口腔粘膜精品教学（中山大学）4.大疱-感染.pdfVIP

附属口腔医院 中山大学黏膜科 Bullous disease of oral mucosa 院 Pemphigus is a group of blistering 腔医 autoimmune diseases that affect the skin 口 and mucous membranes 属 Pemphigoid is a group of uncommon 学附 科 autoimmune blistering skin diseases 大 黏膜 --As its name indicates, pemphigoid is similar 山 中 to pemphigus, however, unlike pemphigus, pemphigoid does not have a feature of acantholysis (棘层松解) What is Acantholysis? • the loss of intercellular connections, such as 院 desmosomes, resulting in loss of cohesion between keratinocytes 口腔医 学附属科 中山大 黏膜 Basal membrane How does Acantholysis Happen? • autoantibodies form against desmoglein (桥粒芯蛋白). 院 • Desmoglein forms the glue that attaches adjacent 医 epithelium cells via attachment points called desmosomes. 口腔 • When autoantibodies attack desmogleins, the cells 附属 become separated from each other and the 学 科 epithelium becomes unglued”. 中山大 黏膜 attack How to Dignosis Acantholysis ? • Nikolsky’s sign -gentle lateral pressure on 院 unaffected mucosa or skin with a cotton 腔医 swab or finger raises a bulla. 口 • 揭皮试验(+)：撕去或提取疱壁时，连同临近外观 属 正常的黏膜/皮肤一并无痛性撕去，并遗留下一鲜 红的创面大学附膜科 • 探针试验(+)：在糜烂面