{"id":12684,"date":"2023-11-22T21:57:10","date_gmt":"2023-11-22T13:57:10","guid":{"rendered":"https:\/\/docquity.com\/?post_type=articles&p=12684"},"modified":"2025-02-11T13:37:56","modified_gmt":"2025-02-11T05:37:56","slug":"bao-cao-ca-vay-phan-do-nang-long","status":"publish","type":"articles","link":"https:\/\/docquity.com\/vi\/articles\/bao-cao-ca-vay-phan-do-nang-long\/","title":{"rendered":"B\u00c1O C\u00c1O CA: V\u1ea3y ph\u1ea5n \u0111\u1ecf nang l\u00f4ng"},"content":{"rendered":"\n

B\u1ec7nh nh\u00e2n 70 tu\u1ed5i \u0111\u1ebfn ph\u00f2ng kh\u00e1m da li\u1ec5u do b\u1ecb ng\u1ee9a kh\u1eafp c\u01a1 th\u1ec3 \u0111\u00e3 h\u01a1n 2 th\u00e1ng nay. Ban \u0111\u1ea7u b\u1ec7nh nh\u00e2n ch\u1ec9 th\u1ea5y ng\u1ee9a \u1edf v\u00f9ng da \u0111\u1ea7u \u2013 m\u1eb7t, nh\u01b0ng sau \u0111\u00f3 ng\u1ee9a lan ra to\u00e0n b\u1ed9 c\u01a1 th\u1ec3. B\u1ec7nh nh\u00e2n kh\u00f4ng s\u1ed1t, kh\u00f4ng \u0111\u1ed3 m\u1ed3 h\u00f4i tr\u1ed9m, kh\u00f4ng m\u1ec7t m\u1ecfi, kh\u00f4ng s\u1ee5t c\u00e2n, kh\u00f4ng th\u1edf g\u1ea5p, kh\u00f4ng \u0111au ng\u1ef1c, kh\u00f4ng bu\u1ed3n n\u00f4n, n\u00f4n hay ti\u00eau ch\u1ea3y.<\/p>\n\n\n\n

B\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u01b0\u1ee3c k\u00ea thu\u1ed1c n\u00e0o m\u1edbi g\u1ea7n \u0111\u00e2y, b\u1ec7nh nh\u00e2n c\u0169ng kh\u00f4ng d\u00f9ng c\u00e1c ch\u1ebf ph\u1ea9m ch\u1ee9c n\u0103ng n\u00e0o. B\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 ti\u1ec1n s\u1eed b\u1ecb v\u1ea3y n\u1ebfn, vi\u00eam da c\u01a1 \u0111\u1ecba hay c\u00e1c b\u1ec7nh l\u00fd da li\u1ec5u. G\u1ea7n \u0111\u00e2y b\u1ec7nh nh\u00e2n c\u0169ng kh\u00f4ng nhi\u1ec5m virus hay vi khu\u1ea9n.<\/p>\n\n\n\n

T\u1ea1i ph\u00f2ng kh\u00e1m, th\u00e2n nhi\u1ec7t c\u1ee7a b\u1ec7nh nh\u00e2n l\u00e0 37.1\u25e6C, huy\u1ebft \u00e1p 128\/26 mmHg, t\u1ea7n s\u1ed1 tim 110 nh\u1ecbp\/ph\u00fat, t\u1ea7n s\u1ed1 th\u1edf 30 nh\u1ecbp\/ph\u00fat. Th\u0103m kh\u00e1m l\u00e2m s\u00e0ng th\u1ea5y b\u1ec7nh nh\u00e2n c\u00f3 nhi\u1ec1u s\u1ea9n nang l\u00f4ng, h\u1ee3p nh\u1ea5t th\u00e0nh c\u00e1c m\u1ea3ng d\u1ea1ng v\u1ea3y c\u00e1 xung quanh nang l\u00f4ng\/t\u00f3c, c\u00e1c sang th\u01b0\u01a1ng t\u1ea1o th\u00e0nh t\u1eebng m\u1ea3ng, m\u00e0u c\u00e1 h\u1ed3i. C\u00f3 m\u1ed9t s\u1ed1 v\u00f9ng da kh\u00f4ng b\u1ecb \u1ea3nh h\u01b0\u1edfng \u1edf th\u00e2n m\u00ecnh c\u1ee7a b\u1ec7nh nh\u00e2n. V\u00f9ng da \u1edf l\u00f2ng b\u00e0n tay v\u00e0 l\u00f2ng b\u00e0n ch\u00e2n c\u1ee7a b\u1ec7nh nh\u00e2n d\u00e0y, s\u1edd v\u00e0o gi\u1ed1ng nh\u01b0 s\u00e1p, bong tr\u00f3c nh\u01b0 v\u1ea3y c\u00e1 (h\u00ecnh 1). B\u1ec7nh nh\u00e2n c\u00f2n c\u00f3 t\u00ecnh tr\u1ea1ng ly m\u00f3ng. B\u1ec7nh nh\u00e2n b\u1ecb l\u1ed9n m\u00ed m\u1ee9c \u0111\u1ed9 n\u1eb7ng, khi\u1ebfn cho m\u1eaft b\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ec3 \u0111\u00f3ng ho\u00e0n to\u00e0n (h\u00ecnh 1).<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

