Tib neeg cov tawv nqaij ua mob: mob ntshav qab zib mellitus (duab thiab piav qhia)

Cov kws kho mob ntawm ntau qhov tshwj xeeb, suav nrog endocrinologist, ntsej muag hloov pauv ntawm daim tawv nqaij pathological. Cov tawv nqaij mob tuaj yeem yog qhov nrhiav pom lossis tus neeg tsis txaus siab lub ntsiab lus tsis txaus siab. Ua kom mob siab thaum xub thawj, kev hloov pauv ntawm daim tawv nqaij yuav yog qhov qhia ntawm tus mob hnyav. Daim tawv nqaij yog cov khoom siv tau nkag mus rau txoj kev tshawb fawb thiab tib lub sijhawm muaj cov ntaub ntawv tseem ceeb tshaj plaws. Cov tawv nqaij mob tuaj yeem qhia meej qhov kev kuaj mob hauv ntau cov mob sab hauv, suav nrog mob ntshav qab zib mellitus (DM).

Cov tawv nqaij hloov pauv hauv ntshav qab zib kuj tshwm sim ntau. Kev cuam tshuam ntawm cov metabolism hauv lub hauv paus ua rau cov kab mob ntshav qab zib ua rau muaj kev hloov pauv hauv yuav luag txhua qhov hauv lub cev thiab cov nqaij mos, nrog rau daim tawv nqaij.

Qee cov tsos mob ntawm daim tawv nqaij mob ntshav qab zib yog qhov tshwm sim ncaj qha los ntawm kev hloov pauv hauv lub cev, xws li hyperglycemia thiab hyperlipidemia 4, 7. Muaj kev puas tsuaj rau cov leeg ntshav, cov hlab ntsha lossis lub cev tsis muaj zog tiv thaiv kab mob tseem ua rau muaj kev txhim kho cov tsos mob ntawm daim tawv nqaij. Cov txheej txheem ntawm lwm qhov kev mob ntshav qab zib-txog cov ntshav qab zib tseem tsis tau paub txog 7, 20.

Hyperinsulinemia tuaj yeem tseem tuaj yeem hloov pauv ntawm daim tawv nqaij, raws li tau pom nyob rau thaum ntxov ntawm insulin-resistant hom 2 ntshav qab zib.

Kuj tseem ceeb qhov kev ua kom tawv nqaij hloov pauv ntawm kev mob ntshav qab zib loj dua - thiab microangiopathy. Hauv cov neeg mob ntshav qab zib, muaj qhov nce ntxiv "to" los yog permeability ntawm lub vascular phab ntsa, txo qis vascular reactivity rau kev tiv thaiv sab hauv thiab muaj kev ntxhov siab hypoxemic 4, 43. Hauv kev sib xyaw ua ke nrog arteriosclerosis ntawm cov hlab ntsha loj, cov kab mob microvascular no ua rau muaj qhov mob ntshav qab zib. Tsis tas li ntawd, nrog ntshav qab zib, ib qho kev ploj ntawm daim tawv nqaij sab hauv lub siab tsis hnov ​​qab, uas cov kab mob ua rau kis mob thiab puas tsuaj. Raws li txoj cai, cov tawv nqaij mob ntshav qab zib muaj qhov chaw kawm tau ntev thiab pheej nrog kev tshem tawm ntau zaus thiab nyuaj kho.

Muaj ntau cov kev faib tawm ntawm cov tawv nqaij mob ntshav qab zib, lawv tau ua raws li cov yam ntxwv kuaj mob thiab qee qhov kev tshwm sim ntawm cov kab mob ntawm daim tawv nqaij hloov. Raws li kev faib tawm ntawm Khlebnikova A.N., Marycheva N.V. (2011) zawv zawg tawv nqaij pathology hauv ntshav qab zib tau muab faib ua tsib pawg loj:

1) cov tshuaj tiv thaiv kabmob ntshav qab zib ua rau muaj ntshav qab zib,

2) cov tawv nqaij kab mob cuam tshuam nrog mob ntshav qab zib thiab insulin tsis kam,

3) cov tawv nqaij ua kab mob cuam tshuam nrog mob ntsws,

4) idiopathic ua pob,

5) cov kab mob thiab cov kab mob fungal.

