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16 dbw

Ykgi|dw fi `ygbwd

b|dk x bgykd|

D`pbkkdw vimwdw phik

Wimwdghm fi d|fb|

Fi|`dvbkbad H_W

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Ni`ba|d`d3 dmi`hd+ kiygbpimhd

_i|ehk nipvhgb3 mb|`dk

_i|ehk khpfhgb3 mb|`dk

_i|ehk |imdk3 mb|`dk

Kd|hmabwgbphd3 ehl|bwhw fi gyi|fdw ubgdkiw

Gbkbmbwgbpd3 mb eyi pbwhlki pb| iwvimbwhw dmdk

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_imehabhfi fi `i`l|dmdw `ygbwdw

HaA x G7

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D- _imehab uykad|

L- _imehab pd|dmibpkwhgb

G- _imehabhfi fi kdw `i`l|dmdw `ygbwdwF- _imehabhfi fi kdw `i`l|dmdw ygbwdw pd|dmibpkwhg

I- Imei|`ifdf Ha D khmidk fik dfykvb

E- Whmf|b`i fi Ligniv

A- whmf|b`i fi \ihvi|

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Ha A** x G7**

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Fiw|fimiw d`pbkkd|iw

wyliphvikhdkiw hm`ymb`ifhdfbw

.h``ymi- `ifhdvif wylipvnhvikhdklkhwvi|hma fhwidwiw( H@WILF

pimehabfi d`pbkkd|

_imehabhfi fi kdw `i`l|dmdw `ygbwdw

fi|`dvbwhw HaD khmidk

fi|`dvbwhw d`pbkkd| g|mhgd fi kd hmedmghd

fi|`dvhvhw ni|pivheb|`i

iphfi|`khwhw d`pbkkd| dftyh|hfd

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Nhwvb|hd

4186 Qhgn`dmm3 pmehab lygdk x bgykd| 4>91 Gbbpi|3 ~i|bwhw gbmcymvhudk

4>18 Udm A|diei3 iwv|ignd`himvb iwimghdk gbmcymvhudk

4>>> @b||hw x \bli|vw3 pmehab fi `ygbwdw gbmvimfimghd whmityhdmvi x fi e|dgdwb vi|dpyvhgb

4>85 Vnbwv 3 pmehab g|mhgb fi kdw `i`l|dmdw

`ygbwdw

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Nhwvb|hd

4844 Vnbwv3 gd|dgvi|wvhgdw `w h`pb|vdmviw

4868 Ghudvvi3 fhei|imghdw nhwvbkahgdw imv|i pmehab x

pimehabhfi

4894 Qdkvi| Kiui|3 pimehabhfi limhamb fi kdw `ygbwdw

4891 L|ymwvhma x _i||x3 1 dmghdmbw gbm d`pbkkdwwyliphf|`hgdw |igy||imviw x ghgdv|hsdkiw wbl|i pkdgdw

fi fhwv|hlyghm ni|pivheb|`i+ im gdlisd x gyikkb+

whm gb`p|b`hwb `ygbwb+ `dxb|d ud|bmiw3

pimehabhfi ghgdv|hsdk .`ygbwb(

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Nhwvb|hd

4887 Cbkx3 pimehabhfi ghgdv|hsdk b `ygbwb3 p|bldlkieb|`d kbgdkhsdfd fi iphfi|`khwhw d`pbkkd| dftyh|hfd

4891 Cdlkbmwjd3 pimehabhfi fi kdw `ygbwdw

489> Kbvd|v x Cdgbl3 kbgdkhsdghm gyvmid mb |d|d+limhamhfdf |ikdvhud .giayi|d x whmityhdw(

fi|`dvhvhw d`pbkkd| `ygbwhmityhdmvi dv|behdmvi

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Nhwvb|hd

4888 Gnhgdab- Hkkhmbhw- YWD+ Gndma+ Dmndkv

_|h`i| Gbmwimwb Hmvi|mdghbmdk fi _imehabhfi fi kdw

@i`l|dmdw @ygbwdw

fiehmi kd vbpba|ded fb`hmdmvi

gb`p|b`hwb wbl|i gydktyhi| `i`l|dmd `ygbwd

gkmhgd+ `vbfb fhdamwvhgb+ g|hvi|hbw vi|dpyvhgbw

Wyp|h`hfb v|`hmb pimehabhfi ghgdv|hsdk pb|tyi ndx

pdghimviw tyi mb fiwd||bkkdm ghgdv|hgiw+ gb`b im dkaymbgdwbw fi deigghm lygdk whm wigyikdw

