LOT MING

LOT MING

Tn Hng 1053020030Rhm k36 nhm 2

NH NGHALot ( Ulcer) l tn thng mt cht vt qu mng y+ Kch thc thay i t vi mm n vi cm+ C th hnh thnh t s v ra ca bng nc hay mn nc+ y vt lot c m lin kt, m si, bch cu a nhn (hin tng vim cp)V d: lot do + chn thng, kch thch ti ch+ p t + dng thuc+ bnh v mu+ ung th biu m t bo gai

Vt lot do nhit ming

https://en.wikipedia.org/wiki/Mouth_ulcer

Vt lot do chn thng

https://en.wikipedia.org/wiki/Mouth_ulcer

Lot do ung th

Ung th ming tin trin (T4 N2 M0, giai on 4).

Phn bitVt cht (erosion) l tn thng mt cht khng vt qu mng y+ y c s tit dch thng xuyn v nh mch mu m lin kt bn di nn thng c mu .+ c th hi auV d: vt st, cht do mang hm gi

Vt cht do mang hm gi

http://www.intelligentdental.com/2009/08/18/denture-related-problems-affecting-the-mouth-part1/

Vim ming do lu cu, ban , v vt cht nim mc ming

http://www.dentalstrings.com/2012/02/gonococcal-stomatitis.html

Nhng bnh c biu hin vt lot trong mingLot do bnh t min:p tPemphigoidPemphigusLichen phngLupus ban Hng ban a dngLot do virus:Vim nu ming Herpes cp tnhHerpesZonnaBnh tay chn mingLot do vi khun:Sng giang maiLaoLot do ung th Lot do chn thngHoi t chuyn sn tuyn nc bt

I. LOT DO BNH T MIN

p tPemphigoidPemphigusLichen phngLupus ban Hng ban a dng

1.1. P Tp t n ginp t khng lp t dng HerpesHi chng Behcet

P T N GINL dng thng gp nhtV tr thng gp nim mc mi, m, bng li, khu ci mm. Ti phtKhi u cm thy nng bng, chm chchVt lot xut hin trn nn ban :Nng, hnh trn hay bu dc kch thc thng 5- 10mm, y mu vngPh lp mng mu vng trng, c qung vim xung quanh. Rt auLnh sau 7- 10 ngy khng li soTi pht sau nhiu tun thng ty theo bnh nhn.

P T KHNG LL dng lm sng nng nht ca vim ming p tThng gp ti mi, khu ci mm, tr amidanKhng lin quan vi mt tc nhn gy bnh c th xc nh c Sc khe ton thn b nh hng do n ung km v lo lng qu mc.p t khng l thng xut hin vi tnh trng suy gim min dch nng (HIV) vi CD4 < 100 t bo / mm3.Vt lot:Su B khng uKch thc ln 1-3 cm, Lot to (>10 mm) au, khng lnhau nhiuLu lnh, li so.Ti pht lin tc v nhiu ln

P T DNG HERPESNhiu vt let kch thc nh 1-3mm thnh tng chmS lng nhiu, auChn on phn bit vi nhim Herpes cp tnh

HI CHNG BEHCETL bnh ton thn khng r nguyn nhn, c lin quan n yu t duy truynVt lot ngoi biu hin ming cn mt v b phn sinh dc.

http://www.slideshare.net/Drchitra/behcets

IU TR P TCh nhm lm gim triu chngCh yu dng Corticoid ti ch v ton thn+ ti ch: Flucocinonide 0,05% gel (Lidex) bi sau khi n v trc khi ng Gim au: Xylocain 5% (pommade) bi 6-8 ln/ngy+ ton thn:Prednisolone 20-40 mg/ngyIsoprinosine 8 vin/ngy x 6 ngyThuc sc ming: Chlorhexidine, TetracylineVitamins: acid folic, vitamin B12, st

1.2. PEMPHIGOIDL bnh t minThng biu hin ngoi da, t biu hin trong mingThng gp n, > 50 tuiDo s mt bm dnh ca b mt biu m C ch: khng th t thn khng lp mng yTn thng dng mn nc, bng nc, vt trtV tr: nu, m, khu ci, sn mingChn on: k thut min dch hunh quangiu tr: corticoid ti ch v ton thn