Hauv kev faib tawm tau piav qhia los ntawm Andrea A. Kalus, Andy J. Chien, John E. Olerud (2012), cov kab mob ntshav qab zib los ntawm kev tawv nqaij tau raug cais:

1) cov tawv nqaij ua rau cov ntshav qab zib muaj feem cuam rau cov khoom noj hauv lub cev, vascular, neurological lossis lub cev tiv thaiv kab mob (ntshav qab zib scleredema, mob dub acanthosis, mob ntshav qab zib, ua kom muaj kev sib koom ua ke thiab scleroderma zoo li syndrome, eantive xanthomas, mob tawv nqaij (kab mob, fungal), mob ntshav qab zib),

2) cov kab mob cuam tshuam nrog cov ntshav qab zib, nrog qhov tsis paub meej pathogenesis (lipoid necrobiosis, annular granuloma, ntshav zais zis, ntshav qab zib dermopathy).

Cov kev cais no tsis sib txawv thiab tsuas sib txuam.

Rau cov tshuaj tiv thaiv kab mob ntshav qab zib muaj xws li mob ntshav qab zib sclerodema. Tus mob scleredema muaj ntau dua nrog cov ntshav qab zib mus ntev ntev ua ke nrog kev rog thiab pom los ntawm qhov mob sib txawv hauv cov tawv nqaij hloov feem ntau yog nyob hauv caj dab thiab sab saud peb sab nraub qaum zoo li lub txiv kab ntxwv tev. Raws li ntau tus kws sau ntawv, qhov ntau zaus ntawm nws tshwm sim hauv cov neeg mob ntshav qab zib yog 2.5-14% 28, 25, 50.

Nws tau hais tias lub pathogenesis ntawm ntshav qab zib scleredema muaj nyob rau hauv kev tsim cov khoom tsis raug cai ntawm cov txheej txheem sib txawv ntawm cov lwg me me los ntawm fibroblasts, uas ua rau kom cov tuab ntawm collagen thiab nce ntawm cov glycosaminoglycans (GAG). Cov neeg mob uas muaj ntshav qab zib sclerodema yuav muaj kev poob qis hauv qhov mob thiab lub teeb rhiab hauv thaj tsam ntawm cov tawv nqaij cuam tshuam, nrog rau kev yws ntawm cov teeb meem nyuaj ntawm kev txav ntawm qaum thiab caj dab. Hauv cov xwm txheej huab, tus kab mob tuaj yeem ua rau tag nrho cov kev sib koom ua ke, txawm li cas los xij, qhov pom ntawm scleredema tsis cuam tshuam nrog retinopathy, nephropathy, neuropathy, lossis kev puas tsuaj rau cov hlab ntsha loj 4, 25.

PHOTO 1. Mob ntshav qab zib scleredema

Kev sib txuas nrog insulin tsis kam thiab rog rog tuaj yeem pom hauv acanthosis dub (acantosis nigricans), uas tau tshwm sim hauv thaj chaw ntawm hyperpigmentation ntawm daim tawv nqaij nrog papillomatous kev loj hlob hauv caj dab thiab cov quav loj. Lub luag haujlwm tseem ceeb hauv kev txhim kho acanthosis yog ua si los ntawm insulin. Rau cov poj niam uas muaj mob acanthosis, qhov kev ploj ntawm kev ua haujlwm ntawm cov insulin receptor lossis anti-insulin antibody receptor (hom A thiab type B syndrome) tuaj yeem tshawb pom 18, 31. Nws ntseeg tau tias ntau dhau ntawm kev txhawb nqa ntawm kev loj hlob ntawm daim tawv nqaij ua rau muaj kev cuam tshuam loj heev ntawm keratinocytes thiab fibroblasts, uas ua rau muaj kev txhim kho kev soj ntsuam. kev tshwm sim ntawm dub acanthosis. Nyob rau hauv cov xwm txheej ntawm insulin tsis kam thiab hyperinsulinemia, acanthosis tuaj yeem tsim vim muaj ntau cov kev khi ntawm insulin rau IGF-1 receptors ntawm keratinocytes thiab fibroblasts. Cov ntaub ntawv pov thawj nyob rau hauv dej siab ntawm lub luag haujlwm ntawm ntau yam kev loj hlob hauv lub pathogenesis ntawm acanthosis dub txuas ntxiv mus ntxiv.

