{"id":34691,"date":"2022-11-24T20:34:37","date_gmt":"2022-11-24T13:34:37","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=34691"},"modified":"2022-11-26T09:38:12","modified_gmt":"2022-11-26T02:38:12","slug":"cau-truc-va-chuc-nang-cua-da","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/cau-truc-va-chuc-nang-cua-da\/","title":{"rendered":"T\u00ecm hi\u1ec3u v\u1ec1 c\u1ea5u tr\u00fac v\u00e0 ch\u1ee9c n\u0103ng c\u1ee7a da"},"content":{"rendered":"

Bi\u00ean d\u1ecbch: B\u00e1c s\u0129 Tr\u01b0\u01a1ng T\u1ea5n Minh V\u0169\u00a0<\/em><\/p>\n

vnras.com\/drug – \u0110\u1ec3 t\u1ea3i file PDF c\u1ee7a b\u00e0i vi\u1ebft C\u1ea5u tr\u00fac v\u00e0 ch\u1ee9c n\u0103ng c\u1ee7a da<\/strong><\/a>, xin vui l\u00f2ng click v\u00e0o link \u1edf \u0111\u00e2y<\/a>.<\/p>\n

N\u1ed9i dung<\/h2>\n
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Bi\u1ec3u b\u00ec\n
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K\u1ebft c\u1ea5u<\/li>\n
C\u00e1c th\u00e0nh ph\u1ea7n t\u1ebf b\u00e0o kh\u00e1c<\/li>\n
L\u1edbp n\u1ed1i b\u00ec v\u00e0 bi\u1ec3u b\u00ec – V\u00f9ng m\u00e0ng \u0111\u00e1y \u2022B\u00ec<\/li>\n<\/ul>\n<\/li>\n
Ph\u1ea7n ph\u1ee5 c\u1ee7a da<\/li>\n
M\u1ee1 d\u01b0\u1edbi da<\/li>\n<\/ul>\n
Nh\u1eefng \u0111i\u1ec3m ch\u00ednh<\/h2>\n
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Ch\u1ee9c n\u0103ng ch\u00ednh c\u1ee7a da l\u00e0 h\u00e0ng r\u00e0o \u0111\u1ec3 duy tr\u00ec c\u00e2n b\u1eb1ng n\u1ed9i m\u00f4i b\u00ean trong<\/li>\n
L\u1edbp bi\u1ec3u b\u00ec l\u00e0 h\u00e0ng r\u00e0o ch\u00ednh c\u1ee7a da<\/li>\n<\/ol>\n
T\u00f3m t\u1eaft<\/h2>\n
Da l\u00e0 m\u1ed9t c\u01a1 quan l\u1edbn, n\u1eb7ng trung b\u00ecnh 4 kg v\u00e0 c\u00f3 di\u1ec7n t\u00edch 2 m2. Ch\u1ee9c n\u0103ng ch\u00ednh c\u1ee7a n\u00f3 l\u00e0 ho\u1ea1t \u0111\u1ed9ng nh\u01b0 m\u1ed9t h\u00e0ng r\u00e0o ch\u1ed1ng l\u1ea1i m\u00f4i tr\u01b0\u1eddng kh\u00f4ng thu\u1eadn l\u1ee3i – \u0111\u1ec3 b\u1ea3o v\u1ec7 c\u01a1 th\u1ec3 kh\u1ecfi nh\u1eefng \u1ea3nh h\u01b0\u1edfng c\u1ee7a th\u1ebf gi\u1edbi b\u00ean ngo\u00e0i. T\u1ea7m quan tr\u1ecdng c\u1ee7a da \u0111\u01b0\u1ee3c th\u1ec3 hi\u1ec7n r\u00f5 b\u1edfi t\u1ef7 l\u1ec7 t\u1eed vong cao li\u00ean quan \u0111\u1ebfn m\u1ea5t da di\u1ec7n r\u1ed9ng do b\u1ecfng.<\/p>\n
H\u00e0ng r\u00e0o ch\u00ednh \u0111\u01b0\u1ee3c cung c\u1ea5p b\u1edfi l\u1edbp bi\u1ec3u b\u00ec. B\u00ean d\u01b0\u1edbi l\u1edbp bi\u1ec3u b\u00ec l\u00e0 l\u1edbp b\u00ec c\u00f3 m\u1ea1ch m\u00e1u cung c\u1ea5p h\u1ed7 tr\u1ee3 v\u00e0 dinh d\u01b0\u1ee1ng cho c\u00e1c t\u1ebf b\u00e0o ph\u00e2n chia trong l\u1edbp bi\u1ec3u b\u00ec. L\u1edbp b\u00ec c\u0169ng ch\u1ee9a c\u00e1c d\u00e2y th\u1ea7n kinh v\u00e0 ph\u1ea7n ph\u1ee5: tuy\u1ebfn m\u1ed3 h\u00f4i, nang l\u00f4ng v\u00e0 tuy\u1ebfn b\u00e3 nh\u1eddn. M\u00f3ng tay c\u0169ng \u0111\u01b0\u1ee3c coi l\u00e0 ph\u1ea7n ph\u1ee5 c\u1ee7a da. L\u1edbp th\u1ee9 ba v\u00e0 s\u00e2u nh\u1ea5t c\u1ee7a da l\u00e0 l\u1edbp m\u1ee1 d\u01b0\u1edbi da. Ch\u1ee9c n\u0103ng c\u1ee7a t\u1ea5t c\u1ea3 c\u00e1c th\u00e0nh ph\u1ea7n n\u00e0y \u0111\u01b0\u1ee3c li\u1ec7t k\u00ea trong B\u1ea3ng 2.1.<\/p>\n
C\u00e1c th\u00e0nh ph\u1ea7n c\u1ee7a da:<\/p>\n
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Bi\u1ec3u b\u00ec<\/li>\n
L\u1edbp b\u00ec<\/li>\n
C\u00e1c ph\u1ea7n ph\u1ee5 c\u1ee7a da<\/li>\n
M\u1ee1 d\u01b0\u1edbi da<\/li>\n<\/ol>\n
Bi\u1ec3u b\u00ec<\/h2>\n
Nh\u1eefng \u0111i\u1ec3m ch\u00ednh<\/p>\n
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T\u1ebf b\u00e0o s\u1eebng l\u00e0 t\u1ebf b\u00e0o ch\u00ednh c\u1ee7a l\u1edbp bi\u1ec3u b\u00ec<\/li>\n
C\u00e1c l\u1edbp theo th\u1ee9 t\u1ef1 t\u0103ng d\u1ea7n: l\u1edbp t\u1ebf b\u00e0o \u0111\u00e1y, l\u1edbp gai, l\u1edbp h\u1ea1t, l\u1edbp s\u1eebng<\/li>\n
T\u1ebf b\u00e0o \u0111\u00e1y l\u00e0 t\u1ebf b\u00e0o ch\u01b0a bi\u1ec7t h\u00f3a, \u0111ang t\u0103ng sinh.<\/li>\n
L\u1edbp gai ch\u1ee9a c\u00e1c t\u1ebf b\u00e0o s\u1eebng \u0111\u01b0\u1ee3c g\u1eafn k\u1ebft b\u1edfi c\u00e1c desmosomes<\/li>\n
C\u00e1c h\u1ea1t keratohyalin \u0111\u01b0\u1ee3c th\u1ea5y trong l\u1edbp h\u1ea1t<\/li>\n
L\u1edbp s\u1eebng l\u00e0 h\u00e0ng r\u00e0o v\u1eadt l\u00fd ch\u00ednh<\/li>\n
S\u1ed1 l\u01b0\u1ee3ng v\u00e0 k\u00edch th\u01b0\u1edbc c\u1ee7a c\u00e1c melanosome, kh\u00f4ng ph\u1ea3i melanocyte, x\u00e1c \u0111\u1ecbnh m\u00e0u da<\/li>\n
T\u1ebf b\u00e0o Langerhans c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb t\u1ee7y x\u01b0\u01a1ng v\u00e0 l\u00e0 tuy\u1ebfn b\u1ea3o v\u1ec7 mi\u1ec5n d\u1ecbch \u0111\u1ea7u ti\u00ean c\u1ee7a da<\/li>\n
V\u00f9ng m\u00e0ng \u0111\u00e1y l\u00e0 ch\u1ea5t n\u1ec1n \u0111\u1ec3 g\u1eafn bi\u1ec3u b\u00ec v\u1edbi b\u00ec<\/li>\n
B\u1ed1n v\u00f9ng si\u00eau c\u1ea5u tr\u00fac ch\u00ednh g\u1ed3m: m\u1ea3ng hemidesmosomal c\u1ee7a t\u1ebf b\u00e0o s\u1eebng l\u1edbp \u0111\u00e1y, lamina lucida, lamina densa, v\u00e0 c\u00e1c s\u1ee3i neo n\u1eb1m \u1edf v\u00f9ng sublamina densa c\u1ee7a l\u1edbp b\u00ec nh\u00fa.<\/li>\n<\/ol>\n