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Nhwvb|hd

Hmdp|bphdfb ik gdkhehgdvhub fi limhamb3 giayi|d+iwvimbwhw kd|maid x iwbeahgd+

_mehabhfi ghgdv|hsdk fi L|ymwvhma- _i||x3 iw i~gkyhfb: mb

p|iwimvd kiwhbmiw b|dkiw Wyw wigyikdw x ghgdv|hgiw+ wbkb

deigvdm phik gdlikkyfd x gyikkb

Ahmahuhvhw fiwgd`dvhud3 fiwg|hvd im 4>86

487

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_imehabhfi fi kdw `ygbwdw

a|ypb nivi|bamib fi imei|`ifdfiw d`pbkkd|iwwyliphvikhdkiw+ hmekd`dvb|hdw+ dyvbhm`ymiw+|iwbkyvhudw+ ghgdv|sdkiw x g|mhgdw

deigvdm ymd `ygbwd .kbgdkhsdfb(

ud|hdw ygbwdw .aimi|dkhsdfb(

`ygbwdw lygdk+ bgykd|+ mdwdk+ ed|maid+ kd|maid+iwbeahgd x dmbaimhvdk

im dkaymbw gdwbw+ whm pd|vhghpdghm fi phik

gbm gb`p|b`hwb gyvmib im ym 7?) fi ikkbw

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_imehabhfi fi kdw `ygbwdw

fipwhvbw khmidkiw fi dyvbdmvhgyi|pbw HaA+ HaD+ b fi

d`lbw i Ha@ x G7 im `i`l|dmd ldwdk3 im kd ymhm

iphvikhb- wyliphvikhb

pimehabhfi ghgdv|hsdk+ pimehabhfi limhamb fi kdw

`ygbwdw+ pimehabhfi b|dk+ ahmahuhvhw fiwgd`dvhud+

pimehabhfi ghgdv|hsdk bgykd| b fi|`dvhvhw d`pbkkd|

`ygbwhmityhdmvi x dv|behdmvi fi Kbvd|v x Cdgbl

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_imehabhfi fi kdw `ygbwdw

Imei|`ifdf uiwhgbd`pbkkd| |d|d+ g|mhgd+ gbm

p|ifhkigghm pb|`i`l|dmdw `ygbwdw3 b|dk xbgykd|Vimfimghd d ficd| ghgdv|hgiw

9-5 fgdfd

L_4>? .G-vi|`hmdk(Iphkha|hmd3 4?)Kd`hmhmd 9

Dg gbmv|d 73 im vbfbw kbw pdghimviw Dg gbmv|d 73 pbgbw Dg gbmv|d 73 `yx pbgbw

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SBMD FI KD YMHM FI\@B-I_HF\@HGD

Tyi|dvhmbghvb ldwdk Tyi|dvhmbghvb ldwdk

Fiw`bwb`d

Ni`hfiw`bwb`d Ni`hfiw`bwb`d

K`hmd kghfd

K`hmd fimwd

gbkaimb vhpb HU

Ehl|hkkdw fi dmgkdci. gbkaimb vhpb UHH(

_kdgd fi dmgkdci

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Ehkd`imvbw hmvi|`ifhbw_kigvhmd

_kdgd hmvi|mdL_

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Dmvaimbw lkdmgb hfimvhehgdfbw im _@Gbmbghfbw3

Dmvaimb fik pimehabhfi d`pbkkd| 4 .L_?+ Gbkaimb vhpb ^UHH(

Kd`hmhmd 9 .gdfimdw 77 x Jf

_|bvimd iphvikhdk fi 4

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Dmvaimbw lkdmgb x wyw hmvi|dgghbmiw

`bkigykd|iw . 4 (

L_ 4>?3 hmvia|hmd 56

L_?

gbkaimb UHH

Kd`hmhmd 53 kd`hmhmd 9

lk h h

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Dmvaimbw lkdmgb x wyw hmvi|dgghbmiw

`bkigykd|iw .? .MG 45D(

kd`hmhmd 9

Hmvia|hmd 63 hmvia|hmd 5

L_4>?

pkigvhmd

kd`hmhmd 9

Gbkaimb UHH3 kd`hmhmd 9

gbkaimb vhpb HU

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Wyla|ypbw pb| hm`ymbnhwvbty`hgd

4- Dmvhiphkha|hmd .kd`hmhmd 9(

Kbw Dg HaA wi ymim dk kdfb f|`hgb fy|dmvi ik wpkhv

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Gd|dgvi|wvhgdw

@yci|iw- 9? d 1? dbw

Lbgd3 >? d 4?? )- Imgd3 5? )

Bcbw3 9? d 5?)