PHOTO 2. Dub kev kho mob acanthosis

Cov ntshav qab zib tsis muaj qhov tsis pom thiab hypertriglyceridemia tuaj yeem ua rau xanthomas 46, 8 ntawm daim tawv nqaij. Lawv liab liab-daj papules 1-4 hli qhov loj me, nyob ntawm lub pob tw thiab txuas sab nraud ntawm nqaj. Lub ntsiab lus pathological tshwm sim hauv cov hom nplej thiab lub sijhawm dhau los tuaj yeem sib koom ua ke nrog kev tsim cov quav hniav. Thaum pib, triglycerides predominate nyob rau hauv cov tawv nqaij, tab sis txij li thaum lawv sib sau tau yooj yim dua li cov roj cholesterol, nrog lawv cov hniav lwj, ntau dua thiab ntau dua cov roj uas txhaws nyob hauv daim tawv.

Insulin yog qhov tseem ceeb tswj hwm ntawm LDL kev ua haujlwm. Qib ntawm enzyme deficiency thiab kev ntxuav tom qab ntawm cov ntshiab triglycerides yog sib npaug rau cov ntsuas ntawm insulin deficiency thiab hyperglycemia. Kev tshem tawm ntawm cov ntshav lipoproteins ntshav yog nyob ntawm cov tshuaj insulin kom txaus. Hauv cov ntshav qab zib uas tsis tuaj yeem tswjfwm, xws li qhov tsis muaj peev xwm mus teeb tsa thiab tso cov kua roj chylomicrons thiab lipoproteins ntau ntau uas muaj triglycerides tuaj yeem ua rau nce ntshav plasma triglycerides ntau rau txhiab. Cov mob ntshav qab zib tsis muaj feem tswj tau yog ib qho ua rau muaj cov ntshav ntshav qab zib ntau dua 4, 26, 29.

PHOTO 3 tawg tuaj xanthomas

Cov neeg mob ntshav qab zib yog cov nquag txhim kho daim tawv nqaij kis kab mob, tshwj xeeb yog kev tswj tsis zoo glycemic. Nyob rau ntawm daim tawv nqaij ntawm cov neeg mob ntshav qab zib, 2,5 lub sij hawm muaj cov kab mob me me ntau dua li cov neeg muaj kev noj qab haus huv, thiab cov kev ua kom cov kab mob ntawm daim tawv nqaij hauv cov neeg mob ntshav qab zib tsawg dua li ntawm 20%. Qhov no txo ​​qis ncaj qha cuam tshuam nrog qhov mob hnyav ntawm ntshav qab zib. Cov kab mob sib kis thiab mob feem ntau txhim kho cov tawv nqaij ntawm qhov qis qis hauv kev sib txuas nrog angio thiab neuropathies. Qhov ua rau feem ntau yog kis mob polymicrobial: Staphylococcus aureus, Streptococcus pawg A thiab B, gram-negative aerobic kab mob thiab ntau yam anaerobes. Pyoderma yog sawv cev feem ntau los ntawm folliculitis, ecthyma, erysipelas thiab tuaj yeem cuam tshuam los ntawm eczematization. Ntxiv rau, kev txhim kho ntawm furunculosis, carbuncles, paronychia, cov nqaij mos mos ua mob yog ua tau.

Tawm tsam keeb kwm yav dhau los ntawm cov ntshav qab zib mellitus, pom muaj ntau zaus ntawm cov kab mob fungal tau pom, uas nyob hauv tus qauv ntawm cov kab mob hauv cov neeg mob ntawm pawg no, raws li cov kws sau ntawv sib txawv, yog 32.5 - 45% 14, 9. Hauv cov xwm txheej ntawm hyperkalemia, fungi nquag siv suab thaj rau lawv cov txheej txheem metabolic thiab muab ntau zog, ua rau tus kab mob. Ntawm cov ntshav qab zib mellitus, microcirculation hauv cov hlab ntsha ntawm qhov qis qis yog pom 20 zaug ntau dua li cov neeg uas tsis muaj endocrine pathology, uas ua rau muaj kev txhim kho ntawm fungal kis ntawm taw thiab onychomycosis. Cov kab mob ua rau cov mob fungal yog dermatophytes thiab Candida albicans. Ntxiv mus, nyob rau hauv cov pejxeem ib txwm, cov tawv nqaij ua tawv nqaij ua rau mob los ntawm C. albicans tsis pub tshaj 20%, thaum nyob hauv cov neeg mob somatically li cov ntsuas no nce txog 80 - 90%. Nws yuav tsum raug sau tseg tias 80% ntawm kev tso npe ntawm daim tawv nqaij candidiasis tshwm sim hauv cov neeg mob ntshav qab zib. Feem ntau intertrigo (nrog rau kev puas tsuaj rau axillary, inguinal, interdigital tej qhov chaw), vulvovaginitis, balanitis, paronychia, glossitis thiab angular cheilitis. Ntxiv rau kev soj ntsuam kab mob hauv lub paum, cov kev muaj mob asymptomatic kuj tseem nce ntxiv hauv cov neeg mob ntshav qab zib.