L\u1edbp bi\u1ec3u b\u00ec \u0111\u01b0\u1ee3c chia th\u00e0nh b\u1ed1n l\u1edbp, b\u1eaft \u0111\u1ea7u t\u1eeb ph\u1ea7n n\u1ed1i b\u00ec v\u1edbi l\u1edbp t\u1ebf b\u00e0o \u0111\u00e1y v\u00e0 k\u1ebft th\u00fac \u1edf b\u1ec1 m\u1eb7t ngo\u00e0i c\u1ee7a l\u1edbp s\u1eebng. M\u1eb7t ph\u00eda b\u00ec c\u1ee7a bi\u1ec3u b\u00ec c\u00f3 \u0111\u01b0\u1eddng vi\u1ec1n kh\u00f4ng \u0111\u1ec1u. C\u00e1c ph\u1ea7n nh\u00f4 xu\u1ed1ng d\u01b0\u1edbi \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 g\u1edd rete, bi\u1ec3u hi\u1ec7n 3 chi\u1ec1u nh\u01b0 m\u1ed9t ma tr\u1eadn gi\u1ed1ng pho m\u00e1t Th\u1ee5y S\u0129 v\u1edbi c\u00e1c l\u1ed7 \u0111\u01b0\u1ee3c l\u1ea5p \u0111\u1ea7y b\u1edfi c\u00e1c nh\u00fa b\u00ec h\u00ecnh v\u00f2m. C\u1ea5u h\u00ecnh n\u00e0y gi\u00fap c\u1ed1 \u0111\u1ecbnh l\u1edbp bi\u1ec3u b\u00ec v\u00e0o l\u1edbp b\u00ec. M\u00f4 h\u00ecnh n\u00e0y r\u00f5 r\u00e0ng nh\u1ea5t \u1edf c\u00e1c khu v\u1ef1c ch\u1ecbu ma s\u00e1t t\u1ed1i \u0111a, nh\u01b0 l\u00f2ng b\u00e0n tay v\u00e0 l\u00f2ng b\u00e0n ch\u00e2n.<\/p>\n
C\u00e1c t\u1ebf b\u00e0o trong l\u1edbp bi\u1ec3u b\u00ec tr\u1ea3i qua qu\u00e1 tr\u00ecnh ph\u00e2n chia v\u00e0 bi\u1ec7t h\u00f3a. S\u1ef1 ph\u00e2n chia t\u1ebf b\u00e0o x\u1ea3y ra \u1edf l\u1edbp t\u1ebf b\u00e0o \u0111\u00e1y v\u00e0 s\u1ef1 bi\u1ec7t h\u00f3a \u1edf c\u00e1c l\u1edbp b\u00ean tr\u00ean n\u00f3.<\/p>\n
S\u1ef1 ph\u00e2n chia t\u1ebf b\u00e0o x\u1ea3y ra \u1edf l\u1edbp t\u1ebf b\u00e0o \u0111\u00e1y.<\/p>\n
B\u1ec7nh da minh h\u1ecda c\u1ea5u tr\u00fac v\u00e0 ch\u1ee9c n\u0103ng. M\u1ea5t ho\u1eb7c khi\u1ebfm khuy\u1ebft trong c\u1ea5u tr\u00fac da l\u00e0m suy gi\u1ea3m ch\u1ee9c n\u0103ng c\u1ee7a da. B\u1ec7nh da s\u1ebd \u0111\u01b0\u1ee3c th\u1ea3o lu\u1eadn chi ti\u1ebft h\u01a1n trong c\u00e1c ch\u01b0\u01a1ng kh\u00e1c.<\/p>\n
B\u1ea2NG 2.1 C\u00e1c ch\u1ee9c n\u0103ng c\u1ee7a da<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Ch\u1ee9c n\u0103ng<\/td>\n C\u1ea5u tr\u00fac ch\u1ecbu tr\u00e1ch nhi\u1ec7m<\/td>\n<\/tr>\n
H\u00e0ng r\u00e0o<\/td>\n Bi\u1ec3u b\u00ec<\/td>\n<\/tr>\n
V\u1eadt l\u00fd<\/td>\n L\u1edbp s\u1eebng<\/td>\n<\/tr>\n
M\u00e0u s\u1eafc<\/td>\n T\u1ebf b\u00e0o h\u1eafc t\u1ed1<\/td>\n<\/tr>\n
Mi\u1ec5n d\u1ecbch<\/td>\n T\u1ebf b\u00e0o Langerhans<\/td>\n<\/tr>\n
N\u1ec1n t\u1ea3ng d\u1ebbo dai<\/td>\n B\u00ec<\/td>\n<\/tr>\n
\u0110i\u1ec1u h\u00f2a nhi\u1ec7t \u0111\u1ed9<\/td>\n M\u1ea1ch m\u00e1u<\/p>\n
Tuy\u1ebfn m\u1ed3 h\u00f4i eccrine<\/td>\n<\/tr>\n
C\u1ea3m gi\u00e1c<\/td>\n D\u00e2y th\u1ea7n kinh<\/td>\n<\/tr>\n
N\u1eafm ch\u1eb7t<\/td>\n M\u00f3ng tay<\/td>\n<\/tr>\n
Trang tr\u00ed<\/td>\n T\u00f3c<\/td>\n<\/tr>\n
Kh\u00f4ng x\u00e1c \u0111\u1ecbnh<\/td>\n Tuy\u1ebfn b\u00e3 nh\u1eddn<\/td>\n<\/tr>\n
B\u1ea3o v\u1ec7 kh\u1ecfi l\u1ea1nh v\u00e0 ch\u1ea5n th\u01b0\u01a1ng<\/td>\n M\u1ee1 d\u01b0\u1edbi da<\/td>\n<\/tr>\n
N\u01a1i ch\u1ee9a calo<\/td>\n M\u1ee1 d\u01b0\u1edbi da<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
K\u1ebft c\u1ea5u<\/h2>\n
L\u1edbp t\u1ebf b\u00e0o \u0111\u00e1y (Basal Cell Layer)<\/h3>\n
T\u1ebf b\u00e0o \u0111\u00e1y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c coi l\u00e0 \u2018t\u1ebf b\u00e0o g\u1ed1c\u2019 c\u1ee7a l\u1edbp bi\u1ec3u b\u00ec. Ch\u00fang l\u00e0 nh\u1eefng t\u1ebf b\u00e0o ch\u01b0a bi\u1ec7t h\u00f3a, \u0111ang t\u0103ng sinh. C\u00e1c t\u1ebf b\u00e0o con t\u1eeb l\u1edbp t\u1ebf b\u00e0o \u0111\u00e1y di chuy\u1ec3n l\u00ean tr\u00ean v\u00e0 b\u1eaft \u0111\u1ea7u qu\u00e1 tr\u00ecnh bi\u1ec7t h\u00f3a. \u1ede da b\u00ecnh th\u01b0\u1eddng, qu\u00e1 tr\u00ecnh ph\u00e2n chia t\u1ebf b\u00e0o kh\u00f4ng di\u1ec5n ra \u1edf tr\u00ean l\u1edbp t\u1ebf b\u00e0o \u0111\u00e1y. M\u1ea5t kho\u1ea3ng 2 tu\u1ea7n \u0111\u1ec3 c\u00e1c t\u1ebf b\u00e0o di chuy\u1ec3n t\u1eeb l\u1edbp t\u1ebf b\u00e0o \u0111\u00e1y l\u00ean tr\u00ean c\u00f9ng c\u1ee7a l\u1edbp t\u1ebf b\u00e0o h\u1ea1t, v\u00e0 th\u00eam 2 tu\u1ea7n n\u1eefa \u0111\u1ec3 c\u00e1c t\u1ebf b\u00e0o v\u01b0\u1ee3t qua l\u1edbp s\u1eebng \u0111\u1ec3 l\u00ean b\u1ec1 m\u1eb7t, n\u01a1i cu\u1ed1i c\u00f9ng ch\u00fang b\u1ecb r\u01a1i ra. T\u1ed5n th\u01b0\u01a1ng v\u00e0 vi\u00eam nhi\u1ec5m l\u00e0m t\u0103ng t\u1ed1c \u0111\u1ed9 t\u0103ng sinh v\u00e0 tr\u01b0\u1edfng th\u00e0nh (H\u00ecnh 2.1).<\/p>\n
L\u1edbp gai (Stratum Spinosum)<\/h3>\n
L\u1edbp n\u00e0y n\u1eb1m tr\u00ean l\u1edbp \u0111\u00e1y v\u00e0 \u0111\u01b0\u1ee3c c\u1ea5u t\u1ea1o b\u1edfi c\u00e1c t\u1ebf b\u00e0o s\u1eebng, ph\u00e2n bi\u1ec7t v\u1edbi c\u00e1c t\u1ebf b\u00e0o \u0111\u00e1y b\u00ean d\u01b0\u1edbi ch\u00fang. T\u1ebf b\u00e0o s\u1eebng t\u1ea1o ra keratin, m\u1ed9t lo\u1ea1i protein d\u1ea1ng s\u1ee3i l\u00e0 th\u00e0nh ph\u1ea7n ch\u00ednh c\u1ee7a l\u1edbp s\u1eebng.<\/p>\n
$\"H\u00ccNH$