\"\"H\u00ecnh 1. <\/strong>H\u00ecnh \u1ea3nh l\u00e2m s\u00e0ng c\u1ee7a b\u1ec7nh nh\u00e2n<\/p>\n\n\n\n

B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c chuy\u1ec3n \u0111\u1ebfn khoa c\u1ea5p c\u1ee9u. T\u1ea1i \u0111\u00e2y, b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c l\u00e0m c\u00e1c x\u00e9t nghi\u1ec7m sinh h\u00f3a. K\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m c\u00f4ng th\u1ee9c m\u00e1u to\u00e0n ph\u1ea7n b\u00ecnh th\u01b0\u1eddng, n\u1ed3ng \u0111\u1ed9 lactate dehydrogenase b\u00ecnh th\u01b0\u1eddng. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c l\u00e0m gi\u1ea5y nh\u1eadp vi\u1ec7n v\u00e0 \u0111\u01b0\u1ee3c b\u00f9 d\u1ecbch qua \u0111\u01b0\u1eddng ti\u00eam t\u0129nh m\u1ea1ch, qu\u1ea5n b\u0103ng \u01b0\u1edbt t\u1ea9m thu\u1ed1c m\u1ee1 triamciolone (0.1%) b\u00f4i ngo\u00e0i da \u1edf th\u00e2n m\u00ecnh, c\u00e1nh tay, c\u1eb3ng ch\u00e2n, ti\u1ebfp theo b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c qu\u1ea5n th\u00eam m\u1ed9t l\u1edbp g\u1ea1c \u1ea9m v\u00e0 \u1ea5m. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c m\u1eb7c qu\u1ea7n \u00e1o b\u1eb1ng v\u1ea3i cotton, kh\u00f4 v\u00e0 s\u1ea1ch.<\/p>\n\n\n\n

B\u00c0N LU\u1eacN<\/strong><\/p>\n\n\n\n

M\u1ea5u ch\u1ed1t \u0111\u1ec3 \u0111\u01b0a ra ch\u1ea9n \u0111o\u00e1n \u0111\u00fang l\u00e0 nh\u1eadn \u0111\u1ecbnh \u0111\u01b0\u1ee3c m\u1ea3ng sang th\u01b0\u01a1ng h\u1ec7 th\u1ed1ng, m\u00e0u c\u00e1 h\u1ed3i k\u00e8m nh\u1eefng \u0111\u1ea3o da kh\u00f4ng b\u1ecb t\u1ed5n th\u01b0\u01a1ng. T\u00ecnh tr\u1ea1ng d\u00e0y s\u1eebng l\u00f2ng b\u00e0n tay, b\u00e0n ch\u00e2n, s\u1edd v\u00e0o gi\u1ed1ng s\u00e1p l\u00e0 nh\u1eefng bi\u1ec3u hi\u1ec7n \u0111\u1eb7c tr\u01b0ng c\u1ee7a v\u1ea3y ph\u1ea5n \u0111\u1ecf nang l\u00f4ng. X\u00e9t nghi\u1ec7m t\u1ef1 kh\u00e1ng th\u1ec3 (autoantibody) \u0111\u1eb7c tr\u01b0ng cho vi\u00eam c\u01a1 (l\u1ef1a ch\u1ecdn A), x\u00e9t nghi\u1ec7m anti-dsDNA (l\u1ef1a ch\u1ecdn C) v\u00e0 x\u00e9t nghi\u1ec7m HLA-B27 (l\u1ef1a ch\u1ecdn D) l\u00e0 kh\u00f4ng h\u1ee3p l\u00fd v\u00ec bi\u1ec3u hi\u1ec7n da li\u1ec5u c\u1ee7a b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u1eb7c tr\u01b0ng cho vi\u00eam da c\u01a1, lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng ho\u1eb7c vi\u00eam kh\u1edbp ph\u1ea3n \u1ee9ng1<\/sup>.<\/p>\n\n\n\n