1.3. PEMPHIGUS* Bnh chia 2 phn nhmc c im lm sng v min dch hc khc nhau. Mi phn nhm gm 2 th bnh: Pemphigus su: s to thnh bng nc xy ra su trn mng y,gm:+ Pemphigus thng thng (pemphigus vulgaris), cn gi l pemphigus c tnh.+ Pemphigus si ( pemphigus vegetans) Pemphigus nng: s tch xy ra nng, di lp sng, lp ht, gm:+ Pemphigus l (pemphigus foliaceus)+ Pemphigus da (pemphigus erythematosus) hay cn gi pemphigus titb(pemphigus seborrheic)* Th c bit: Pemphigus do thuc (drug induced pemphigus). Pemphigus cn tn sinh (paraneoplastic pemphigus) IgA pemphigus ( intercellular IgA dermatosis) Pemphigus dng herpes ( pemphigus herpetiformis) Pemphigoid- pemphigus.

1.3. PEMPHIGUSBnh t min, c khng th IgGMt bm dnh gia lp biu m v mng yTui 40-60Tn thng bng nc, vt trt nim mc ming sau lan ra da.Trong ming: khu ci mm, m, nuDu hiu Nikolsky (+)CLS: min dch hunh quangNguy him n tnh mng

DU HIU NIKOLSKYDu hiu Nikolsky (+):dng ngn tay n mit nhiu ln vng da cch bng nc 1,5 2 cm s to thnh vt trt da. Tuy nhin du hiu ny khng c hiu. Nu khng in hnh s thy vi lp sng bong ra. Ch theo di thi gian 6-12-24 gi sau: ch mit bong sng s ln bng nc (v khi ta lm s dn lp t bo gai). Du hiu trn dng tnh chng t bng nc nm trong thng b.

PEMPHIGUS THNG THNG (pemphigus vulgaris)EMPHIGUS VEGETANS

1.4. LICHEN PHNGNguyn nhn cha rThng BN> 25 tui, n nhiu hn namL bnh ngoi da thng cho biu hin ming nht (55%)Tn thng ko di V tr: nim mc m, lng li, nuTn thng: Dng mng li: sc Wickham l nhng sc mnh mu trng an thnh mng li hay vng trn, thng gp nhtDng teoDng trtDng mngXut hin 2 bn v c tnh cht i xngiu tr: p ng tt vi Corticoid ti ch v ton thn

DNG MNG LI

DNG TEO

DNG TRT

DNG MNG

LICHEN NGOI DA

1.5. LUPUS L bnh t min ca m lin ktLS: st, kh , au khp, mt mi, lot ming, pht ban m hnh cnh bm, c lin quan n hi chng Sjogren20% bnh c biu hin mingMing: vt lot hay trt , c nhng sc khng in hnh, thng xut hin 1 bn khu ci, m..CLS: xt nghim tm khng th khng nhn

1.6. HNG BAN A DNGL bnh vim da pht banNguyn nhn a dng: Thuc: sulphonamide, barbiturate, dilantin, PhenicilineVirus: Herpes simplex..Vi khunBnh l ton thnThng gp ngi trTn thng dng hnh bia ngoi da kt hp nhiu loi tn thng: mng, sn, mn nc, bng nc..Biu hin ming: 30% c triu chng ming, thng mi di, tn thng dng p t khng liu tr: khng c iu tr c hiu, dng corticoid

CHN ON PHN BITC IMPEMPHIGUS THNG THNGPEMPHIGOIDBULLEUXHNG BAN A DNG BNG NCTUITHNG NGI LNNGI 60 TUITHNG NGI TRTIN CHNG(-)(+)(+) OR (-)PHT BAN N DNG: BNG NCA DNG: MNG HNG BAN, MY AY, BNG NCA DNGTNH CHT BNG NCLN, CHNG NHIU HN CNG, VT L KH LNHLN, CNG, VT L D LNHLN HOC NH, NHANH CHNG HOI TCCH SP XPRI RC TRN NN DA BNH THNGKHUYNH HNG HP LI TRN NN HNG BAN HAY DA LNHTHNH VNG, HNH BIA TRN NN HNG BANDU NIKOLSKY(+)(-)(-)TNG TRNGNH HNG NHIUC NH HNGTTTIN LNG D DTD DTTTIU TRCORTICOIDCORTICOIDNNG TNG TRNGCORTICOID TRNG HP NNG

