I-lupus erythematosus yesikhumba

nguBret Kenny kanye no-Allison Osmond MD FRCPC
Mashi 9, 2023

Iyini i-cutaneous lupus erythematosus?

I-Cutaneous lupus erythematosus (CLE) igama elisetshenziswa odokotela lapho isifo esibizwa ngokuthi i-lupus erythematosus sihlasela isikhumba. Cishe izingxenye ezimbili kwezintathu zeziguli ezine-lupus zizothuthukisa i-CLE. Iziguli eziningi ezine-CLE nazo zinezinye izitho, njengenhliziyo, amaphaphu, izinso, imisipha, namalunga, nazo ezithintekayo yi-lupus.

Iyini i-lupus erythematosus?

I-Lupus erythematosus yisifo se-autoimmune esiholela ekwandeni ukuvuvukala ezingxenyeni eziningi zomzimba. Ukuvuvukala, noma ukulimala, kungabangelwa ngokuqondile amaseli omzimba noma amaprotheni akhethekile okuthiwa ama-antibodies akhiqizwa amaseli omzimba. Ezigulini eziningi ezine-lupus, amasosha omzimba enza ama-anti-nuclear antibodies (ANA), anikezwa leli gama ngoba anamathela nucleus yamaseli avamile.

Yini ebangela i-lupus erythematosus?

I-Lupus erythematosus ibangelwa inhlanganisela yezakhi zofuzo, imvelo, kanye nezici zamasosha omzimba, okuholela ekwandeni ukuvuvukala.

• Ufuzo: Abacwaningi bathole izakhi zofuzo eziningi ezihlotshaniswa nengozi eyengeziwe yokuthuthukisa i-lupus erythematosus. Iziguli ezine-lupus erythematosus zivame ukuba nelungu lomndeni elithintekayo.
• Environmental: I-Lupus erythematosus ingabangelwa izici zemvelo kubantu abathambekele ekuguleni lesi sifo. Esinye sezimbangela ezivame kakhulu ukuchayeka elangeni, kanye nokubhema ugwayi, amahomoni, izifo, neminye imithi.
• Amasosha omzimba: I-Lupus erythematosus kucatshangwa ukuthi ihilela izingxenye eziningi zamasosha omzimba kuhlanganise ama-antibodies kanye namaprotheni, okuholela ekwandeni ukuvuvukala. Amaseli omzimba akhethekile abizwa ngama-T-cell, kanye nezingxenye zamasosha ethu omzimba adlala indima ebalulekile ekuthuthukisweni nasekugcinweni kwe-lupus erythematosus.

Yiziphi izinhlobo ze-cutaneous lupus erythematosus?

I-Cutaneous lupus erythematosus (CLE) ingavela ngohlu olubanzi lwesikhumba izilonda. Odokotela bahlukanisa lezi zilonda zesikhumba zibe izigaba ezintathu noma izinhlobo ezibizwa ngokuthi i-acute, i-subacute, ne-chronic noma i-discoid.

I-acute cutaneous lupus erythematosus

I-Acute CLE ivame ukuvela njengokuqubuka okubomvu ezihlathini nasemakhaleni, okubizwa ngokuthi “i-butterfly rash”. Iningi leziguli ezine-CLE eziyingozi ekugcineni zizothuthukisa i-lupus kwezinye izingxenye zomzimba.

I-Subacute cutaneous lupus erythematosus

I-Subacute CLE ivamise ukuvezwa njengokuqubuka okubomvu, okuphakanyisiwe, okunenkakha ezindaweni ezichayeke elangeni. Izilonda zesikhumba zivame ukufana nendandatho futhi zingabukeka zifana ne-psoriasis noma i-eczema. Cishe i-10-15% yeziguli ezinalolu hlobo lwe-CLE ekugcineni ziba ne-lupus kwezinye izingxenye zomzimba.

I-lupus erythematosus engapheli/i-discoid

I-CLE ehlala isikhathi eside noma i-discoid CLE ivamise ukuqala ngokubomvu, okuyindilinga, ukuqubuka kwesikhumba esikhumbeni, ebusweni, ezindlebeni, nakwezinye izindawo ezichayeke elangeni. Izilonda esikhumbeni zingaphola kodwa zishiye izibazi eziguqukile kanye nokuqothuka kwezinwele ekhanda. Cishe u-5-10% weziguli ezinaleli fomu zigcina ziba ne-lupus kwezinye izingxenye zomzimba.

Itholakala kanjani i-cutaneous lupus erythematosus?

Ukuxilongwa kwe-CLE kudinga ulwazi oluvela emithonjeni eyahlukene okuhlanganisa umlando wakho wezokwelapha, ukuhlolwa ngokomzimba, ukuhlolwa kwegazi, kanye nesikhumba. i-biopsy. Ithimba lakho lezokwelapha lizosebenza ngokubambisana ukuze liqoqe futhi labelane ngalolu lwazi ukuze linqume ukuxilongwa okufanele.

Ibukeka kanjani i-lupus erythematosus ngaphansi kwe-microscope?

Isikhumba i-biopsy kuyinqubo lapho kukhishwa khona isampula elincane lesicubu bese lithunyelwa kudokotela wezifo ukuze lihlolwe ngesibonakhulu. Isampula yethishu ingasetshenziswa ukubheka ukuvuvukala, ukulimala kwezicubu, nokungajwayelekile ama-antibodies esikhunjeni.

Izici ezivamile ze-microscopic ye-cutaneous lupus erythematosus:

• Ushintsho lwesixhumi esibonakalayo: Leli gama lisetshenziselwa ukuchaza umonakalo ongezansi kwe-epidermis lapho amaseli e-squamous ahlangana ne-dermis.
• Imizimba ye-Civatte noma ye-colloid: Umzimba we-civatte noma we-colloid wonakele i-squamous cell. Njengoba i-squamous cell ifa iba yincane futhi ibe pink ekhanyayo.
• Ukuqina kwe-membrane engaphansi: Ulwelwesi olungaphansi luwungqimba oluncane lwezicubu oluhlukanisa i-epidermis nedermis. Ku-CLE, iba ugqinsi ngendlela engavamile.
• Ukwanda kwe-dermal mucin: I-dermis iyingqimba ewugqinsi yezicubu ezixhumeneyo ngaphansi nje kolwelwesi olungaphansi. I-CLE iphumela ekulimaleni kwesikhumba ngo amangqamuzana okuvuvukala kanye nokwanda kokukhiqizwa kwento ebizwa ngokuthi mucin.

Iyini i-immunofluorescence eqondile futhi isiza kanjani ukwenza ukuxilongwa?

I-Direct immunofluorescence (DIF) ukuhlolwa okwenziwa yizazi zezifo ukuze zibheke amaprotheni athile kusampula yethishu. Ngokungafani namasampula ezicubu eziningi, ahlolwa kusetshenziswa ukukhanya okujwayelekile, amasampula ezicubu ze-DIF ahlolwa kusetshenziswa ukukhanya kwe-fluorescent. Lokhu kwenza kube lula kudokotela wakho wezifo ukuthi abone noma yimaphi amaprotheni angajwayelekile kusampula. Ezigulini ezine-CLE, amasampula ezicubu ahlolwe kusukela ekuhlolweni kwe-DIF ngokuvamile azobonisa amanani anyukile amaprotheni ahlobene namasosha omzimba endaweni yolwelwesi olungaphansi. Lawa maprotheni afaka i-IgG, i-IgM, i-IgA, ne-C3.