PHOTO 4 Cov kev mob ntsig txog cov qhov loj

Cov kab mob cuam tshuam nrog ntshav qab zib thiab muaj qhov tsis paub meej txog pathogenesis muaj xws li lipoid necrobiosis, annular granuloma, ntshav zais ntshav thiab ntshav qab zib dermopathy.

Lipoid necrobiosis (Oppenheim-Urbach tus kab mob) yog ib qho kev mob ntsws muaj ntau ntawm kev mob vascular-pauv qhov, yog ib tus mob hauv cheeb tsam lipoidosis nrog lipid deposition nyob rau thaj chaw ntawm dermis qhov twg muaj kev ua kom tsis meej los yog muaj kev ua tiav ntawm collagen. Thawj cov tsos mob ntawm tus mob dermatosis feem ntau tshwm sim rau pawg hnub nyoog 20 txog 60 xyoo. Hauv cov menyuam yaus, tus kab mob Oppenheim-Urbach tsis tshua muaj tshwm sim. Kev nquag muaj tshwm sim ntawm lipoid necrobiosis ntawm cov neeg mob ntshav qab zib yog 0.1-3% 38, 6.

Cov duab kab mob hauv Oppenheim-Urbach muaj ntau haiv neeg. Cov txheej txheem yuav koom nrog ntau thaj chaw ntawm daim tawv nqaij, tab sis feem ntau yog daim tawv nqaij ntawm qhov chaw anterior ntawm ob txhais ceg. Qhov no tuaj yeem piav qhia los ntawm qhov tseeb tias nyob rau hauv cov ntshav qab zib, txoj kev hloov kab mob thaum pib tshwm sim hauv cov hlab me me ntawm qhov qis qis. Feem ntau, lipoid necrobiosis tshwm li ib los yog ntau yam qhia kom meej cov xim daj-xim av plaques. Cov ntsiab muaj cov paj yeeb daj tsis xwm yeem uas yauv sawv saum npoo tawv lossis ua denser. Thaum lub sijhawm dhau los, cov ntsiab kab sib dhos thiab thaj chaw nruab nrab daj lossis txiv kab ntxwv ua atrophic; telangiectasias tuaj yeem pom ntau zaus, uas ua rau thaj chaw muaj teeb ci ntawm "ci ntsa iab". Hauv thaj chaw ntawm plaques muaj qhov ploj ntawm qhov rhiab ntawm 44, 2, 42.

PHOTO 5 Lipoid necrobiosis

Generalized annular granuloma hauv 20% ntawm cov neeg mob yog thawj lub cim ntawm ib yam kab mob ntshav qab zib tsis tau kuaj pom zaum 2. Cov kev sib raug zoo ntawm annular granuloma nrog ntshav qab zib tseem yog cov ntsiab lus ntawm kev sib cav, vim nws tuaj yeem cuam tshuam nrog lwm yam kab mob. Kev ib cheeb tsam, dav dav, nrog rau subcutaneous nodular thiab perforating cov ntaub ntawv ntawm cov annul granuloma txuam nrog ntshav qab zib 3, 37, 24 tau pom.

Ib txwm keeb kwm ntawm annular granuloma koom nrog ib lossis ntau dua papules pheej loj ntawm cov khoom plig nrog kev daws teeb meem hauv lub chaw nruab nrab. Lub foci tuaj yeem khaws cov xim ntuj ntawm daim tawv nqaij lossis ua erythematous lossis liab doog. Qhov ntau thiab tsawg cov foci los ntawm 1 mus rau 5 cm inch. Cov nplhaib zoo li pob zeb granuloma, raws li txoj cai, yog asymptomatic, cov tawv nqaij me me khaus khaus yog ua tau, mob foci yog tsawg.