H\u00ccNH 2.1 B\u1ec7nh v\u1ea9y n\u1ebfn – m\u1ed9t b\u1ec7nh r\u1ed1i lo\u1ea1n t\u1ef1 mi\u1ec5n \u0111\u1eb7c tr\u01b0ng b\u1edfi l\u1edbp bi\u1ec3u b\u00ec d\u00e0y l\u00ean v\u00e0 t\u0103ng v\u1ea3y.<\/figcaption><\/figure>\n
L\u1edbp gai c\u00f3 t\u00ean g\u1ecdi t\u1eeb c\u00e1c ‘gai’, ho\u1eb7c c\u1ea7u n\u1ed1i gian b\u00e0o, k\u00e9o d\u00e0i gi\u1eefa c\u00e1c t\u1ebf b\u00e0o s\u1eebng v\u00e0 c\u00f3 th\u1ec3 nh\u00ecn th\u1ea5y b\u1eb1ng k\u00ednh hi\u1ec3n vi \u00e1nh s\u00e1ng. V\u1ec1 m\u1eb7t si\u00eau c\u1ea5u<\/p>\n
tr\u00fac g\u1ed3m c\u00e1c desmosomes, l\u00e0 nh\u1eefng ph\u1ea7n k\u00e9o d\u00e0i t\u1eeb keratin b\u00ean trong t\u1ebf b\u00e0o s\u1eebng; v\u1ec1 m\u1eb7t ch\u1ee9c n\u0103ng, ch\u00fang gi\u1eef c\u00e1c t\u1ebf b\u00e0o l\u1ea1i v\u1edbi nhau (H\u00ecnh 2.2).<\/p>\n
Qu\u00e1 tr\u00ecnh s\u1eebng h\u00f3a b\u1eaft \u0111\u1ea7u t\u1eeb l\u1edbp gai.<\/p>\n
L\u1edbp h\u1ea1t (Stratum Granulosum)<\/h3>\n
Qu\u00e1 tr\u00ecnh bi\u1ec7t h\u00f3a ti\u1ebfp t\u1ee5c trong l\u1edbp t\u1ebf b\u00e0o h\u1ea1t, \u1edf \u0111\u00f3 c\u00e1c t\u1ebf b\u00e0o thu nh\u1eadn th\u00eam keratin v\u00e0 tr\u1edf n\u00ean d\u1eb9t h\u01a1n. Ngo\u00e0i ra, ch\u00fang ch\u1ee9a c\u00e1c h\u1ea1t s\u1eabm m\u00e0u ri\u00eang bi\u1ec7t, c\u00f3 th\u1ec3 d\u1ec5 nh\u00ecn th\u1ea5y tr\u00ean k\u00ednh hi\u1ec3n vi, \u0111\u01b0\u1ee3c c\u1ea5u t\u1ea1o t\u1eeb keratohyalin. Keratohyalin ch\u1ee9a hai protein, m\u1ed9t trong s\u1ed1 \u0111\u00f3 \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 profilaggrin, ti\u1ec1n th\u00e2n c\u1ee7a filaggrin. Nh\u01b0 t\u00ean g\u1ecdi c\u1ee7a n\u00f3, filaggrin \u0111\u00f3ng m\u1ed9t vai tr\u00f2 quan tr\u1ecdng trong vi\u1ec7c t\u1eadp h\u1ee3p c\u00e1c s\u1ee3i keratin trong l\u1edbp s\u1eebng. Protein c\u00f2n l\u1ea1i \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 involucrin (t\u1eeb ti\u1ebfng Latinh c\u00f3 ngh\u0129a l\u00e0 ‘phong b\u00ec’), v\u00e0 \u0111\u00f3ng m\u1ed9t vai tr\u00f2 trong vi\u1ec7c h\u00ecnh th\u00e0nh v\u1ecf t\u1ebf b\u00e0o c\u1ee7a c\u00e1c t\u1ebf b\u00e0o trong l\u1edbp s\u1eebng. Ichthyosis vulgaris (ichthys, ti\u1ebfng Hy L\u1ea1p c\u00f3 ngh\u0129a l\u00e0 \u2018c\u00e1\u2019) l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng da kh\u00f4 di truy\u1ec1n th\u1ee9 ph\u00e1t do thi\u1ebfu h\u1ee5ts\u1ea3n xu\u1ea5t filaggrin, h\u00ecnh \u1ea3nh c\u1ee7a sinh thi\u1ebft da tr\u00ean k\u00ednh hi\u1ec3n vi cho th\u1ea5y l\u1edbp h\u1ea1t gi\u1ea3m ho\u1eb7c kh\u00f4ng c\u00f3 (H\u00ecnh 2.3).<\/p>\n
T\u1ebf b\u00e0o h\u1ea1t c\u0169ng ch\u1ee9a c\u00e1c h\u1ea1t d\u1ea1ng phi\u1ebfn, \u0111\u01b0\u1ee3c ghi nh\u1eadn b\u1eb1ng k\u00ednh hi\u1ec3n vi \u0111i\u1ec7n t\u1eed. C\u00e1c h\u1ea1t d\u1ea1ng phi\u1ebfn ch\u1ee9a polysaccharide, glycoprotein v\u00e0 lipid nh\u00f4 v\u00e0o kho\u1ea3ng gian b\u00e0o v\u00e0 cu\u1ed1i c\u00f9ng \u0111\u01b0\u1ee3c cho l\u00e0 gi\u00fap h\u00ecnh th\u00e0nh ‘xi m\u0103ng’gi\u1eef c\u00e1c t\u1ebf b\u00e0o l\u1edbp s\u1eebng l\u1ea1i v\u1edbi nhau. C\u00e1c enzym ph\u00e2n h\u1ee7y c\u0169ng \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong c\u00e1c t\u1ebf b\u00e0o h\u1ea1t; ch\u1ecbu tr\u00e1ch nhi\u1ec7m g\u00e2y ra s\u1ef1 ph\u00e1 h\u1ee7y cu\u1ed1i c\u00f9ng c\u1ee7a nh\u00e2n t\u1ebf b\u00e0o v\u00e0 c\u00e1c b\u00e0o quan trong t\u1ebf b\u00e0o ch\u1ea5t.<\/p>\n
$\"H\u00ccNH$
H\u00ccNH 2.2 Pemphigus vulgaris – m\u1ed9t b\u1ec7nh b\u00f3ng n\u01b0\u1edbc t\u1ef1 mi\u1ec5n, trong \u0111\u00f3 c\u00e1c kh\u00e1ng th\u1ec3 ch\u1ed1ng l\u1ea1i desmosom d\u1eabn \u0111\u1ebfn s\u1ef1 ph\u00e2n t\u00e1ch t\u1ebf b\u00e0o s\u1eebng trong l\u1edbp gai.<\/figcaption><\/figure>\n
$\"H\u00ccNH$
H\u00ccNH 2.3 Ichthyosis vulgaris – m\u1ed9t t\u00ecnh tr\u1ea1ng da kh\u00f4 di truy\u1ec1n t\u1ef1 mi\u1ec5n ph\u1ed5 bi\u1ebfn th\u1ee9 ph\u00e1t do thi\u1ebfu h\u1ee5t s\u1ea3n xu\u1ea5t filaggrin. V\u1ea3y \u2018gi\u1ed1ng c\u00e1\u2019 \u1edf \u1ed1ng ch\u00e2n tr\u01b0\u1edbc.<\/figcaption><\/figure>\n
T\u1ebf b\u00e0o h\u1ea1t ch\u1ee9a keratohyalin v\u00e0 h\u1ea1t h\u00ecnh phi\u1ebfn.<\/p>\n
L\u1edbp s\u1eebng (Stratum Corneum)<\/h3>\n
M\u1ed9t s\u1ef1 chuy\u1ec3n \u0111\u1ed5i \u0111\u1ed9t ng\u1ed9t \u0111\u00e1ng k\u1ec3 x\u1ea3y ra gi\u1eefa c\u00e1c t\u1ebf b\u00e0o c\u00f2n s\u1ed1ng, c\u00f3 nh\u00e2n \u1edf tr\u00ean c\u00f9ng c\u1ee7a l\u1edbp h\u1ea1t v\u00e0 c\u00e1c t\u1ebf b\u00e0o ch\u1ebft c\u1ee7a l\u1edbp s\u1eebng (H\u00ecnh 2.4). C\u00e1c t\u1ebf b\u00e0o trong l\u1edbp s\u1eebng l\u00e0 nh\u1eefng t\u1ea5m d\u1ea1ng phong b\u00ec, l\u1edbn, ph\u1eb3ng, \u0111a di\u1ec7n, ch\u1ee9a \u0111\u1ea7y keratin. Ch\u00fang \u0111\u01b0\u1ee3c x\u1ebfp ch\u1ed3ng l\u00ean nhau th\u00e0nh nhi\u1ec1u l\u1edbp theo chi\u1ec1u d\u1ecdc c\u00f3 \u0111\u1ed9 d\u00e0y t\u1eeb 15 \u0111\u1ebfn 25 l\u1edbp tr\u00ean h\u1ea7u h\u1ebft c\u00e1c b\u1ec1 m\u1eb7t c\u01a1 th\u1ec3, c\u00f3 th\u1ec3 \u0111\u1ebfn 100 l\u1edbp tr\u00ean l\u00f2ng b\u00e0n tay v\u00e0 l\u00f2ng b\u00e0n ch\u00e2n. C\u00e1c t\u1ebf b\u00e0o \u0111\u01b0\u1ee3c li\u00ean k\u1ebft v\u1edbi nhau b\u1eb1ng l\u1edbp d\u00ednh gi\u00e0u lipid theo ki\u1ec3u nh\u01b0 \u201cg\u1ea1ch v\u00e0 v\u1eefa\u201d. C\u00e1c l\u1edbp v\u1ecf ch\u1ee9a keratin, g\u1eafn k\u1ebft ch\u1eb7t ch\u1ebd trong l\u1edbp s\u1eebng t\u1ea1o th\u00e0nh m\u1ed9t l\u1edbp h\u1ea7u nh\u01b0 kh\u00f4ng th\u1ec3 xuy\u00ean qua, t\u1ea1o th\u00e0nh h\u00e0ng r\u00e0o v\u1eadt l\u00fd ch\u00ednh c\u1ee7a da.<\/p>\n
