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[遗传性水疱性疾病]

[Hereditary blistering disorders].

作者信息

Has C, Kern J S, Bruckner-Tuderman L

机构信息

Universitäts-Hautklinik Freiburg.

出版信息

Hautarzt. 2004 Oct;55(10):920, 922-30. doi: 10.1007/s00105-004-0798-0.

Abstract

Epidermolysis bullosa (EB) is a group of genetic skin disorders whose common feature is the formation of blisters following minor trauma. They present with a wide clinical spectrum of manifestations because of a variety of molecular defects. In patients with mild phenotypes, only skin is affected. The most severe EB forms are multiorgan disorders with a poor prognosis. EB arises from abnormalities in proteins of the dermal-epidermal junction. These specialized protein components aggregate to form anchoring complexes, which attach the epidermis to the dermis. Three major EB-forms can be distinguished on the basis of ultrastructural blistering level: EB simplex--epidermolytic, junctional EB--in the lamina lucida and dystrophic EB--dermolytic. To establish a provisional diagnosis for an EB patient, clinical data, family history and morphologic examination of the skin, e.g. by antigen-mapping, are needed. Complete knowledge of the genetic defect provides the basis to a rational genetic counseling and prenatal testing. Treatment of EB is based on wound care; multidisciplinary management of cases with severe course is required.

摘要

大疱性表皮松解症(EB)是一组遗传性皮肤病,其共同特征是轻微创伤后形成水疱。由于多种分子缺陷,它们呈现出广泛的临床表现谱。在轻度表型患者中,仅皮肤受到影响。最严重的EB类型是多器官疾病,预后不良。EB源于真皮 - 表皮交界处蛋白质的异常。这些特殊的蛋白质成分聚集形成锚定复合物,将表皮附着于真皮。根据超微结构水疱形成水平可区分出三种主要的EB类型:单纯性EB——表皮松解性、交界性EB——在透明层以及营养不良性EB——真皮松解性。为对EB患者进行初步诊断,需要临床数据、家族史以及皮肤的形态学检查,例如通过抗原定位。对基因缺陷的全面了解为合理的遗传咨询和产前检测提供了基础。EB的治疗基于伤口护理;对于病程严重的病例需要多学科管理。

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