PHOTO 6 Lub nplhaib muaj lub ntsej muag zoo li pob zeb

Ntshav qab zib bullosis yog subepidermal bullous dermatosis uas tshwm sim hauv cov neeg mob ntshav qab zib.

Thawj thawj zaug, ua npuas yog ib qho ntawm cov kev xaiv rau tawv nqaij mob ntshav qab zib tau pom los ntawm D. Kramer nyob rau xyoo 1930. A. Cantwell thiab W. Martz piav qhia tias tus mob ntshav qab zib yog ntshav qab zib 23,11.

Qhov ua kom ntshav mus rau hauv cov neeg mob ntshav qab zib yuav tsis paub meej. Muaj cov theories hais txog lub luag haujlwm ntawm microangiopathy thiab kev cuam tshuam ntawm lub plab hauv lub zos. Mob ntshav qab zib feem ntau tshwm sim rau cov tib neeg uas mob ntshav qab zib mus ntev, qee zaus feem ntau ntawm cov poj niam. Lub hnub nyoog ntawm qhov pib ntawm tus kab mob nyob ntawm 17 txog 79 xyoo.

Cov kua npuas muaj qhov loj los ntawm ob peb millimeters mus rau ob peb centimeters (feem ntau nyob rau ntawm daim tawv nqaij ntawm qhov qis qis) tshwm sim ntawm daim tawv tsis hloov. Ob yam ntawm qhov txhab muaj qhov sib txawv: qhov tso tawm hauv lub ntsej muag uas ploj yam tsis muaj caws pliav, thiab hlwv subepidermal, tom qab ntawd atrophied nti muaj nyob. Cov pob xoo tawm hauv cheeb tsam feem ntau ntawm ko taw thiab txhais ceg, tab sis tuaj yeem tshwm sim ntawm tes thiab caj npab. Ua npuas nthawv daws tom qab 2-5 lub lis piam, rov huam mob tuaj yeem ua tau.

PHOTO 7 Mob khaub thuas muaj npuas

Atrophic tawv hloov ntawm qhov qis qis, los yog "pom pom tob tob," thawj zaug tau piav qhia thiab tau npaj ua lub cim ntshav qab zib hauv xyoo 1964. Tom qab ntawv tsis ntev, Binkley tau sau cov lus hais txog ntshav qab zib "dermopathy" los cuam tshuam cov kev hloov pauv hloov pauv no nrog cov kev rov ua dua tshiab, mob hlwb, thiab neuropathy. Dermicathy mob ntshav qab zib muaj ntau dua rau cov neeg mob uas muaj ntshav qab zib ntev thiab muaj ntau dua rau cov txiv neej 29, 40. Clinically, nws yog qhov me me (tsawg dua 1 cm) atrophic me ntsis los ntawm liab dawb mus rau xim av hauv xim thiab zoo li caws pliav cov ntaub so ntswg uas nyob hauv thaj chaw pretibial. Cov ntsiab lus no muaj kev kawm asymptomatic thiab ploj tom qab 1-2 xyoo, tawm hauv qab me me atrophy lossis hypopigmentation. Qhov rov tshwm sim ntawm cov tshiab hais tias pigmentation thiab atrophy yog cov mob pheej.

PHOTO 8 Mob ntshav qab zib mob taub hau

Kev hloov pauv-endocrine cuam tshuam feem ntau yog qhov ua rau kev txhim kho qee cov tshuaj dermatoses. Qee qhov kev sib raug zoo ntawm cov chav kawm ntawm cov kabmob no thiab qhov pom ntawm endocrinopathy tau sau tseg. Cov kab mob ntshav qab zib raug tshawb pom hauv 19% ntawm cov neeg mob uas muaj tus kab mob lichen planus, hauv qee tus muaj kev hloov pauv hauv kev kuaj ntshav qabzib. Feem ntau, kev puas tsuaj rau cov hnoos qeev ntawm lub qhov ncauj kab mob nrog lichen planus yog ua ke nrog cov ntshav qab zib thiab mob ntshav siab (Potekaev-Grinshpan syndrome), thiab ua pob rau ntawm cov qog ua kua, raws li txoj cai, yog qhov xeb thiab ulcerative hauv qhov. Hauv kev tshawb nrhiav qhov loj los txiav txim txog kev sib raug zoo ntawm tus mob psoriasis thiab kev noj qab haus huv feem ntau, nws tau pom tias cov poj niam uas muaj psoriasis yog 63% feem ntau yuav muaj ntshav qab zib, piv nrog cov neeg mob uas tsis muaj dermatosis no. Tawm tsam cov keeb kwm ntawm ntshav qab zib, psoriasis mob hnyav dua, xws li cov ntawv los ntawm exudative psoriasis, psoriatic polyarthritis, psoriasis ntawm cov quav loj tau pom.