$\"H\u00ccNH$
H\u00ccNH 2.4 Bi\u1ec3u b\u00ec<\/figcaption><\/figure>\n
$\"H\u00ccNH$
H\u00ccNH 2.5 B\u1ea1ch bi\u1ebfn \u2013 m\u1ed9t b\u1ec7nh t\u1ef1 mi\u1ec5n d\u1eabn \u0111\u1ebfn m\u1ea5t c\u00e1c t\u1ebf b\u00e0o h\u1eafc t\u1ed1<\/figcaption><\/figure>\n
L\u1edbp s\u1eebng l\u00e0 r\u00e0o c\u1ea3n v\u1eadt l\u00fd ch\u00ednh.<\/p>\n
Bi\u1ec3u b\u00ec bao g\u1ed3m c\u00e1c t\u1ebf b\u00e0o ph\u00e2n chia \u1edf l\u1edbp t\u1ebf b\u00e0o \u0111\u00e1y, s\u1eebng h\u00f3a \u1edf c\u00e1c l\u1edbp k\u1ebf ti\u1ebfp (t\u1ebf b\u00e0o s\u1eebng), v\u00e0 cu\u1ed1i c\u00f9ng tr\u1edf th\u00e0nh c\u00e1c t\u1ebf b\u00e0o ch\u1ebft, ch\u1ee9a \u0111\u1ea7y ch\u1ea5t s\u1eebng trong l\u1edbp s\u1eebng.<\/p>\n
C\u00e1c th\u00e0nh ph\u1ea7n t\u1ebf b\u00e0o kh\u00e1c<\/h2>\n
Ngo\u00e0i c\u00e1c t\u1ebf b\u00e0o \u0111\u00e1y v\u00e0 t\u1ebf b\u00e0o s\u1eebng, hai t\u1ebf b\u00e0o kh\u00e1c n\u1eb1m trong l\u1edbp bi\u1ec3u b\u00ec: t\u1ebf b\u00e0o h\u1eafc t\u1ed1 v\u00e0 t\u1ebf b\u00e0o Langerhans.<\/p>\n
T\u1ebf b\u00e0o h\u1eafc t\u1ed1 (Melanocytes)<\/h3>\n
T\u1ebf b\u00e0o h\u1eafc t\u1ed1 l\u00e0 t\u1ebf b\u00e0o c\u00f3 \u0111u\u00f4i gai, s\u1ea3n xu\u1ea5t s\u1eafc t\u1ed1 n\u1eb1m \u1edf l\u1edbp t\u1ebf b\u00e0o \u0111\u00e1y (H\u00ecnh 2.4, 2.5). Ch\u00fang b\u1ea3o v\u1ec7 da kh\u1ecfi b\u1ee9c x\u1ea1 tia c\u1ef1c t\u00edm. Nh\u1eefng ng\u01b0\u1eddi c\u00f3 \u00edt ho\u1eb7c kh\u00f4ng c\u00f3 s\u1eafc t\u1ed1 s\u1ebd b\u1ecb t\u1ed5n th\u01b0\u01a1ng do \u00e1nh n\u1eafng m\u1eb7t tr\u1eddi r\u00f5 r\u1ec7t v\u00e0 nhi\u1ec1u b\u1ec7nh ung th\u01b0 da. C\u00e1c \u0111u\u00f4i gai k\u00e9o d\u00e0i v\u00e0o l\u1edbp gai v\u00e0 \u0111\u00f3ng vai tr\u00f2 nh\u01b0 c\u00e1c \u1ed1ng d\u1eabn, qua \u0111\u00f3 c\u00e1c h\u1ea1t s\u1eafc t\u1ed1 \u0111\u01b0\u1ee3c chuy\u1ec3n \u0111\u1ebfn c\u00e1c t\u1ebf b\u00e0o s\u1eebng l\u00e2n c\u1eadn c\u1ee7a ch\u00fang. C\u00e1c h\u1ea1t n\u00e0y \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 melanosome, v\u00e0 s\u1eafc t\u1ed1 b\u00ean trong l\u00e0 melanin, \u0111\u01b0\u1ee3c t\u1ed5ng h\u1ee3p t\u1eeb tyrosine. Melanosome \u01b0u ti\u00ean n\u1eb1m ph\u00eda tr\u00ean nh\u00e2n \u0111\u1ec3 b\u1ea3o v\u1ec7 DNA.<\/p>\n
Con ng\u01b0\u1eddi thu\u1ed9c m\u1ecdi ch\u1ee7ng t\u1ed9c \u0111\u1ec1u c\u00f3 s\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o h\u1eafc t\u1ed1 nh\u01b0 nhau. S\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 s\u1eafc t\u1ed1 da ph\u1ee5 thu\u1ed9c v\u00e0o (1) s\u1ed1 l\u01b0\u1ee3ng v\u00e0 k\u00edch th\u01b0\u1edbc c\u1ee7a c\u00e1c melanosome v\u00e0 (2) s\u1ef1 ph\u00e2n b\u1ed1 c\u1ee7a ch\u00fang trong da. \u1ede da c\u00f3 s\u1eafc t\u1ed1 s\u1eabm m\u00e0u, melanosome c\u00f3 k\u00edch th\u01b0\u1edbc l\u1edbn h\u01a1n v\u00e0 nhi\u1ec1u h\u01a1n so v\u1edbi melanosome \u1edf da c\u00f3 s\u1eafc t\u1ed1 nh\u1ea1t. \u00c1nh s\u00e1ng m\u1eb7t tr\u1eddi k\u00edch th\u00edch c\u00e1c t\u1ebf b\u00e0o h\u1eafc t\u1ed1 t\u0103ng s\u1ea3n xu\u1ea5t s\u1eafc t\u1ed1 v\u00e0 ph\u00e2n t\u00e1n c\u00e1c melanosome r\u1ed9ng r\u00e3i h\u01a1n.<\/p>\n
T\u1ebf b\u00e0o Langerhans<\/h3>\n
T\u1ebf b\u00e0o Langerhans l\u00e0 t\u1ebf b\u00e0o \u0111u\u00f4i gai trong l\u1edbp bi\u1ec3u b\u00ec c\u00f3 ch\u1ee9c n\u0103ng mi\u1ec5n d\u1ecbch (H\u00ecnh 2.4), c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb t\u1ee7y x\u01b0\u01a1ng v\u00e0 chi\u1ebfm kho\u1ea3ng 5% t\u1ebf b\u00e0o trong l\u1edbp bi\u1ec3u b\u00ec. Ki\u1ec3m tra b\u1eb1ng k\u00ednh hi\u1ec3n vi \u0111i\u1ec7n t\u1eed, c\u00f3 th\u1ec3 th\u1ea5y c\u00e1c h\u1ea1t h\u00ecnh \u201cv\u1ee3t tennis\u201d \u0111\u1eb7c tr\u01b0ng. T\u1ebf b\u00e0o Langerhans gi\u1ed1ng h\u1ec7t v\u1edbi c\u00e1c \u0111\u1ea1i th\u1ef1c b\u00e0o c\u1ee7a m\u00f4 v\u00e0 tr\u00ecnh di\u1ec7n c\u00e1c kh\u00e1ng nguy\u00ean cho c\u00e1c t\u1ebf b\u00e0o lympho m\u00e0 ch\u00fang t\u01b0\u01a1ng t\u00e1c th\u00f4ng qua c\u00e1c th\u1ee5 th\u1ec3 b\u1ec1 m\u1eb7t c\u1ee5 th\u1ec3. Nh\u01b0 v\u1eady, t\u1ebf b\u00e0o Langerhans l\u00e0 th\u00e0nh ph\u1ea7n quan tr\u1ecdng c\u1ee7a h\u00e0ng r\u00e0o mi\u1ec5n d\u1ecbch c\u1ee7a da.<\/p>\n
T\u1ebf b\u00e0o Langerhans l\u00e0 h\u00e0ng r\u00e0o b\u1ea3o v\u1ec7 mi\u1ec5n d\u1ecbch \u0111\u1ea7u ti\u00ean c\u1ee7a da.<\/p>\n
T\u1ebf b\u00e0o Merkel<\/h3>\n