_hik .gdlisd x gyikkb(3

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kiwhbmp|h`d|hd3d`pbkkd

|ypvy|d

i|bwhmb ykgi|d

gy|dghm

ghgdv|hs

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`ygbwd b|dk .>9)(

gbmcymvhud .56)(

phik .)(

dmb .6)(

iwedab .6)(

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Ehay|i 45 Limham `ygbyw `i`l|dmi pi`pnhabhf

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Ehay|i 45 Limham `ygbyw `i`l|dmi pi`pnhabhf

Kyifvji _ iv dk \dfhba|dpnhgw

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imgd .56)(

`ygbwd xyadk .9>)(

pdkdfd| .

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i|hvi`d x ifi`d ahmahudk kiuiw ndwvd eb|`dghm fi

d`pbkkdw+ i|bwhbmiw x kgi|dw

`dw e|igyimvi3 ahmahuhvhw fiwgd`dvhud b i|bwhud

@buhkhfdf fimvdk3 @DK _\BMBWVHGB

|ipd|dghm `yx kimvd+ vimfimghd d eb|`dghm fi

ghgdv|hgiw+ ehl|bwhw x whmityhdw

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Ahmavhuhvhw fiwgd`dvhud

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Ahmavhuhvhw fiwgd`dvhud_|hms 487

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gbmcymvhuhvhw g|mhgd3 tyi`dsm+h||hvdghm+ kda|h`ib xeb|`dghm fi `ygbwhfdf

dkvi|mdmghd im i~dgi|ldghm x |i`hwhm

p|ba|iwhm d ehl|bwhw gbmcymvhudk wyliphvikhdk

wh`lked|bm .dfni|imghdw(+ |ifygghm fik e|mh~ hmei|hb|

p|pdfb wi dfnhi|i d akblb bgykd| x kb ehcd

blkhvi|dghm fi wdgb gbmcymvhudk3 dmtyhkblked|bm

v|htyhdwhw .b|himvdghm dmb|`dk fi kdw piwvddw(

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imv|bphm

hmekd`dghm x ehl|bwhw kkiudm d fiwv|ygghm

fi gbmfygvbw x akmfykdw kda|h`dkiw+ gbm ~i|bwhw+

x kgi|dw gb|midmdw pb| v|dy`dw pityibw akblb bgykd| i~pyiwvb pb| h`pbwhlhkhfdf fi `buhkhsd| kbw

p|pdfbw

bpdghfdfiw gb|midmdw pb| gb|mhehgdghm fik iphvikhbwypi|ehghdk eb|`dghm fi vichfb fi a|dmykdghm .pdmmywgb|midmb( gbm giayi|d im

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Wyla|ypbw gkmhgbw

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Wyla|ypbw gkmhgbw

4 _imehabhfi `ygbwb gbm Dg dmvh-kd`hmhmd-9 .dmvh-iphkha|hmd(3

d`pbkkdw x ghgdv|hgiw im `ygbwdw b|dk x bgykd|+ d uigiw iw pd|dmibpkwhgb

7/23/2019 Penfigoide de las membranas mucosas

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_HIK WI_D\DFD GBM GkMd 4 @bkd|

Gkykd ldwdk

.L_Da4+ L_Da

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Bevdk`kbab

B\K

Fi|`dvkbab

Y|kbab

Adwv|bimvi|kbab

_|bgvkbab

Iwvb`dvkbab

V v h v f k _@@

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V|dvd`himvb fik _@@

Im ldwi d kbw whvhbw fi gb`p|b`hwb dmdv`hgb

_dghimviw fi ldcb |hiwab3 gbm wbkb deigvdghm fi

`ygbwd b|dk b gbm kiwhbmiw b|dkiw x im phik

_dghimviw fi dkvb |hiwab3 pd|vhghpdghm fi `ygbwd

bgykd|+ aimhvdk+ mdwbed|maid+ iwbeahgd+ dmdk x"bkd|maid

Gndm KW+ Dn`if D\+ Dmndkv AC+ iv dk _|h`i| gbmwimwb hmvi|mdghbmdk wbl|i pimehabhfi

fi kdw `ygbwdw3 g|hvi|hbw fi fiehmhghm+ fhdamwvhgb+ edgvb|iw pdvaimbw+ v|dvd`himvb

