Health Worlds

Bullous pemphigoid check what should be done?
The taking of active lesions in patients with peripheral blood for indirect immunofluorescence, is shown in the blood circulation or BPAG2 of anti-BPAG1 IgG antibodies, indirect immunofluorescence test substrate to guinea pigs or monkeys in the esophagus is appropriate, can also be normal skin as substrate, and bullae in bullous skin around the basement with IgG and C3 deposition, taken for direct immunofluorescence lesions show basement membrane have banded fluorescence (Figure 3), immune electron microscopy showed that immunoglobulin deposited in the skin basement membrane of the transparent plate, consistent with the site of occurrence of bullae.
Almost half of patients have elevated serum IgE and IgG anti-basement membrane zone antibodies and the titer of the same, IgE antibody levels associated with the degree of itching, in patients with peripheral blood eosinophils significantly increased erythrocyte sedimentation rate may be faster, serum white protein decreased.
Histopathology: the edge of the skin in bullous epidermal junction of the true, we can see there small blisters, bullous skin under the blister for the mirror can be seen around the dermal papilla to eosinophil-based micro-tumor, and its top is a full-thickness skin, No degeneration of early skin changes, bullae containing serum, fibrin and numerous eosinophils, intraepidermal eosinophils are also seen, according to the extent of disease, visible bloo


d vessels dermal inflammation, endothelial swelling, vascular wall thickening, vascular Peripheral lymphocyte and neutrophil infiltration, and erythema at the edge of the bullous skin, direct immunofluorescence examination showed linear uniform deposition of IgG and complement C3, 70% to 80% of the patients sera by indirect immunofluorescence in circulating anti-basement membrane zone antibodies under the skin, electron microscopy revealed vesicles located under the transparent plate.

The treatment of bullous pemphigoid What is theClass days package from the title got sore how to do a year ago, taking the risk of class-day package sore hormone withdrawal and reduce the amount of drugs a year will be a recurrence of hormone use too much what Vice medicine can cureHusband impotence - premature ejaculation - how to do Viagra lacrimal gland prolapse good results in patients with symptoms after surgical treatment of large cell body symptoms sore overof class days, a large cell of cell type-day formation of epidermal cell water sore is characterized by a cell
Department of Integrative Medicine
Corner scar sore the next day pyoderma pigment and so instead of delaying treatment of measles, such as neglect of negative consequences caused by water causes sores or large holding of reasons acantholytic
Professor Zhu Xuejun summarize 30 years of basic and clinical research experience, make an effective treatment of severe autoimmune bullous disease program is worth promoting. - Compiled byPemphigus and bullous pemphigoid, severe skin disease, not treated in time can be life-threatening. First Affiliated Hospital of PLA General Hospital Dermatology Liu Shaoqing
Early diagnosis and treatment, as soon as controlling, long-term follow-up is the key to successful treatment.
* Treatment of choice is the system to use of corticosteroids (referred to as "hormone"), the dosage is divided into the first dose (dose given at diagnosis), control the amount (dose required for complete control of skin lesions) and maintenance dose (the maintenance treatment phase with the condition improved while decreasing the dose.)
* Disease classification: According to the lesions of 70% total body surface area is divided into mild, moderate, severe and serious cases.
* Close monitoring and control related adverse reactions, may be given mucosal protective agent, calcium and so on, in patients taking large doses of hormones should be monitored in water and electrolyte balance and blood glucose, blood pressure, potassium timely manner.
Can be combined immunosuppressive therapy, for patients with hormone contraindications immunosuppressive agents can be used alone.
* Emphasis on supportive care, including system use of antibiotics.
* Note that topical treatment and wound care.1. Hormones to prednisone, for example, the first is generally mild dose of 0.5 mg / kg.d, the symptoms 0.75 mg / kg.d, severe 1.0 mg / kg.d, severe 1.5 mg / kg.d. 3 to 5 days after treatment if no improvement in the original lesions and more new blisters appear, then increasing to 50% of the original dose, until the skin lesions of control. 120 mg of oral prednisone can not control the lesions, should change the program. Severe and serious cases to methylprednisolone pulse therapy (intravenous infusion of 500 ~ 1000 mg / d, for 3 days). Only the damage of early oral pemphigus vulgaris (PV) patients may be prednisolone (including service) 30 ~ 40 mg / d.
Usually in the skin lesions healed after 2 weeks reduced the amount of hormones. PV treatment generally 3 to 4 years, slightly faster reduction in the early stage, later to be slow, avoid sudden withdrawal. The first end of the year to reduce the amount of the general control of 40% to 50% a year later, as the disease can be reduced doses of 50% the previous year, and gradually replaced by the next day medication.
2. Immunosuppressive drugs on in, and serious cases of severe combined immune inhibitors, including methotrexate (weekly 10 mg, increasing to a week to 15 ~ 20 mg), cyclophosphamide (50 mg, bid or tid, serious cases intravenously once a week or every other day 600 ~ 800 mg 200 mg), azathioprine (50 mg, bid or tid) or cyclosporine (3 ~ 5 mg / kg.d).
Hormone contraindications with immunosuppressive agents may separate, but often 4 to 6 weeks after treatment markedly.
3. Antibiotics in patients with a wide range of wound, The wounds were the result of bacterial culture to give antibiotics. Of old tuberculosis patients should be monitored, if necessary, to give anti-TB drugs.
4. Wound care and supportive treatment with 0.05% berberine solution wound clean and wet compress. Serum albumin below 30 g / L who should be corrected. Of liver and kidney dysfunction drugs to choose carefully and properly adjust the dose.
Other measures include intravenous immunoglobulin, lose new blood and so on.1. Potent choice for patients with mild topical steroid ointment.
2. For infirm, to try tetracycline 0.5 g 4 times a day (or minocycline 100 mg 2 times a day) combined with nicotinamide 600 mg 2 times a day. After 10 to 14 days if the effect is not obvious, then switch to other therapies.
3. Hormones to prednisone, for example, the first generally mild dose of 0.4 mg / kg.d, in patients 0.5 mg / kg.d, severe 0.75 mg / kg.d, serious 1 ~ 1.5 mg / kg.d. Reduction principles with pemphigus.
4. The selection of immunosuppressive drugs and antibiotics, wound care and support for the principles of treatment with pemphigus.


Friends Links:Automation Control Blog
Automation Products Order Numbers