T\u1ebf b\u00e0o Merkel n\u1eb1m \u1edf l\u1edbp t\u1ebf b\u00e0o \u0111\u00e1y. Ch\u00fang c\u00f3 nhi\u1ec1u h\u01a1n \u1edf l\u00f2ng b\u00e0n tay v\u00e0 l\u00f2ng b\u00e0n ch\u00e2n v\u00e0 \u0111\u01b0\u1ee3c k\u1ebft n\u1ed1i v\u1edbi c\u00e1c t\u1ebf b\u00e0o s\u1eebng b\u1eb1ng c\u00e1c desmosome. C\u00e1c t\u1ebf b\u00e0o Merkel ho\u1ea1t \u0111\u1ed9ng nh\u01b0 c\u00e1c th\u1ee5 th\u1ec3 c\u01a1 h\u1ecdc. Ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o Merkel l\u00e0 m\u1ed9t lo\u1ea1i ung th\u01b0 da hi\u1ebfm g\u1eb7p v\u1edbi t\u1ef7 l\u1ec7 t\u1eed vong cao.<\/p>\n
N\u1ed1i ti\u1ebfp b\u00ec – bi\u1ec3u b\u00ec – v\u00f9ng m\u00e0ng \u0111\u00e1y<\/h2>\n
M\u1eb7t giao nhau gi\u1eefa l\u1edbp bi\u1ec3u b\u00ec v\u00e0 l\u1edbp b\u00ec \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 v\u00f9ng m\u00e0ng \u0111\u00e1y. D\u01b0\u1edbi k\u00ednh hi\u1ec3n vi th\u01b0\u1eddng, n\u00f3 \u0111\u01b0\u1ee3c th\u1ea5y d\u01b0\u1edbi d\u1ea1ng m\u1ed9t \u0111\u01b0\u1eddng m\u1ea3nh. Khi ki\u1ec3m tra b\u1eb1ng k\u00ednh hi\u1ec3n vi \u0111i\u1ec7n t\u1eed cho th\u1ea5y b\u1ed1n v\u00f9ng: (1) c\u00e1c s\u1ee3i keratin trong t\u1ebf b\u00e0o s\u1eebng l\u1edbp \u0111\u00e1y g\u1eafn v\u00e0o hemidesmosome(v\u00f9ng d\u00e0y \u0111\u1eb7c electron), t\u1eeb\u0111\u00f3 g\u1eafn v\u00e0o c\u00e1c s\u1ee3i neo trong (2) lamina lucida. Lamina lucida l\u00e0 m\u1ed9t v\u00f9ng t\u01b0\u01a1ng \u0111\u1ed1i s\u00e1ng \u0111i ngang qua b\u1edfi c\u00e1c s\u1ee3i neo m\u1ecfng manh k\u1ebft n\u1ed1i hemidesmosome c\u1ee7a c\u00e1c t\u1ebf b\u00e0o \u0111\u00e1y v\u1edbi (3) lamina densa; lamina densa l\u00e0 m\u1ed9t v\u00f9ng d\u00e0y \u0111\u1eb7c electron g\u1ed3m ch\u1ee7 y\u1ebfu l\u00e0 collagen lo\u1ea1i IV c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb c\u00e1c t\u1ebf b\u00e0o bi\u1ec3u b\u00ec v\u00e0 (4) c\u00e1c s\u1ee3i neo, l\u00e0 c\u00e1c s\u1ee3i x\u01a1 d\u00e0y g\u1ed3m collagen lo\u1ea1i VII, v\u00e0 n\u1eb1m trong v\u00f9ng sublamina densa c\u1ee7a l\u1edbp b\u00ec nh\u00fa. V\u00f9ng m\u00e0ng \u0111\u00e1y \u0111\u00f3ng vai tr\u00f2 l\u00e0 ‘keo d\u00ednh’gi\u1eefa l\u1edbp bi\u1ec3u b\u00ec v\u00e0 l\u1edbp b\u00ec, v\u00e0 l\u00e0 n\u01a1i h\u00ecnh th\u00e0nh b\u00f3ng n\u01b0\u1edbc trong nhi\u1ec1u b\u1ec7nh (H\u00ecnh 2.6). Do \u0111\u00f3, c\u1ea5u tr\u00fac, th\u00e0nh ph\u1ea7n v\u00e0 \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch c\u1ee7a n\u00f3 ti\u1ebfp t\u1ee5c \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u m\u1ea1nh m\u1ebd.<\/p>\n
$\"H\u00ccNH$
H\u00ccNH 2.6 Pemphigoid b\u00f3ng n\u01b0\u1edbc \u2013 b\u1ec7nh b\u00f3ng n\u01b0\u1edbc t\u1ef1 mi\u1ec5n th\u1ee9 ph\u00e1t ph\u1ed5 bi\u1ebfn nh\u1ea5t \u1edf ng\u01b0\u1eddi cao tu\u1ed5i do s\u1ef1 ph\u00e1 v\u1ee1 mi\u1ec5n d\u1ecbch c\u1ee7a hemidesmosome. B\u00f3ng n\u01b0\u1edbc \u1edf \u0111\u00f9i trong, m\u1ed9t v\u1ecb tr\u00ed \u0111\u1eb7c tr\u01b0ng.<\/figcaption><\/figure>\n
L\u1edbp b\u00ec<\/h2>\n
Nh\u1eefng \u0111i\u1ec3m ch\u00ednh<\/h3>\n
\n
Cung c\u1ea5p t\u00ednh to\u00e0n v\u1eb9n v\u1ec1 c\u1ea5u tr\u00fac v\u00e0 c\u00f3 ho\u1ea1t \u0111\u1ed9ng sinh h\u1ecdc<\/li>\n
C\u00e1c th\u00e0nh ph\u1ea7n ch\u00ednh c\u1ee7a ch\u1ea5t n\u1ec1n l\u1edbp b\u00ec l\u00e0 collagen, elastin v\u00e0 ch\u1ea5t n\u1ec1n ngo\u1ea1i b\u00e0o<\/li>\n
Collagen l\u00e0 th\u00e0nh ph\u1ea7n ch\u00ednh c\u1ee7a l\u1edbp b\u00ec v\u00e0 chi\u1ebfm 70% tr\u1ecdng l\u01b0\u1ee3ng kh\u00f4 c\u1ee7a da<\/li>\n<\/ol>\n
L\u1edbp b\u00ec l\u00e0 m\u1ed9t c\u1ea5u tr\u00facn\u00e2ng \u0111\u1ee1, ch\u1eafc nh\u01b0ng \u0111\u00e0n h\u1ed3i, ch\u1ee9a c\u00e1c m\u1ea1ch m\u00e1u, d\u00e2y th\u1ea7n kinh v\u00e0 c\u00e1c ph\u1ea7n ph\u1ee5 c\u1ee7a da. N\u00f3 cung c\u1ea5p t\u00ednh to\u00e0n v\u1eb9n v\u1ec1 c\u1ea5u tr\u00fac v\u00e0 ho\u1ea1t \u0111\u1ed9ng sinh h\u1ecdc b\u1eb1ng c\u00e1ch t\u01b0\u01a1ng t\u00e1c v\u00e0 \u0111i\u1ec1u ch\u1ec9nh c\u00e1c ch\u1ee9c n\u0103ng c\u1ee7a t\u1ebf b\u00e0o (t\u00e1i t\u1ea1o m\u00f4). L\u1edbp b\u00ec c\u00f3 \u0111\u1ed9 d\u00e0y t\u1eeb 1 \u0111\u1ebfn 4 mm, d\u00e0y h\u01a1n nhi\u1ec1u so v\u1edbi l\u1edbp bi\u1ec3u b\u00ec, m\u00e0 \u1edf h\u1ea7u h\u1ebft c\u00e1c v\u1ecb tr\u00ed ch\u1ec9 d\u00e0y b\u1eb1ng m\u1ea3nh gi\u1ea5y (H\u00ecnh 2.7). Ch\u1ea5t n\u1ec1n l\u1edbp b\u00ec \u0111\u01b0\u1ee3c c\u1ea5u t\u1ea1o ch\u1ee7 y\u1ebfu t\u1eeb c\u00e1c s\u1ee3i collagen (th\u00e0nh ph\u1ea7n ch\u00ednh), s\u1ee3i elastin v\u00e0 ch\u1ea5t n\u1ec1n (\u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 ch\u1ea5t n\u1ec1n ngo\u00e0i s\u1ee3i), \u0111\u01b0\u1ee3c t\u1ed5ng h\u1ee3p b\u1edfi nguy\u00ean b\u00e0o s\u1ee3i l\u1edbp b\u00ec. Collagen chi\u1ebfm 70% tr\u1ecdng l\u01b0\u1ee3ng kh\u00f4 c\u1ee7a da. Collagen v\u00e0 c\u00e1c s\u1ee3i elastin l\u00e0 c\u00e1c protein d\u1ea1ng s\u1ee3i t\u1ea1o th\u00e0nh khung ch\u1ea5t n\u1ec1n ch\u1eafc nh\u01b0ng m\u1ec1m m\u1ea1i. \u1ede ph\u1ea7n tr\u00ean c\u00f9ng c\u1ee7a l\u1edbp b\u00ec (b\u00ec nh\u00fa), c\u00e1c