Pemphigus vulgaris is usually appearing by 40-60 ages. It is may be begin acute with developing generalized flabby or strained bulls on the invariable of skin (skin of natural folds, scalp and region body) and mucous membrane. Cover of bully rapidly open, contents of bully dry up by serous-hemorrhagic crust. This look fireplaces damage reminds streptococcal pyoderma or microbus eczema. Eruption on the skin there is monomophous characters, present disorderly localize on the skin of the body, extremities and mucous membrane. Bulls may be little and gross there is tend by peripheral grown, confluence between with formation grossly not distinct fireplaces. In consequence of developing acantolise bully even by light damage rapidly open and formation erosion with juicy red base by the peripheral there is scrappy cover of bully. In this period always is positive symptom Nicolskogo not only fireplaces damage as and region look invariable the skin. Essence this phenomena consist by the fall off clinically invariable epidermis by the slide pressure on the surface. Variant symptomís Nicolskogo there is phenomenon Asboe-Hansen Ė increase of bully by pressure on the center pats under heaviness liquids of bully.
Acuteness process by the pemphigus vulgaris redouble rapidly adding secondary infection, which create commonly picture reminds streptococcal and staphylococcal pyoderma.
Characterized peculiarity all form pemphigus there is very slow epithelisation erosion. By peculiar acuteness and maligns process pemphigus vulgaris mark rapidly generalized eruption of the skin, damage of mucous membrane, painfulness commonly condition ill, in consequence of intoxication, edemas and temperature. This process end fatality.
Damage mucous membranes are by much ill there is debut sign and long time there is unique symptoms of diseases.
Cover of bully it is very well removed by spatula and open bright-red erosion. Patient complains of impossible chew, swallow of foot, increase of salivation, deep fissure of angular mouth which not permit open it.
It is possible localized fireplace damage on the mucous membrane throat, nose, larynx, esophagus, stomach, sigmoid and rectum, genital organ, conjunctiva.
Heal up fireplace on the mucous membrane and conjunctiva take place not scaring.
Separation fazes by developing pemphigus.
Firstly fazes characterized relative favorable developing; positive symptomís Nicolscogo only near from fireplace damage.
Secondary characterized generalized of process; symptomís Nicolscogo positive not only near fireplace damage but as on the place look invariable of the skin.
Third fazes characterized epithelisation of erosions in consequence used corticosteroid.
Histological of picture.
More early histological change there is intracellular edema and vanishes between cellular bridges of stratum spinous. In consequence of developing acantolise formation firstly fissure and then bully there is suprabasal localized.
Impotent diagnostic criteria pemphigus there is cellís acantolitica by cytological examine, this method had discovery Tzank of 1948 good van can see by painting of Romanovski-Gimze.
- cells acantolitica smaller normal epitheliocytes but nuclear their more nuclear normal cells;
- nuclear acantolitic cells intensively take up painting;
- into nuclear van can see 2-3 nucleous;
- cytoplasm of cells sharp basophile, painting non even, surround of nuclear light blue zone and by of peripheral Ė intensively blue bordure;
By electron microscope examination jet on the early stages discover dissolve between cells stick together substanz.
Immunomorphological examination with helping straight reaction immunofluorescens by 100% cases may be discovering IgG Ė antibody into cellular between areas. This method is specific and reliable.