Vi\u00eam da bong v\u1ea3y th\u01b0\u1eddng c\u00f3 bi\u1ec3u hi\u1ec7n ph\u00e1t h\u1ed3ng ban v\u00e0 bong v\u1ea3y tr\u00ean kho\u1ea3ng 90% b\u1ec1 m\u1eb7t c\u1ee7a c\u01a1 th\u1ec32<\/sup>. Vi\u00eam da bong v\u1ea3y l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng da li\u1ec5u c\u1ea5p c\u1ee9u v\u00ec c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn m\u1ea5t d\u1ecbch ghi\u00eam tr\u1ecdng, k\u00e8m theo tho\u00e1t nhi\u1ec7t, t\u1eeb \u0111\u00f3 d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng gi\u1ea3m th\u00e2n nhi\u1ec7t, r\u00e9t run, m\u1ea5t n\u01b0\u1edbc, h\u1ea1 huy\u1ebft \u00e1p v\u00e0 suy tim t\u0103ng cung l\u01b0\u1ee3ng tim3<\/sup>. T\u00ecnh tr\u1ea1ng n\u1ee9t\/t\u1ed5n th\u01b0\u01a1ng tr\u00ean b\u1ec1 m\u1eb7t da c\u0169ng c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 vi\u00eam m\u00f4 t\u1ebf b\u00e0o. Vi\u00eam da bong v\u1ea3y th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn v\u1ea3y n\u1ebfn ho\u1eb7c vi\u00eam da t\u1ef1 mi\u1ec5n nh\u01b0ng c\u0169ng c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf b\u1ec7nh nh\u00e2n nhi\u1ec5m tr\u00f9ng (ch\u1eb3ng h\u1ea1n nh\u01b0 HIV, b\u1ec7nh gh\u1ebb), b\u1ec7nh \u00e1c t\u00ednh (ch\u1eb3ng h\u1ea1n nh\u01b0 u lympho t\u1ebf b\u00e0o T \u1edf da), thu\u1ed1c \u0111i\u1ec1u tr\u1ecb (ch\u1eb3ng h\u1ea1n nh\u01b0 kh\u00e1ng sinh, thu\u1ed1c \u0111i\u1ec1u tr\u1ecb \u0111\u1ed9ng kinh) v\u00e0 b\u1ec7nh da li\u1ec5u b\u1ea9m sinh2<\/sup>.<\/p>\n\n\n\n