Yog li, qhov hloov pauv ntawm daim tawv nqaij kuj yuav cuam tshuam nrog cov kab ke ua ntsig txog kab mob ntshav qab zib. Cov chaw soj ntsuam thiab pathomorphological ntawm dermatoses thiab dermopathies, ua ntej lossis tsim tawm tsam ntawm cov keeb kwm ntawm ntshav qab zib, yog ua raws li cov metabolism, vascular, neurological thiab lub cev tsis muaj zog.

Cov Neeg Tshuaj Xyuas:

Valeeva F.V., tus kws kho mob ntawm kev kawm tshawb fawb, xib fwb, lub taub hau. chav kawm, endocrinology, tus xibfwb ntawm chav saib xyuas kev kho mob hauv tsev kho mob nrog chav kawm ntawm endocrinology GBOU VPO "Kazan State Medical University ntawm Ministry of Health ntawm Lavxias Federation", Kazan.

Sergeeva I.G., MD, kws tshaj lij ntawm Lub Tsev Haujlwm Saib Xyuas Cov Nyiaj Siv Tshuaj Kho Mob, FSBEI HPE, Novosibirsk National Tshawb Fawb Tebchaws University, Novosibirsk.

Lipoatrophy thiab Lipohypertrophy

Lipoatrophy thiab Lipohypertrophy

Lipohypertrophy yog cov qog muag muag thiab ua pob rau hauv qhov chaw tas li hno lossis txhaws. Vim li cas cov tshuaj insulin thiaj li tsis tseem ceeb? Cov lumps ntawm cov rog thaum lub sijhawm tuaj yeem ua tawv tawv thiab mob, nrog rau txo qis kev ua haujlwm ntawm cov tshuaj insulin. Lipohypertrophy zoo li nyob rau hauv qhov chaw uas cov tshuaj insulin feem ntau txhaj nrog rab koob xaum hluav taws xob los yog siv lub tshuab nqus insulin.

Lipoatrophy, ntawm qhov tsis sib xws, ua rau cov rog poob ntawm qhov chaw ntawm kev hno heev.

Txoj kev tseem ceeb ntawm kev tiv thaiv thiab kev kho mob yog txhawm rau txhaj tshuaj insulin rau hauv ntau qhov chaw ntawm lub cev thiab tsis txhob siv tsuas yog ib sab ntawm lub plab lossis ncej puab. Yog tias txawm li cas los xij ntawm qhov pom ntawm qhov hnoos tau pom, tom qab ntawd nws yuav tsum kom tsis txhob muaj qhov hno hauv qhov chaw ntawm lub cev no rau qee lub sijhawm, thiab nws yuav ploj tom qab ib ntus. Sim kom tsawg li tsib centimeters ntawm cov ntsiab lus ntawm kev txhaj tshuaj. Tsis txhob rov ua qhov kev txhaj tshuaj nyob qhov qub chaw yam tsawg ob lub lis piam. Yog hais tias lipohypertrophy tshwm sim sai ntawm koj lub cev thiab cuam tshuam nrog kev nqus ntawm insulin, thiab lub hnoos qeev loj dhau, nws zoo dua rau kev ua liposuction. Lwm txoj kev kho yuav tsis tuaj yeem ua rau qhov xav tau.

Ntshav Qab Zib Muaj Tshuaj Mob Ntshav Qab Zib

Ntshav qab zib dermopathy yog qhov ntau tshaj ntawm daim tawv nqaij mob ntshav qab zib. Nws tsis muaj mob thiab tsis xav tau kev kho mob.