s\u1ee3i collagen \u0111\u01b0\u1ee3c s\u1eafp x\u1ebfp l\u1ecfng l\u1ebbo v\u00e0 m\u1ecbn. \u1ede ph\u1ea7n c\u00f2n l\u1ea1i c\u1ee7a l\u1edbp b\u00ec (b\u00ec l\u01b0\u1edbi), c\u00e1c s\u1ee3i d\u00e0y v\u00e0 m\u1eadt \u0111\u1ed9 d\u00e0y \u0111\u1eb7c (H\u00ecnh 2.8). C\u00e1cs\u1ee3i elastin n\u1eb1mch\u1ee7 y\u1ebfu \u1edfl\u1edbp b\u00ec l\u01b0\u1edbi, n\u01a1i ch\u00fang m\u1ecfng h\u01a1n v\u00e0 s\u1eafp x\u1ebfp l\u1ecfng l\u1ebbo h\u01a1n c\u00e1c s\u1ee3i collagen. Ch\u1ea5t n\u1ec1n ngo\u00e0i s\u1ee3i l\u1ea5p \u0111\u1ea7y kho\u1ea3ng tr\u1ed1ng gi\u1eefa c\u00e1c s\u1ee3i. N\u00f3 l\u00e0 m\u1ed9t v\u1eadt li\u1ec7u kh\u00f4ng d\u1ea1ng s\u1ee3i \u0111\u01b0\u1ee3c t\u1ea1o th\u00e0nh t\u1eeb m\u1ed9t s\u1ed1 ph\u00e2n t\u1eed mucopolysaccharide kh\u00e1c nhau, \u0111\u01b0\u1ee3c g\u1ecdi chung l\u00e0 proteoglycan ho\u1eb7c glycosaminoglycan. Ch\u1ea5t n\u1ec1n ngo\u00e0i s\u1ee3i l\u00e0m cho l\u1edbp b\u00ec t\u0103ng t\u00ednh ch\u1ea5t l\u1ecfng h\u01a1n, t\u1ea1o \u0111i\u1ec1u ki\u1ec7n cho s\u1ef1 di chuy\u1ec3n c\u1ee7a ch\u1ea5t l\u1ecfng, ph\u00e2n t\u1eed v\u00e0 t\u1ebf b\u00e0o vi\u00eam.<\/p>\n
C\u00e1c th\u00e0nh ph\u1ea7n c\u1ea5u tr\u00fac c\u1ee7a l\u1edbp b\u00ec:<\/p>\n
\n
Collagen<\/li>\n
S\u1ee3i elastin<\/li>\n
Ch\u1ea5t n\u1ec1n ngo\u00e0i s\u1ee3i<\/li>\n<\/ol>\n
$\"H\u00ccNH$
H\u00ccNH 2.7 X\u01a1 c\u1ee9ng b\u00ec to\u00e0n th\u00e2n \u2013 s\u1ef1 gia t\u0103ng s\u1ed1 l\u01b0\u1ee3ng v\u00e0 ho\u1ea1t \u0111\u1ed9ngc\u1ee7a c\u00e1c nguy\u00eanb\u00e0os\u1ee3i t\u1ea1ora qu\u00e1 nhi\u1ec1u collagen v\u00e0 d\u1eabn \u0111\u1ebfn l\u00e0m d\u00e0y da.<\/figcaption><\/figure>\n
C\u00e1c d\u00e2y th\u1ea7n kinh v\u00e0 m\u1ea1ch m\u00e1u \u0111i qua l\u1edbp b\u00ec, v\u00e0 m\u1ed9t l\u1edbp m\u1ee1 d\u01b0\u1edbi da n\u1eb1m b\u00ean d\u01b0\u1edbi n\u00f3 (H\u00ecnh 2.9).<\/p>\n
C\u00e1c \u0111\u1ea7u d\u00e2y th\u1ea7n kinh t\u1ef1 do l\u00e0 c\u00e1c th\u1ee5 th\u1ec3 c\u1ea3m gi\u00e1c quan tr\u1ecdng nh\u1ea5t.<\/p>\n
$\"H\u00ccNH$
H\u00ccNH 2.8 L\u1edbp b\u00ec nh\u00fa \u2013 c\u00e1c s\u1ee3i collagenm\u1ea3nh v\u00e0 l\u1ecfng l\u1ebbo. L\u1edbp b\u00ec l\u01b0\u1edbi \u2013 c\u00e1c s\u1ee3i collagen d\u00e0y v\u00e0 \u0111\u1eb7c.<\/figcaption><\/figure>\n
$\"H\u00ccNH$
H\u00ccNH 2.9 L\u1edbp b\u00ec v\u00e0 l\u1edbp m\u1ee1 d\u01b0\u1edbi da.<\/figcaption><\/figure>\n
$\"H\u00ccNH$
H\u00ccNH 2.10 Herpes zoster \u2013 s\u1ef1 t\u00e1i ho\u1ea1t c\u1ee7a virus varicella-zoster trong c\u00e1c h\u1ea1ch th\u1ea7n kinh c\u1ea3m gi\u00e1c d\u1eabn \u0111\u1ebfn ph\u00e1t ban da, m\u1ee5n n\u01b0\u1edbc, \u0111au.<\/figcaption><\/figure>\n
$\"H\u00ccNH$
H\u00ccNH 2.11 Tuy\u1ebfn m\u1ed3 h\u00f4i, tuy\u1ebfn apocrine v\u00e0 nang l\u00f4ng v\u1edbi tuy\u1ebfn b\u00e3.<\/figcaption><\/figure>\n
D\u00e2y th\u1ea7n kinh<\/h3>\n
Da l\u00e0 m\u1ed9t th\u1ee5 th\u1ec3 c\u1ea3m gi\u00e1c ch\u00ednh. Kh\u00f4ng c\u00f3 c\u1ea3m gi\u00e1c ch\u1ea1m, nhi\u1ec7t v\u00e0 \u0111au, cu\u1ed9c s\u1ed1ng s\u1ebd k\u00e9m th\u00fa v\u1ecb v\u00e0 nguy hi\u1ec3m h\u01a1n. C\u1ea3m gi\u00e1c \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n tr\u00ean da b\u1edfi c\u1ea3 hai \u0111\u1ea7u d\u00e2y th\u1ea7n kinh t\u1ef1 do v\u00e0 c\u00e1c th\u1ee5 th\u1ec3 ph\u1ee9c t\u1ea1p h\u01a1n c\u00f3 c\u1ea5u tr\u00fac ti\u1ec3u th\u1ec3. C\u00e1c \u0111\u1ea7u d\u00e2y th\u1ea7n kinh t\u1ef1 do ph\u00e2n b\u1ed1 r\u1ed9ng h\u01a1n v\u00e0 c\u00f3 v\u1ebb quan tr\u1ecdng h\u01a1n. Ngu\u1ed3n cung c\u1ea5p th\u1ea7n kinh c\u1ee7a da l\u00e0 ph\u00e2n \u0111o\u1ea1n da, v\u1edbi s\u1ef1 ch\u1ed3ng ch\u00e9o \u0111\u00e1ng k\u1ec3 gi\u1eefa c\u00e1c ph\u00e2n \u0111o\u1ea1n (H\u00ecnh 2.10).<\/p>\n
M\u1ea1ch m\u00e1u<\/h3>\n
C\u00e1c m\u1ea1ch m\u00e1u trong da ph\u1ee5c v\u1ee5 hai ch\u1ee9c n\u0103ng: dinh d\u01b0\u1ee1ng v\u00e0 \u0111i\u1ec1u ho\u00e0 nhi\u1ec7t \u0111\u1ed9. L\u1edbp bi\u1ec3u b\u00ec kh\u00f4ng c\u00f3 ngu\u1ed3n cung c\u1ea5p m\u00e1u n\u1ed9i t\u1ea1i v\u00e0 do \u0111\u00f3 ph\u1ee5 thu\u1ed9c v\u00e0o s\u1ef1 khu\u1ebfch t\u00e1n c\u1ee7a ch\u1ea5t dinh d\u01b0\u1ee1ng v\u00e0 oxy t\u1eeb c\u00e1c m\u1ea1ch m\u00e1u trong l\u1edbp b\u00ec nh\u00fa. C\u00e1c m\u1ea1ch m\u00e1u trong l\u1edbp b\u00ec c\u0169ng cung c\u1ea5p cho m\u00f4 li\u00ean k\u1ebft v\u00e0 c\u00e1c c\u1ea5u tr\u00fac ph\u1ea7n ph\u1ee5 n\u1eb1m trong \u0111\u00f3.<\/p>\n
Ch\u1ee9c n\u0103ng c\u1ee7a m\u1ea1ch m\u00e1u:<\/p>\n
\n
Cung c\u1ea5p dinh d\u01b0\u1ee1ng<\/li>\n
\u0110i\u1ec1u h\u00f2a nhi\u1ec7t \u0111\u1ed9<\/li>\n<\/ol>\n