V\u1ea3y ph\u1ea5n \u0111\u1ecf nang l\u00f4ng l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd vi\u00eam, hi\u1ebfm g\u1eb7p c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn vi\u00eam da bong v\u1ea3y, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh4<\/sup>. V\u1ea3y ph\u1ea5n \u0111\u1ecf nang l\u00f4ng \u0111\u01b0\u1ee3c ph\u00e2n th\u00e0nh 6 nh\u00f3m ph\u1ee5 v\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng. Trong 6 ph\u00e2n nh\u00f3m n\u00e0y, type 1 (\u0111i\u1ec3n h\u00ecnh \u1edf ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh) l\u00e0 ph\u00e2n nh\u00f3m th\u01b0\u1eddng g\u1eb7p nh\u1ea5t, chi\u1ebfm \u0111\u1ebfn kho\u1ea3ng 55% tr\u01b0\u1eddng h\u1ee3p4, 5<\/sup>. B\u1ec7nh nh\u00e2n v\u1ea3y ph\u1ea5n \u0111\u1ecf nang l\u00f4ng type I c\u00f3 bi\u1ec3u hi\u1ec7n d\u00e0y s\u1eebng l\u00f2ng b\u00e0n tay, b\u00e0n ch\u00e2n (s\u1edd v\u00e0o gi\u1ed1ng s\u00e1p) v\u00e0 xu\u1ea5t hi\u1ec7n t\u1eebng m\u1ea3ng da m\u00e0u c\u00e1 h\u1ed3i, c\u00f3 ranh gi\u1edbi r\u00f5 r\u00e0ng ph\u00e2n bi\u1ec7t v\u1edbi v\u00f9ng da kh\u00f4ng b\u1ecb \u1ea3nh h\u01b0\u1edfng (th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n \u1edf n\u1eeda th\u00e2n tr\u00ean)4, 5<\/sup>. V\u1ea3y ph\u1ea5n \u0111\u1ecf nang l\u00f4ng type I c\u0169ng th\u01b0\u1eddng c\u00f3 bi\u1ec3u hi\u1ec7n thay \u0111\u1ed5i m\u00f3ng, r\u1ee5ng t\u00f3c kh\u00f4ng s\u1eb9o v\u00e0 l\u1ed9n m\u00ed \u0111i k\u00e8m. Nh\u1eefng ph\u00e2n nh\u00f3m kh\u00e1c c\u1ee7a v\u1ea3y ph\u1ea5n \u0111\u1ecf nang l\u00f4ng l\u00e0 type II (kh\u00f4ng \u0111i\u1ec3n h\u00ecnh \u1edf ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh), type III (\u0111i\u1ec3n h\u00ecnh \u1edf b\u1ec7nh nh\u00e2n tr\u1ebb tu\u1ed5i), type IV (h\u1ea1n ch\u1ebf \u1edf b\u1ec7nh nh\u00e2n tr\u1ebb tu\u1ed5i), type V (kh\u00f4ng \u0111i\u1ec3n h\u00ecnh \u1edf b\u1ec7nh nh\u00e2n tr\u1ebb tu\u1ed5i) v\u00e0 type VI (li\u00ean quan \u0111\u1ebfn HIV)4<\/sup>.<\/p>\n\n\n\n

V\u1ea3y ph\u1ea5n \u0111\u1ecf nang l\u00f4ng c\u00f3 th\u1ec3 g\u1eb7p \u1edf c\u1ea3 nam v\u00e0 n\u1eef \u1edf m\u1ecdi l\u1ee9a tu\u1ed5i. \u0110\u1ed1i v\u1edbi tr\u1ebb em, t\u1ef7 l\u1ec7 m\u1eafc cao nh\u1ea5t l\u00e0 \u1edf nh\u00f3m tr\u1ebb t\u1eeb 1 \u2013 10 tu\u1ed5i. \u0110\u1ed1i v\u1edbi ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh, t\u1ef7 l\u1ec7 m\u1eafc cao nh\u1ea5t l\u00e0 50 \u2013 60 tu\u1ed5i. M\u1eb7c d\u00f9 sinh b\u1ec7nh h\u1ecdc c\u1ee7a v\u1ea3y ph\u1ea5n \u0111\u1ecf nang l\u00f4ng v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh, nh\u01b0ng m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p x\u1ea3y ra do nhi\u1ec5m khu\u1ea9n ho\u1eb7c nhi\u1ec5m virus. M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n v\u1ea3y ph\u1ea5n \u0111\u1ecf nang l\u00f4ng type V c\u00f3 bi\u1ebfn th\u1ec3 di truy\u1ec1n tr\u00ean CARD14, l\u00e0 y\u1ebfu t\u1ed1 k\u00edch ho\u1ea1t c\u1ee7a \u0111\u01b0\u1eddng truy\u1ec1n t\u00edn hi\u1ec7u li\u00ean quan \u0111\u1ebfn qu\u00e1 tr\u00ecnh vi\u00eam4, 5<\/sup>.<\/p>\n\n\n\n

Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1ea3y ph\u1ea5n \u0111\u1ecf nang l\u00f4ng bao g\u1ed3m v\u1ea3y n\u1ebfn, vi\u00eam da t\u1ef1 mi\u1ec5n, u lympho t\u1ebf b\u00e0o T \u1edf da, ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn to\u00e0n th\u00e2n, immunobullous diseases, b\u1ec7nh da v\u1ea3y c\u00e1, b\u1ec7nh \u0111\u1ecf da \u2013 d\u00e0y s\u1eebng (erythrokeratoderma variabilis). Ch\u1ea9n \u0111o\u00e1n v\u1ea3y ph\u1ea5n \u0111\u1ecf nang l\u00f4ng \u0111\u01b0\u1ee3c \u0111\u01b0a ra d\u1ef1a tr\u00ean nh\u1eefng bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng, \u0111\u1eb7c \u0111i\u1ec3m m\u00f4 b\u1ec7nh h\u1ecdc qua sinh thi\u1ebft da. X\u00e9t nghi\u1ec7m ph\u00e2n t\u00edch d\u00f2ng t\u1ebf b\u00e0o T n\u00ean \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh \u1edf b\u1ec7nh nh\u00e2n vi\u00eam da bong v\u1ea3y c\u00f3 bi\u1ec3u hi\u1ec7n l\u1ed9n m\u00ed v\u00e0\/ho\u1eb7c d\u00e0y s\u1eebng l\u00f2ng b\u00e0n tay, b\u00e0n ch\u00e2n \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 h\u1ed9i ch\u1ee9ng S\u00e9zary1<\/sup>.<\/p>\n\n\n\n