Ntshav qab zib dermopathy tshwm sim nyob rau hauv hom 1 thiab hom 2 ntshav qab zib vim yog kev puas tsuaj rau cov hlab ntsha tshwm sim los ntawm hyperglycemia. Qhov kev mob tshwm sim hauv cov ntshav qab zib kuj tseem muaj lwm cov kev mob ntshav qab zib, xws li retinopathy thiab nephropathy.

Cov tsos mob yog xim av oval ncuav mog qab zib nrog qhov loj me dua li ntawm ib centimeter uas maj mam pib ua kom exfoliate. Lawv nyob ntawm sab ceg qis, ncej puab thiab forearms.

Dermopathy tsis koom nrog kev noj tshuaj, vim nws tsis muaj kev phom sij. Cov chaw raug mob tsis raug mob, tab sis nws khaus thiab khaus. Hmoov tsis zoo, txawm li cas los xij, qhov no tuaj yeem kav mus ntau xyoo, thiab qhov tsom tau txhab ntxiv, tshwj xeeb tshaj yog kev tswj ntshav qab zib tsis txaus. Cov teeb meem tseem ceeb hauv cov neeg muaj ntshav qab zib ua rau lub siab tawv nqaij yog qhov zoo nkauj ntawm qhov teeb meem.

Acanthosis dub

Acanthosis dub yog daim tawv nqaij tshwm sim los ntawm hyperinsulinism (ntau dhau lawm cov insulin hauv lub cev). Nws tuaj yeem tshwm sim hom ntshav qab zib hom II, tsawg dua nyob hauv hom ib. Raws li qhov tshwm sim, lawv yuav tsim muaj insulin tsis kam thiab rog dhau.

Acanthosis dub yog pob cos xim av lossis xim av-grey hauv cov xim, convex me ntsis. Lawv nyob hauv thaj tsam ntawm daim tawv nqaij, ntawm caj dab, hauv qhov tsos, ncig ntawm puab tais, tso tawm los yog hauv popliteal fossa.

Kev kho mob tseem ceeb yog qhov xav tau kom poob phaus, uas tseem txhim kho qhov tsis hnov ​​mob rau insulin.

Daim tawv nqaij tuag

Nov yog ib qho mob uas tsis tshua pom muaj rau cov neeg laus muaj tus mob ntshav qab zib hom 1. Qee zaum cov tib neeg muaj tus mob ntshav qab zib hom 2 kuj tseem raug cuam tshuam. Daim tawv nqaij tuag yog feem ntau thawj cov tsos mob ntshav qab zib. Qhov laj thawj rau qhov no yog qhov ploj ntawm cov rog hauv qab daim tawv nqaij, tshwm sim los ntawm kev puas tsuaj rau cov hlab ntshav.

Ib qho cim ntawm kev tuag ntawm cov tawv nqaij oily yog xim av lossis daj, zoo ib yam li cov uas tau pom hauv cov neeg mob ntshav qab zib mellitus nrog dermopathy, tab sis lawv muaj ntau dua thiab tsawg dua. Cov hlab ntsha tau pom dua. Cov pob ntawd tawg thiab khaus.

Kev kho mob tseem ceeb rau cov tawv nqaij necrosis yog kho nrog corticosteroids, piv txwv li, txiv ntseej ntoo extract lossis acetylsalicylic acid. Ua ntej tshaj plaws, cov chaw raug mob yuav tsum ua kom zoo los ntawm kev raug mob thiab kis kab mob.

Lub cev granuloma

Lub ntsej muag lub ntsej muag pob zeb pob txha pob yog hom mob tshwm sim rau cov neeg muaj ntshav qab zib. Qhov no yog ib qho mob rov qab tshwm sim thiab maj mam ua zuj zus dermatosis uas tsis paub keeb kwm. Tus kab mob no feem ntau cuam tshuam los ntawm cov neeg mob uas muaj ntshav qab zib hom 1 mob ntshav qab zib, tshwj xeeb tshaj yog cov tub ntxhais hluas hnub nyoog qis dua 15 xyoos, txawm li cas los xij, qee zaus granuloma tuaj yeem cuam tshuam rau cov neeg laus, tsis hais txog hom mob ntshav qab zib

Cov tawv nqaij tawv tawv (tawv nqaij tawv), tawv nqaij uas ib txwm muaj nyob ntawm ob txhais ceg, tab sis kuj tuaj yeem ntes tau lwm qhov ntawm lub cev

Raws li kev kho rau cov kab mob ua ntshav siab, ua kom sov nitrogen thiab tshuaj pleev corticosteroid siv. Nws tseem tuaj yeem siv cov ntawv tshaj tawm kev kho mob los ntawm kev siv tshuaj yeeb yaj kiab thiab kho duab (PUV).