M\u1ea1ch m\u00e1u c\u1ee7a da \u0111\u01b0\u1ee3c s\u1eafp x\u1ebfp th\u00e0nh hai \u0111\u00e1m r\u1ed1i n\u1eb1m ngang li\u00ean k\u1ebft v\u1edbi nhau. \u0110\u00e1m r\u1ed1i n\u00f4ng n\u1eb1m \u1edf b\u1edd d\u01b0\u1edbi c\u1ee7a l\u1edbp b\u00ec nh\u00fa v\u00e0 \u0111\u00e1m r\u1ed1i s\u00e2u n\u1eb1m \u1edf l\u1edbp b\u00ec l\u01b0\u1edbi. \u0110i\u1ec1u ho\u00e0 nhi\u1ec7t \u0111\u1ed9 \u0111\u1ea1t \u0111\u01b0\u1ee3c th\u00f4ng qua c\u00e1c \u1ed1ng d\u1eabn gi\u1eefa c\u00e1c \u0111\u00e1m r\u1ed1i. L\u01b0u l\u01b0\u1ee3ng m\u00e1u t\u0103ng l\u00ean \u1edf \u0111\u00e1m r\u1ed1i n\u00f4ng cho ph\u00e9p tho\u00e1t nhi\u1ec7t, trong khi s\u1ef1 chuy\u1ec3n h\u01b0\u1edbng d\u00f2ng m\u00e1u \u0111\u1ebfn \u0111\u00e1m r\u1ed1i s\u00e2u gi\u00fap gi\u1eef nhi\u1ec7t.<\/p>\n
Ph\u1ea5n ph\u1ee5 da (Skin Appendage)<\/h2>\n
Nh\u1eefng \u0111i\u1ec3m ch\u00ednh<\/p>\n
\n
Tuy\u1ebfn eccrine gi\u00fap \u0111i\u1ec1u h\u00f2a nhi\u1ec7t \u0111\u1ed9 c\u01a1 th\u1ec3<\/li>\n
Tuy\u1ebfn m\u1ed3 h\u00f4i apocrine ph\u1ee5 thu\u1ed9c v\u00e0o androgen \u0111\u1ec3 ph\u00e1t tri\u1ec3n<\/li>\n
C\u00e1c t\u1ebf b\u00e0o g\u1ed1c c\u1ee7a nang l\u00f4ng t\u00e1i t\u1ea1o l\u1ea1i ph\u1ea7n kh\u00f4ng c\u1ed1 \u0111\u1ecbnh c\u1ee7a nang l\u00f4ng theo chu k\u1ef3<\/li>\n
Tuy\u1ebfn b\u00e3 nh\u1eddn ch\u1ecbu s\u1ef1ki\u1ec3m so\u00e1t c\u1ee7a androgen 5. M\u00f3ng, l\u00f4ng \u0111\u01b0\u1ee3c l\u00e0m b\u1eb1ng ch\u1ea5t s\u1eebng (keratin)<\/li>\n<\/ol>\n
C\u00e1c ph\u1ea7n ph\u1ee5 c\u1ee7a da l\u00e0 tuy\u1ebfn m\u1ed3 h\u00f4i eccrine v\u00e0 apocrine, nang l\u00f4ng, tuy\u1ebfn b\u00e3 nh\u1eddn v\u00e0 m\u00f3ng. Ch\u00fang c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb bi\u1ec3u b\u00ec, nh\u01b0ng ngo\u1ea1i tr\u1eeb m\u00f3ng, ch\u00fang n\u1eb1m trong l\u1edbp b\u00ec.<\/p>\n
Tuy\u1ebfn m\u1ed3 h\u00f4i eccrine<\/h3>\n
\u0110\u1ed1i v\u1edbi nh\u1eefng ng\u01b0\u1eddi ho\u1ea1t \u0111\u1ed9ng th\u1ec3 ch\u1ea5t v\u00e0 nh\u1eefng ng\u01b0\u1eddi s\u1ed1ng \u1edf v\u00f9ng kh\u00ed h\u1eadu n\u00f3ng, tuy\u1ebfn m\u1ed3 h\u00f4i eccrine l\u00e0 ph\u1ea7n ph\u1ee5 quan tr\u1ecdng nh\u1ea5t c\u1ee7a da v\u1ec1 m\u1eb7t sinh l\u00fd. Ch\u00fang \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t b\u1edfi c\u00e1c k\u00edch th\u00edch c\u1ea3m x\u00fac v\u00e0 nhi\u1ec7t \u0111\u1ed9. H\u1ec7 cholinergic ch\u1ecbu tr\u00e1ch nhi\u1ec7m cho s\u1ef1 b\u00e0i ti\u1ebft eccrine sinh l\u00fd. Botulinum toxin A (Botox) ti\u00eam trong da c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb ch\u1ee9ng t\u0103ng ti\u1ebft m\u1ed3 h\u00f4i \u1edf n\u00e1ch b\u1eb1ng c\u00e1ch ng\u0103n ch\u1eb7n ho\u1ea1t \u0111\u1ed9ng c\u1ee7a acetylcholine. Tuy\u1ebfn m\u1ed3 h\u00f4i eccrine gi\u00fap \u0111i\u1ec1u h\u00f2a nhi\u1ec7t \u0111\u1ed9 c\u01a1 th\u1ec3 b\u1eb1ng c\u00e1ch b\u00e0i ti\u1ebft m\u1ed3 h\u00f4i l\u00ean b\u1ec1 m\u1eb7t da, t\u1eeb \u0111\u00f3 di\u1ec5n ra qu\u00e1 tr\u00ecnh bay h\u01a1i n\u01b0\u1edbc l\u00e0m m\u00e1t. Hai \u0111\u1ebfn ba tri\u1ec7u tuy\u1ebfn m\u1ed3 h\u00f4i eccrine ph\u00e2n b\u1ed1 tr\u00ean to\u00e0n b\u1ed9 b\u1ec1 m\u1eb7t c\u01a1 th\u1ec3, v\u1edbi t\u1ed5ng kh\u1ea3 n\u0103ng b\u00e0i ti\u1ebft l\u00e0 10 L m\u1ed3 h\u00f4i m\u1ed7i ng\u00e0y. B\u1ed9 ph\u1eadn b\u00e0i ti\u1ebft c\u1ee7a tuy\u1ebfn m\u1ed3 h\u00f4i l\u00e0 m\u1ed9t \u1ed1ng cu\u1ed9n n\u1eb1m s\u00e2u trong l\u1edbp b\u00ec. M\u1ed3 h\u00f4i \u0111\u01b0\u1ee3c v\u1eadn chuy\u1ec3n qua l\u1edbp b\u00ec b\u1eb1ng m\u1ed9t \u1ed1ng d\u1eabn m\u1ed3 h\u00f4i xuy\u00ean qua l\u1edbp bi\u1ec3u b\u00ec (H\u00ecnh 2.11). M\u1ed3 h\u00f4i ti\u1ebft ra \u1edf ph\u1ea7n tuy\u1ebfn l\u00e0 \u0111\u1eb3ng tr\u01b0\u01a1ng v\u1edbi huy\u1ebft t\u01b0\u01a1ng nh\u01b0ng tr\u1edf n\u00ean nh\u01b0\u1ee3c tr\u01b0\u01a1ng khi n\u00f3 tho\u00e1t ra kh\u1ecfi da do t\u00e1i h\u1ea5p thu ch\u1ea5t \u0111i\u1ec7n gi\u1ea3i \u1edf \u1ed1ng tuy\u1ebfn. Do \u0111\u00f3, tuy\u1ebfn m\u1ed3 h\u00f4i t\u01b0\u01a1ng t\u1ef1 nh\u01b0 c\u01a1 ch\u1ebf \u1edf th\u1eadn, ngh\u0129a l\u00e0 b\u00e0i ti\u1ebft tuy\u1ebfn (c\u1ea7u th\u1eadn) sau \u0111\u00f3 l\u00e0 t\u00e1i h\u1ea5p thu \u1edf \u1ed1ng.<\/p>\n
C\u00e1c tuy\u1ebfn m\u1ed3 h\u00f4i eccrine gi\u00fap \u0111i\u1ec1u h\u00f2a nhi\u1ec7t \u0111\u1ed9 v\u00e0 ch\u1ecbu s\u1ef1 chi ph\u1ed1i c\u1ee7a h\u1ec7 cholinergic.<\/p>\n
Tuy\u1ebfn m\u1ed3 h\u00f4i apocrine<\/h3>\n
\u1ede ng\u01b0\u1eddi, c\u00e1c tuy\u1ebfn m\u1ed3 h\u00f4i apocrine ph\u1ee5 thu\u1ed9c v\u00e0o androgen \u0111\u1ec3 ph\u00e1t tri\u1ec3n v\u00e0 kh\u00f4ng c\u00f3 ch\u1ee9c n\u0103ng h\u1eefu \u00edch n\u00e0o \u0111\u01b0\u1ee3c bi\u1ebft \u0111\u1ebfn, m\u1eb7c d\u00f9 ch\u00fang ch\u1ecbu tr\u00e1ch nhi\u1ec7m t\u1ea1o ra m\u00f9i c\u01a1 th\u1ec3. M\u00f9i c\u01a1 th\u1ec3 th\u1ef1c s\u1ef1 l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a t\u00e1c \u0111\u1ed9ng c\u1ee7a vi khu\u1ea9n tr\u00ean b\u1ec1 m\u1eb7t da v\u1edbi m\u1ed3 h\u00f4i apocrine \u0111\u01b0\u1ee3c b\u00e0i ti\u1ebft, b\u1ea3n th\u00e2n n\u00f3 kh\u00f4ng c\u00f3 m\u00f9i. C\u00e1c tuy\u1ebfn m\u1ed3 h\u00f4i apocrine n\u1eb1m ch\u1ee7 y\u1ebfu \u1edf v\u00f9ng n\u00e1ch v\u00e0 v\u00f9ng sinh d\u1ee5c. \u0110o\u1ea1n b\u00e0i ti\u1ebft c\u1ee7a tuy\u1ebfn apocrine c\u0169ng l\u00e0 m\u1ed9t \u1ed1ng cu\u1ed9n n\u1eb1m s\u00e2u trong l\u1edbp b\u00ec. Tuy nhi\u00ean, kh\u00f4ng gi\u1ed1ng nh\u01b0 \u1edf c\u00e1c tuy\u1ebfn eccrine, trong \u0111\u00f3 c\u00e1c t\u1ebf b\u00e0o ti\u1ebft v\u1eabn c\u00f2n nguy\u00ean v\u1eb9n, \u1edf c\u00e1c tuy\u1ebfn apocrine, c\u00e1c t\u1ebf b\u00e0o ti\u1ebft \u2018c\u1eaft b\u1ecf\u2019 ph\u1ea7n \u0111\u1ec9nh c\u1ee7a ch\u00fang nh\u01b0 l\u00e0 m\u1ed9t ph\u1ea7n c\u1ee7a s\u1ea3n ph\u1ea9m b\u00e0i ti\u1ebft (H\u00ecnh 2.11). Sau \u0111\u00f3, \u1ed1ng tuy\u1ebfn apocrine d\u1eabn m\u1ed3 h\u00f4i \u0111\u00e3 ti\u1ebft \u0111\u1ed5 v\u00e0o ph\u1ea7n gi\u1eefa c\u1ee7a nang l\u00f4ng, t\u1eeb \u0111\u00f3 m\u1ed3 h\u00f4i cu\u1ed1i c\u00f9ng s\u1ebd \u0111\u1ebfn b\u1ec1 m\u1eb7t da.<\/p>\n