II.LOT DO VIRUSVim nu ming Herpes cp tnhHerpes ti phtZonnaBnh tay chn ming

VIM NU MING HERPES NGUYN PHTDo Herpes Simplex type 1Ly nhim qua tip xc trc tipTn thng l nhng mn nc, sau l vt lot nhVt lot khng u mu ph mng fribrin mu vng rt auXut hin bt k v tr trong ming.Thng km theo st v ni hchXt nghim: tm khng th ca Herpes Simplexiu tr: Acyclovir thoa, vin ung, km dung dch sc mingT lnh sau 7-14 ngyBnh ko di nhim HIV

HERPES MI TI PHTNhim Herpes Simplex th phtV tr: thng vin mi Khi pht: chm chch, nng rt, nn ban ni mn nc vt lot nh ng vy lnh khng li soiu tr: cng sm mi hiu qu, thoa Acyclovir tt nht trong nhng gi u. 5 ln/ngy/7 ngy

ZONNA Do varicella zoster virusThng ngi ln tuiKhi pht: au, nng rt, xut hin nn ban . Sau xut hin mn nc, bng nc dc theo nhnh dy thn kinh V, cm gic au theo dy thn kinh ch 1 bn khng qua ng gia.Rt au.Biu hin ming: nim mc m khu ci mm, au nhiu rng ging vim tyNgi mt mi, kh chuiu tr: Acyclovir dng ng ton thnC th cn triu chng: au sau Zonna

BNH TAY-CHN-MINGDo Coxsackie virus nhm ABnh thnh dch, lan nhanhThng xy ra tr emTriu chng: st, nhiu vt lot lng bn tay, bn chn v mingChn on: xt nghim huyt thanh hcKhng c iu tr c hiu

III. LOT DO VI KHUNSng giang maiLao

SNG GIANG MAISng xut hin sau khi nhim xon khun 3-4 tunV tr thng gp: mi, u liKhi pht: hn chc vi cm, sau b mt lot, vt lot c b g, y sch, trn bng lng mu nh tht ti, nn cng, khng au, lun c hch vng ln cnKm ni nhiu hch

LOT DO LAOt gp, thng BN lao phiV tr thng gp: lng liVt lot: b rch, khng au giai on u

IV. LOT DO UNG THCarcinom t bo gaiUng th tuyn dng nang(TNB ph khu ci)

Carcinom t bo gaiLot b khng u, g cng, nh cao, y hoi t xut huyt, nn cng dnh.Thng li, sn ming

UNG TH TUYN DNG NANG(Adenoid cystic carcinoma, Cylindrome)50% bu tuyn nc bt ph, thng khu ci.Xut pht t t bo c biu m

UNG TH TUYN DNG NANG(Adenoid cystic carcinoma, Cylindrome)Lm sng:Khi sng km lot b mtThng xut hin khu ciPht trin chm c tnh xm ln vo xngThng cho di cn xaKm au nhc v gy lit mt.iu tr: phu thut kt hp x tr. Tin lng: hay ti pht, di cn xa n hch xng v phi

V. LOT DO CHN THNGNguyn nhn: B hm gi tho lpRng bn nhnMing trm dVt lot lin quan n nguyn nhnC kh nng t lnh sau ti phtiu tr: loi tr nguyn nhnChn on phn bit: ung th

VI. HOI T CHUYN SN TUYN NC BTBnh t gpL dng vim ca tuyn nc bt phThng khu ci cngNguyn nhn: chn thngLS: vt lot su, kch thc 2-3 mm, au hoc t auC kh nng t lnh

VI. HOI T CHUYN SN TUYN NC BT

Thank for listening