Ntshav qab zib rubeosis

Ntshav qab zib rubeosis feem ntau cuam tshuam rau cov hluas uas muaj ntshav qab zib hom 1. Nws yog tus cwj pwm los ntawm liab ntawm daim tawv nqaij hauv sab plhu thiab puab tsaig, ntawm caj npab thiab txhais ceg. Nws qhov ua rau kev puas tsuaj rau cov ntshav me me nrog kev tswj tsis tau zoo hauv cov neeg mob ntshav qab zib mellitus thiab hyperglycemia.

Mob ntshav qab zib erythema yog tsis kaj siab nyob rau hauv nws tus kheej, tab sis tsis xav tau kev kho mob tshwj xeeb. Koj yuav tsum ua raws li kev noj haus thiab txo cov ntshav qab zib. Qhov no yog qhov ua rau nws tsis txaus siab rau nws.

Vitiligo, Albinism

Vitiligo yog ib yam mob uas tshwm sim rau cov neeg muaj ntshav qab zib hom 2. Cov tsos mob tseem ceeb yog cov pob dawb nyob hauv daim tawv nqaij, uas hauv lawv tus kheej tsis muaj kev phom sij, tab sis tuaj yeem dhau los ua cov teeb meem zoo nkauj rau tus neeg mob. Feem ntau, lawv tshwm sim rau sab nraub qaum, caj npab, ntsej muag thiab txhais ceg.

Yog tias vitiligo twb tshwm sim, hmoov tsis, nws yog qhov nyuaj txaus kom hle nws. Cov pob dawb yog rhiab heev rau lub hnub, yog li nws pom zoo kom tiv thaiv lawv los ntawm kev nphav raug tshav nrog cream. Raws li kev kho mob, kho mob duab ci ua ke nrog tshuaj ntsuab npaj, tshuaj pleev corticosteroid yog tsim nyog.

Cov txheej txheem kom tau tshem ntawm vitiligo tuaj yeem siv sijhawm ntev txog li ib xyoos. Txawm li cas los xij, koj pib kho sai dua, muaj ntau dua kev muaj hmoo.

Kab mob pwm thiab kab mob kis

Cov pwm thiab kab mob cuam tshuam nrog cov ntshav qab zib yog ib qho yooj yim kom tau txais, tab sis nyuaj nyuaj kho. Lawv tshwm sim ntawm lub cev hauv daim ntawv ntawm cev rwj, "barley", pob tw los yog txhaws ntsia hlau. Cov tsos mob tseem ceeb yog liab, nti, khaus, hlwv, thiab lwm yam. Cov kab mob pwm thiab cov kab mob yuav tsum tau siv cov tshuaj tua kab mob thiab tshuaj tiv thaiv kom raug xaiv. Nws tseem raug pom zoo kom sab laj nrog kws kho mob nqaij daim tawv

Mob ko taw

Ib qho piv txwv ntawm cov zawv plab mob ko taw

Mob ko taw mob ko taw yog ib tug kab mob uas tuaj yeem ua rau muaj mob txaus ntshai thiab ua rau txiav tes taw. Mob plab kiav txhab feem ntau tshwm sim nyob rau sab qis ntawm tus taw hauv daim ntawv ntawm cov txheej txheem purulent-necrotic, mob rau sab hauv thiab osteoarticular txhab. Nws yog feem ntau rau ntawm tus taw ntawm cov neeg uas muaj hom 1 thiab ntshav qab zib hom 2.

Txawm li cas los xij, qhov xwm txheej tseem ceeb rau kev kho kab mob ntawm daim tawv nqaij hauv ntshav qab zib thiab rau kev tswj glycemic yog qhov ua tiav ntawm qib tsim nyog ntawm HbA1c.

Yog hais tias muaj teeb meem dermatological, nws zoo dua yog tiv thaiv lawv qhov tshwm sim lossis tswj cov ntshav qab zib ntau dua los kho.