`fhgb i hmfhgdfb|iw fi p|bmwvhgb D|gn Fi|`dvbk

7/23/2019 Penfigoide de las membranas mucosas

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fi ldcb |hiwabImei|`ifdf b|dk kh`hvdfd whm p|ba|iwhm |phfd3

Vi|dphd vphgd gb`b gbdfxyudmvi b `bmbvi|dphd3 iwvi|bhfiw vphgbw

ghgkbwpb|hmd

vdg|bkh`ywIhwim F+ Ikkhw GM+ Ubb|niiw CC Vbphgdk gxgkbwpb|hmi eb| b|dk lykkbyw fhwb|fi|w C D`Dgdf Fi|`dvbk 488?:

7/23/2019 Penfigoide de las membranas mucosas

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Dmviw Fiwpyw

V|dvd`himvb fi _@@

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fi ldcb |hiwabImei|`ifdf kiui whm p|ba|iwhm |phfd + gbm `mh`d

b mykd |iwpyiwvd d vi|dphd vphgd3

Fdpwbmd3 hmhghd| gbm

7/23/2019 Penfigoide de las membranas mucosas

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Dmviw Fiwpyw

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Dmviw Fiwpyw

V|dvd`himvb fi _@@

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fi dkvb |hiwab

Mykd |iwpyiwvd d FFW+ imei|`ifdf wiui|d b gbm |phfd

_|ba|iwhm d bv|dw `ygbwdw3

_|ifmhwbmd3 4 d 49 `a"ja"fd+ ud|hbw `iwiw

Wypki`imvbw fi gdkghb+ uhvd`hmd F cymvb gbm

lhebwebmdvbw

D kd |i`hwhm gkmhgd+ |ifygh| a|dfydk`imvi fbwhw

@dmvimh`himvb3 fbw dbw dp|b~h`dfd`imvi

V|dvd`himvb fi _@@

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fi dkvb |hiwab

Edkvd fi `d|gdfd `icb|d im 7 `iwiw fi gb|vhgbhfiw bdeigghm d whvhb fi dkvb |hiwab+ .wypi|ehghi bgykd|(3

Dsdvhbp|hmd+ `ivbv|i~dvb b ghgkbebwed`hfd ub

\iuhwd| fehghv akygbwd-5-ebwedvb+Iudkyd| |hiwab fi ni`khwhw pb| dmi`hd ni`bkvhgd+

`ivdni`bakblhmi`hd y bv|bw ieigvbw wigymfd|hbw

hfhbwhmg|vhgbw gb`b da|dmykbghvbwhw+ nipdvhvhw b wmf|b`i

fi nhpi|wimwhlhkhfdf d FFW

V|dvd`himvb fi _@@

f k h

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fi dkvb |hiwab

Imei|`ifdf wiui|d+ b gbm |phfd p|ba|iwhm3

Ghgkbebwed`hfd3 hmhghd| cymvb gbm iwvi|bhfiw whwv`hgbw

4 d

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fi dkvb |hiwab Dsdvhbp|hmd3 dmkbab fi py|hmd dgvhub tyi wi hmgb|pb|d d

DFM x D\M gbm gbmwhayhimvi hmnhlhghm fik `ivdlbkhw`b py|hmdw x fhuhwhm gikykd|

Fbwhw3 4 d 6 `a " ja " fd+ fipimfhimfb fik mhuik fi

vhbpy|hmd `ivhkv|dmwei|dwd Ieigvbw dfui|wbw a|duiw3 kiygbpimhd+ pdmghvbpimhd+

hmeigghbmiw+ vy`b|iw `dkhambw x wmf|b`i fi

nhpi|wimwhlhkhfdf

Wiayh`himvb3 ni`ba|d`d gb`pkivb x eymghm nipvhgd

V|dvd`himvb fi _@@

f kv h

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fi dkvb |hiwab @ivbv|i~dvb3 Wbkhvd|hb im vi|dphd fi @@_ bgykd|

Fbwhw3 9 d 8) fi pdghimviw gbm @@

x 4??) gbm @@_ d f|badw

Ieigvbw dfui|wbw a|duiw3 nipdvbvb~hghfdf .ehl|bwhw nipvhggh||bwhw(+ miy`bmhvhw dayfd hfhbwhmg|whgd+ ehl|bwhw pyk`bmd

pdmghvbpimhd+ x vy`b|iw `dkhambw

Gbmv|bk3 ni`ba|d`d gb`pkivb+ p|yildw |imdkiw+ fi eymgh

nipvhgd Lhbpwhd nipvhgd fiwpyw fi ymd fbwhw dgy`ykdvhufi 4+9 d 7 a|d`bw

V|dvd`himvb fi _@@

f kv h

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fi dkvb |hiwab @hgbeimbkdvb `beivhkb3 hmnhli fiwnhf|baimdwd hmbwhmd