M\u1eb7c d\u00f9 ch\u01b0a c\u00f3 h\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb d\u1ef1a tr\u00ean b\u1eb1ng ch\u1ee9ng \u0111\u1ec3 ki\u1ec3m so\u00e1t b\u1ec7nh nh\u00e2n v\u1ea3y ph\u1ea5n \u0111\u1ecf nang l\u00f4ng, \u0111i\u1ec1u tr\u1ecb n\u00ean bao g\u1ed3m corticosteroid \u0111\u01b0\u1eddng b\u00f4i ngo\u00e0i da, methotrexate, retinoid h\u1ec7 th\u1ed1ng, quang tr\u1ecb li\u1ec7u v\u00e0 cyclosprine4 \u2013 6<\/sup>. V\u1ea3y ph\u1ea5n \u0111\u1ecf nang l\u00f4ng \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o c\u00f3 c\u1ea3i thi\u1ec7n khi \u0111i\u1ec1u tr\u1ecb v\u1edbi c\u00e1c li\u1ec7u ph\u00e1p sinh h\u1ecdc (ch\u1eb3ng h\u1ea1n nh\u01b0 ch\u1ea5t \u1ee9c ch\u1ebf y\u1ebfu t\u1ed1 ho\u1ea1i t\u1eed kh\u1ed1i u \u2013 TNF v\u00e0 anti-IL-17 ho\u1eb7c anti-IL-12\/IL-23) \u1edf m\u1ed9t s\u1ed1 b\u00e1o c\u00e1o ca v\u00e0 chu\u1ed7i b\u00e1o c\u00e1o ca nh\u1ecf7 \u2013 9<\/sup>.<\/p>\n\n\n\n

K\u1ebeT C\u1ee4C \u2013 THEO D\u00d5I<\/strong><\/p>\n\n\n\n

Sinh thi\u1ebft m\u1eabu da \u1edf l\u01b0ng c\u1ee7a b\u1ec7nh nh\u00e2n cho th\u1ea5y t\u00ecnh tr\u1ea1ng d\u00e0y l\u1edbp t\u1ebf b\u00e0o gai, d\u00e0y l\u1edbp h\u1ea1t th\u01b0\u1ee3ng b\u00ec v\u00e0 d\u00e0y l\u1edbp keratin. X\u00e9t nghi\u1ec7m \u0111\u00e1nh gi\u00e1 d\u00f2ng t\u1ebf b\u00e0o T kh\u00f4ng th\u1ea5y nh\u1eefng \u0111\u1eb7c tr\u01b0ng c\u1ee7a h\u1ed9i ch\u1ee9ng S\u00e9zary. K\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m HIV c\u0169ng \u00e2m t\u00ednh.<\/p>\n\n\n\n

Khi n\u1eb1m vi\u1ec7n, b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng acitretin 50 mg\/ng\u00e0y, methotrexate 25 mg\/tu\u1ea7n, infliximab 10 mg\/kg\/4 tu\u1ea7n v\u00e0 thu\u1ed1c m\u1ee1 triamciolone 0.1% b\u00f4i ngo\u00e0i da. S\u00e1u th\u00e1ng sau, t\u00ecnh tr\u1ea1ng vi\u00eam da bong v\u1ea3y c\u1ee7a b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt t\u1ea1o h\u00ecnh m\u1eaft cho t\u00ecnh tr\u1ea1ng l\u1ed9n m\u00ed. V\u00e0o l\u1ea7n th\u0103m kh\u00e1m g\u1ea7n nh\u1ea5t (3 n\u0103m k\u1ec3 t\u1eeb ng\u00e0y nh\u1eadp vi\u1ec7n), b\u1ec7nh nh\u00e2n v\u1eabn \u0111ang \u0111i\u1ec1u tr\u1ecb b\u1eb1ng infliximab 5 mg\/kg\/6 tu\u1ea7n v\u00e0 methotrexate 12.5 mg\/tu\u1ea7n. \u1ede l\u1ea7n th\u0103m kh\u00e1m n\u00e0y, k\u1ebft qu\u1ea3 x\u1ebft nghi\u1ec7m da li\u1ec5u c\u1ee7a b\u1ec7nh nh\u00e2n \u0111\u00e3 tr\u1edf l\u1ea1i b\u00ecnh th\u01b0\u1eddng.<\/p>\n\n\n\n

