observed:

  • fetid odor from the mouth;
  • decreased appetite due to soreness;
  • erosion on the oral mucosa.

On the epidermis, the vesicles will begin to appear several months after their formation on the mucous membrane of the mouth.Very rarely, redness of the dermis around the bladder can be noted.It is like a thin rim.Eruptions in this pathology are focal.The rash usually manifests itself in the following areas:

  • inguinal folds;
  • back;
  • axillary area;
  • chest.

Bubble opening occurs a few days after the onset.Formed erosions are bright pink color, large size, a tendency to drain.The patient begins to worry such signs:

  • weakness;
  • subfebrile;
  • appearance of purulent discharge on erosions;
  • pain;
  • turbidity of the fluid accumulated inside the blisters;
  • pyoderma( it can develop after infection).

The differential diagnosis of pemphigus is further considered.

Diagnosis

Particularly important are mechanical symptoms that indicate acantholysis.Specialists can carry out such procedures:

  1. Symptom detection of Nikolsky .This symptom is the exfoliation of the epidermis after a slight rubbing of the healthy dermis.
  2. Detection of the marginal symptom of Nikolsky .To do this, you need to pull a piece of shkurochki from a bursting bubble.The symptom will be positive if the epidermis exfoliates a considerable distance from erosion.
  3. Detection of the Asbo-Hansen symptom .To do this, you need to press your finger on the bubble.The answer will be positive when the epidermis is peeled off in the periphery of the bladder, and its area grows.

To confirm the alleged diagnosis, a cytological examination( Tzank method) can be performed.Due to the smear microscopy, which is taken from the bottom of the wound, it is possible to detect acantholytic cells.These cells are present in the spiky layer of the epidermis.Biopsy is taken from a fresh bladder.

Also can conduct immunological studies( direct / indirect RIF).They are necessary to confirm / disprove the autoimmune nature of the disease.

Treatment

The only effective way to treat this disease is to use medications.As an auxiliary method, one can use the therapeutic method.

Therapeutic

Along with the use of drugs, extracorporeal hemocorrection is prescribed.For the purification of blood more often used:

  • plasmophoresis;
  • hemosorption.

Medicated

Drug therapy involves the use of such groups of drugs:

  • corticosteroids( Prednisolone, Triamcinolone, Dexamethasone);
  • cytostatics( "Cyclosporine", "Methotrex" "Azathioprine").

Antibiotics are also necessary in case of infection.To prevent complications that may occur as a result of corticosteroid therapy, it is necessary to take medications that have a protective function on the walls of the stomach( "Bismuth nitrate").

In this video Elena Malysheva will talk about the treatment of pemphigus:

Prevention of vulgar pemphigus

After eliminating the signs of the disease, one should think about a number of preventive measures that are necessary to prevent relapses.They consist in:

  • tracking the condition of the dermis;
  • with the intake of vitamins, calcium, potassium;
  • following the appearance of adverse reactions after taking medication;
  • control of( regular) sugar levels in urine, blood;
  • control of blood pressure;
  • control of prothrombin.

Next, complications of pemphigus and prognosis are considered.

Vulgar pemphigus in the oral cavity

Complications

Because of the large number of side effects in glucocorticoids, serious complications are possible.Long-term use of these drugs can cause:

  • atrophy of the adrenal glands, stopping the production of your glucocorticoids;
  • disruptions in carbohydrate metabolism, in addition to this occurrence of steroid diabetes;
  • changes in the mental state( the emergence of euphoria, manic-depressive psychosis);
  • exacerbation of ulcers( peptic);
  • thrombophlebitis;
  • malfunctions in the menstrual cycle;
  • disruptions in protein metabolism;
  • slowing down the recovery process;
  • disorders of fat metabolism;
  • spontaneous fractures( they arise due to decalcification of bones);
  • decreased immunity.

Forecast

If treatment is started in a timely manner( using corticosteroids), it is possible to avoid a lethal outcome. The use of drugs of this group can provoke the development of dangerous complications in the field of internal organs, systems.

The patient will need to take the corticosteroids for life, but in a small dosage.Long-term use of such medications can also provoke a fatal outcome.