`bmbebwedvb+ gbm lkbtyib fi wmviwhw fi mbub fi py|hmdwV|dfyghfb gb`b hmnhlhghm fi |iwpyiwvd p|bkhei|dvhud fi

gkykdw L x V

Fbwhw3 4??? d

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fi dkvb |hiwab HA HU3 lkbtyid |igipvb|iw Eg+ dkvi|d p|bfygghm x dmvdabmhw`b

ghvbtyhmdw+ hmnhli gb`pki`imvb x miyv|dkhsd dyvbdmvhgyi|pbwgh|gykdmviw

Fbwhw3 < d 7 a"ja" 7 d 9 fdw"7 d 6 wi`dmdw

\idgghm d kd hmeywhm3 i|hvi`d+ giedkid+ iwgdkbe|bw+ mywidw+

vdtyhgd|fhd+ nhpbvimwhm x whlhkdmghdw Yvhkiw dmvhnhwvd`mhgbw+pd|dgivd`bk b iwvi|bhfiw pb| ud hmv|duimbwd

Bv|bw ieigvbw dfui|wbw3 dmdehkd~hw+ gbdaykdghm hmv|dudwgykd|

fhwi`hmdfd+ v|b`lbwhw i hmwyehghimghd |imdk dayfd

Ni`ba|d`d gb`pkivb+ p|yildw |imdkiw+ eymghm nipvhgd+ pdmi

fi nipdvhvhw+ UHN+ HaD+ E\ x g|hbakblykhmdw

Bv|dw vi|dphdw fi _@@

fi dkvb |hiwab

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fi dkvb |hiwab

Daimviw dmvhedgvb| fi mig|bwhw vy`b|dk 3

Ivdmi|gipv i Hmekh~h`dl Fdgkhsy`dl+ dmvdabmhwvd fik |igipvb| fi hmvi|kiyghmd-< 3

`bmbvi|dphd fik _@@ bgykd|

\hvy~h`dl3 dmvh-GF

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imei|`ifdf bgykd|

Gb`pki`imvd|hd d vi|dphd whwv`hgd

Gb|vhgbwvi|bhfiw vphgbw x wylgbmcymvhudkiw3pdkhd| wmvb`dw

Mb iehgdgiw pd|d fivimi| p|ba|iwhm fi kd imei|`ifdf

Hmnhlhfb|iw fi kd gdkghmiy|hmd+ ghgkbwpb|hmd D x

vdg|bkh`yw3 |iwykvdfbw ud|hdlkiw

@hvb`hghmd G3 dktyhkdmvi tyi hmnhli wmviwhw fi DFM x

p|bkhei|dghm fi ehl|blkdwvbw3 fiwpyw fi khwhw tyh||ahgd

fi whmityhdw gbmcymvhudkiwFbmmimeikf IF+ _i||x NF+ Qdkki|wvihm D+ iv dk Wylgbmcymgvhudk `hvb`xghm G eb| vni v|idv`imv be

bgykd| ghgdv|hghdk pi`pnhabhf Bpnvndk`bkbax 4888: 4?5 31fhwgywwhbm 18

Vi|dphd vphgd fi

imei|`ifdf bgykd|

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imei|`ifdf bgykd|

Lkied|hvhw dmvi|hb| x pbwvi|hb|+ x v|htyhdwhw3 gb`p|iwdw

gdkhimviw fbw uigiw dk fd

Kdudfb fi p|pdfbw gbm gnd`p fi lil fhkyhfb

dpkhgdghm mbgvy|md fi pb`dfd gbm dmvhlhvhgbw gb`b

i|hv|b`hghmd b ldghv|dghmd Hmekd`dghm gbmcymvhudk b gb|midk whamhehgdvhud3

iwvi|bhfiw vphgbw dwbghdfbw gbm dmvhlhvhgbw

Gndkdshm b @ihlb`hvhw3 viv|dghgkhmd b fb~hghgkhmd b|dk

Ikfi| @C+ Li|mdyi| Q G|xbvni|dpx eb| v|hgnhdwhw hm bgykd| ghgdv|hghdk pi`pnhabhf

L| C Bpnvndk`bk 4886: 1> 315814

Vi|dphd vphgd fiimei|`ifdf bgykd|

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