\n\n\n\n

T\u00c0I LI\u1ec6U THAM KH\u1ea2O<\/strong><\/p>\n\n\n\n

    \n
  1. Shaw KS, Sanchez-Melendez S, Vleugels RA. Diffuse Cutaneous Eruption. JAMA. 2023;329(24):2187\u20132188. doi:10.1001\/jama.2023.7322<\/li>\n\n\n\n
  2. Tso S, Satchwell F, Moiz H, et al. Erythroderma (exfoliative dermatitis), part 1: underlying causes, clinical presentation and pathogenesis. Clin Exp Dermatol. 2021;46(6):1001-1010. doi:10.1111\/ced.14625<\/li>\n\n\n\n
  3. Tso S, Moiz, Satchwell F, et al. Erythroderma (exfoliative dermatitis), part 2: energy homeostasis and dietetic management strategies. Clin Exp Dermatol. 2021;46(6):1011-1015. doi:10.1111\/ced.14667<\/li>\n\n\n\n
  4. Roenneberg S, Biedermann T. Pityriasis rubra pilaris: algorithms for diagnosis and treatment. J Eur Acad Dermatol Venereol. 2018;32(6):889-898. doi:10.1111\/jdv.14761.<\/li>\n\n\n\n
  5. Wang D, Chong VC, Chong WS, Oon HH. A review on pityriasis rubra pilaris. Am J Clin Dermatol. 2018;19(3):377-390. doi:10.1007\/s40257-017-0338-1PubMedGoogle ScholarCrossref 5. Pityriasis rubra pilaris. National Institutes of Health. Accessed March 29, 2023.<\/li>\n\n\n\n
  6. Ringin SA, Daniel BS. Treatment modalities for pityriasis rubra pilaris subtypes: a review. J Dermatolog Treat. 2022;33(1):587-588. doi:10.1080\/09546634.2020.1729954<\/li>\n\n\n\n
  7. Feldmeyer L, Mylonas A, Demaria O, et al. Interleukin 23-helper T cell 17 axis as a treatment target for pityriasis rubra pilaris. JAMA Dermatol. 2017;153(4):304-308. doi:10.1001\/jamadermatol.2016.5384.<\/li>\n\n\n\n
  8. Maloney NJ, Hisaw LD, Worswick S. Type I pityriasis rubra pilaris treated with tumor necrosis factor inhibitors, ustekinumab, or secukinumab: a review. J Am Acad Dermatol. 2018;79(3):585-587. doi:10.1016\/j.jaad.2018.02.063.<\/li>\n\n\n\n
  9. Napolitano M, Abeni D, Didona B. Biologics for pityriasis rubra pilaris treatment: a review of the literature. J Am Acad Dermatol. 2018;79(2):353-359. doi:10.1016\/j.jaad.2018.03.036<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    B\u1ec7nh nh\u00e2n 70 tu\u1ed5i \u0111\u1ebfn ph\u00f2ng kh\u00e1m da li\u1ec5u do b\u1ecb ng\u1ee9a kh\u1eafp c\u01a1 th\u1ec3 \u0111\u00e3 h\u01a1n 2 th\u00e1ng nay. Ban \u0111\u1ea7u b\u1ec7nh nh\u00e2n ch\u1ec9 th\u1ea5y ng\u1ee9a \u1edf v\u00f9ng da \u0111\u1ea7u \u2013 m\u1eb7t, nh\u01b0ng sau \u0111\u00f3 ng\u1ee9a lan ra to\u00e0n b\u1ed9 c\u01a1 th\u1ec3. B\u1ec7nh nh\u00e2n kh\u00f4ng s\u1ed1t, kh\u00f4ng \u0111\u1ed3 m\u1ed3 h\u00f4i tr\u1ed9m, kh\u00f4ng m\u1ec7t m\u1ecfi, …<\/p>\n

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