ຂໍ້ມູນເພີ່ມເຕີມ ― Lao

Urticarial vasculitis ເປັນສະພາບທີ່ຫາຍາກທີ່ບົ່ງບອກໄດ້ໂດຍອາການທີ່ຕິດມາດົນນານ ຫຼືເປັນຊ້ຳໆ. ໃນຂະນະທີ່ອາການຂອງຜິວຫນັງຂອງມັນສາມາດຄ້າຍຄືກັບອາການຄັນຊໍາເຮື້ອ, ພວກມັນມີລັກສະນະພິເສດເພາະວ່າອາການຄັນດັ່ງກ່າວຕິດຢູ່ປະມານຢ່າງຫນ້ອຍ 24 ຊົ່ວໂມງແລະສາມາດເຮັດໃຫ້ເກີດຈຸດດ່າງດໍາຫຼັງຈາກຈາງລົງ. ເຖິງວ່າຈະມີສາເຫດທີ່ບໍ່ຮູ້ສາເຫດເລື້ອຍໆ, ບາງຄັ້ງມັນສາມາດຖືກກະຕຸ້ນໂດຍຢາບາງຊະນິດ, ການຕິດເຊື້ອ, ພະຍາດ autoimmune, ຄວາມຜິດປົກກະຕິຂອງເລືອດ, ຫຼືມະເຮັງ. ບາງການສຶກສາຍັງໄດ້ເຊື່ອມໂຍງມັນກັບ COVID-19 ແລະໄຂ້ຫວັດ H1N1. ມັນຍັງສາມາດສົ່ງຜົນກະທົບຕໍ່ພາກສ່ວນອື່ນໆຂອງຮ່າງກາຍເຊັ່ນ: ກ້າມຊີ້ນ, ຫມາກໄຂ່ຫຼັງ, ປອດ, ກະເພາະອາຫານ, ແລະຕາ. ໃນຂະນະທີ່ການກວດເນື້ອເຍື່ອບາງຊະນິດສາມາດຢືນຢັນການບົ່ງມະຕິ, ມັນບໍ່ ຈຳ ເປັນສະ ເໝີ ໄປ. ການປິ່ນປົວໂດຍທົ່ວໄປຈະເລີ່ມຕົ້ນດ້ວຍຢາຕ້ານເຊື້ອ, dapsone, colchicine, ຫຼື hydroxychloroquine ສໍາລັບກໍລະນີທີ່ບໍ່ຮຸນແຮງ. ສໍາລັບກໍລະນີທີ່ຮຸນແຮງກວ່າ, ຢາທີ່ສະກັດກັ້ນລະບົບພູມຕ້ານທານເຊັ່ນ: methotrexate ຫຼື corticosteroids ອາດຈະຕ້ອງການ. ບໍ່ດົນມານີ້, ການປິ່ນປົວດ້ວຍທາງຊີວະວິທະຍາ (rituximab, omalizumab, interleukin-1 inhibitors) ໄດ້ສະແດງໃຫ້ເຫັນຄໍາສັນຍາສໍາລັບກໍລະນີທີ່ຫຍຸ້ງຍາກ.
Urticarial vasculitis is a rare clinicopathologic entity that is characterized by chronic or recurrent episodes of urticarial lesions. Skin findings of this disease can be difficult to distinguish visually from those of chronic idiopathic urticaria but are unique in that individual lesions persist for ≥24 hours and can leave behind dusky hyperpigmentation. This disease is most often idiopathic but has been linked to certain drugs, infections, autoimmune connective disease, myelodysplastic disorders, and malignancies. More recently, some authors have reported associations between urticarial vasculitis and COVID-19, as well as influenza A/H1N1 infection. Urticarial vasculitis can extend systemically as well, most often affecting the musculoskeletal, renal, pulmonary, gastrointestinal, and ocular systems. Features of leukocytoclastic vasculitis seen on histopathologic examination are diagnostic of this disease, but not always seen. In practice, antibiotics, dapsone, colchicine, and hydroxychloroquine are popular first-line therapies, especially for mild cutaneous disease. In more severe cases, immunosuppressives, including methotrexate, mycophenolate mofetil, azathioprine, and cyclosporine, as well as corticosteroids, may be necessary for control. More recently, select biologic therapies, including rituximab, omalizumab, and interleukin-1 inhibitors have shown promise for the treatment of recalcitrant or refractory cases.

ຜູ້ຊາຍອາຍຸ 35 ປີໄດ້ເຂົ້າມາໃນປະຫວັດ 15 ມື້ຂອງສີແດງສົດໃສ, ເຈັບປວດທີ່ຂາແລະຂາ, ພ້ອມກັບຄວາມເຈັບປວດຮ່ວມກັນ. ລາວມີອາການທາງເດີນປັດສະວະເປັນເວລາ ໜຶ່ງ ອາທິດກ່ອນທີ່ຜື່ນຈະປາກົດ. ຜິວໜັງຂອງລາວເປັນຮູບວົງແຫວນທີ່ອ່ອນໂຍນຫຼາຍ, ບາງສ່ວນສາມາດຟອກໄດ້, ມີແຜ່ນສີແດງຢູ່ທັງສອງດ້ານຂອງຂາແລະຂາຂອງລາວ. ລາວໄດ້ຮັບຢາ prednisolone ທາງປາກ (40 ມກ/ມື້) ເປັນເວລາ 1 ອາທິດພ້ອມກັບຢາຕ້ານເຊື້ອທີ່ບໍ່ງ້ວງຊຶມ (fexofenadine) . ພາຍໃນຫນຶ່ງອາທິດ, ຜື່ນທັງຫມົດຫາຍໄປຫມົດ. ບໍ່ມີຕຸ່ມຜື່ນອີກໃນໄລຍະ 6 ເດືອນຕໍ່ໄປຂອງການກວດກາປົກກະຕິ.
A 35-year-old man came in with a 15-day history of bright red, painful rashes on both thighs and legs, along with joint pain. He had a urinary tract infection for a week before the rash appeared. His skin showed several tender, ring-shaped, partially blanchable, red plaques on both sides of his thighs and legs. He was given oral prednisolone (40mg/day) for a week along with a non-drowsy antihistamine (fexofenadine). Within a week, all the rashes disappeared completely. There were no more rashes during the next 6 months of regular check-ups.