Ho\u1ea1t \u0111\u1ed9ng c\u1ee7a vi khu\u1ea9n tr\u00ean m\u1ed3 h\u00f4i apocrine g\u00e2y ra m\u00f9i c\u01a1 th\u1ec3.<\/p>\n
Nang l\u00f4ng (Hair Follicle)<\/h3>\n
\u1ede h\u1ea7u h\u1ebft c\u00e1c lo\u00e0i \u0111\u1ed9ng v\u1eadt c\u00f3 v\u00fa, l\u00f4ng c\u00f3 ch\u1ee9c n\u0103ng b\u1ea3o v\u1ec7, nh\u01b0ng \u1edf ng\u01b0\u1eddi, l\u00f4ng ch\u1ee7 y\u1ebfu l\u00e0 \u0111\u1ec3 trang tr\u00ed.<\/p>\n
C\u00e1c nang l\u00f4ng ph\u00e2n b\u1ed1 tr\u00ean to\u00e0n b\u1ed9 b\u1ec1 m\u1eb7t c\u01a1 th\u1ec3, tr\u1eeb l\u00f2ng b\u00e0n tay v\u00e0 l\u00f2ng b\u00e0n ch\u00e2n. L\u00f4ng c\u00f3 hai k\u00edch c\u1ee1: (1) l\u00f4ng t\u01a1, ng\u1eafn, m\u1ecbn, s\u00e1ng m\u00e0u v\u00e0 \u00edt th\u1ea5y r\u00f5; v\u00e0 (2) l\u00f4ng tr\u01b0\u1edfng th\u00e0nh d\u00e0y h\u01a1n, d\u00e0i h\u01a1n v\u00e0 s\u1eabm m\u00e0u h\u01a1n lo\u1ea1i l\u00f4ng t\u01a1. L\u00f4ng tr\u01b0\u1edfng th\u00e0nh \u1edf m\u1ed9t s\u1ed1 v\u1ecb tr\u00ed b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1edfi hormon v\u00e0 kh\u00f4ng xu\u1ea5t hi\u1ec7n cho \u0111\u1ebfn tu\u1ed5i d\u1eady th\u00ec, v\u00ed d\u1ee5: r\u00e2u \u1edf nam gi\u1edbi, l\u00f4ng mu v\u00e0 l\u00f4ng n\u00e1ch \u1edf c\u1ea3 hai gi\u1edbi.<\/p>\n
C\u00e1c lo\u1ea1i l\u00f4ng:<\/p>\n
\n
L\u00f4ng t\u01a1 (vellus hair) s\u00e1ng v\u00e0 m\u1ea3nh<\/li>\n
L\u00f4ng tr\u01b0\u1edfng th\u00e0nh (terminal hair) t\u1ed1i v\u00e0 d\u00e0y<\/li>\n<\/ol>\n
M\u1ed9t nang l\u00f4ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c xem nh\u01b0 m\u1ed9t khoang \u0111\u1eb7c bi\u1ec7t c\u1ee7a bi\u1ec3u b\u00ec (H\u00ecnh 2.11), v\u1edbi m\u1ed9t qu\u1ea7n th\u1ec3 t\u1ebf b\u00e0o \u1edf ph\u00eda d\u01b0\u1edbi (c\u1ee7 l\u00f4ng) \u0111ang t\u00e1i t\u1ea1o th\u1eadm ch\u00ed c\u00f2n t\u00edch c\u1ef1c h\u01a1n c\u00e1c t\u1ebfb\u00e0o \u0111\u00e1y bi\u1ec3u b\u00ec b\u00ecnh th\u01b0\u1eddng. Nh\u1eefng t\u1ebf b\u00e0o n\u00e0y t\u1ea1o th\u00e0nh ch\u1ea5t n\u1ec1n l\u00f4ng. C\u0169ng nh\u01b0 c\u00e1c t\u1ebf b\u00e0o \u0111\u00e1y trong l\u1edbp bi\u1ec3u b\u00ec, c\u00e1c t\u1ebf b\u00e0o n\u1ec1n \u0111\u1ea7u ti\u00ean ph\u00e2n chia v\u00e0 sau \u0111\u00f3 bi\u1ec7t h\u00f3a, cu\u1ed1i c\u00f9ng t\u1ea1o th\u00e0nh m\u1ed9t s\u1ee3il\u00f4ng c\u00f3 ch\u1ea5t s\u1eebng. Melanocytestrong ch\u1ea5t n\u1ec1n \u0111\u00f3ng g\u00f3p s\u1eafc t\u1ed1, v\u1edbi s\u1ed1 l\u01b0\u1ee3ng x\u00e1c \u0111\u1ecbnh m\u00e0u t\u00f3c. Khi c\u00e1c t\u1ebf b\u00e0o ch\u1ea5t n\u1ec1n ti\u1ebfp t\u1ee5c ph\u00e2n chia, l\u00f4ng \u0111\u01b0\u1ee3c \u0111\u1ea9y ra ngo\u00e0i v\u00e0 tho\u00e1t ra ngo\u00e0i qua l\u1edbp bi\u1ec3u b\u00ec v\u1edbi t\u1ed1c \u0111\u1ed9 kho\u1ea3ng 1 cm m\u1ed7i th\u00e1ng. S\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a l\u00f4ng trong m\u1ed9t nang l\u00f4ng ri\u00eang l\u1ebb l\u00e0 theo chu k\u1ef3, v\u1edbi giai \u0111o\u1ea1n t\u0103ng tr\u01b0\u1edfng (anagen), giai \u0111o\u1ea1n chuy\u1ec3n ti\u1ebfp (catagen) v\u00e0 giai \u0111o\u1ea1n ngh\u1ec9 ng\u01a1i (telogen). \u0110\u1ed9 d\u00e0i c\u1ee7a c\u00e1c giai \u0111o\u1ea1n thay \u0111\u1ed5i t\u1eeb v\u00f9ng n\u00e0y sang v\u00f9ng kh\u00e1c c\u1ee7a c\u01a1 th\u1ec3. V\u00ed d\u1ee5, tr\u00ean da \u0111\u1ea7u, giai \u0111o\u1ea1n anagen k\u00e9o d\u00e0i kho\u1ea3ng 3 n\u0103m, giai \u0111o\u1ea1n catagen kho\u1ea3ng 3 tu\u1ea7n v\u00e0 giai \u0111o\u1ea1n telogen kho\u1ea3ng 3 th\u00e1ng. \u0110\u1ed9 d\u00e0i c\u1ee7a giai \u0111o\u1ea1n anagen thay \u0111\u1ed5i t\u00f9y theo t\u1eebng c\u00e1 nh\u00e2n, gi\u1ea3i th\u00edch t\u1ea1i sao m\u1ed9t s\u1ed1 ng\u01b0\u1eddi c\u00f3 th\u1ec3 m\u1ecdc t\u00f3c d\u00e0i h\u01a1n nh\u1eefng ng\u01b0\u1eddi kh\u00e1c.<\/p>\n
Chu k\u1ef3 ph\u00e1t tri\u1ec3n c\u1ee7a l\u00f4ng th\u00f4ng qua c\u00e1c giai \u0111o\u1ea1n t\u0103ng tr\u01b0\u1edfng (anagen), chuy\u1ec3n ti\u1ebfp (catagen) v\u00e0 ngh\u1ec9 ng\u01a1i (telogen).<\/p>\n
V\u00e0o cu\u1ed1i giai \u0111o\u1ea1n anagen, qu\u00e1 tr\u00ecnh t\u0103ng tr\u01b0\u1edfng d\u1eebng l\u1ea1i v\u00e0 nang l\u00f4ng b\u01b0\u1edbc v\u00e0o giai \u0111o\u1ea1n catagen v\u00e0 telogen, trong \u0111\u00f3 ph\u1ea7n ch\u1ea5t n\u1ec1n v\u00e0 2\/3 d\u01b0\u1edbi c\u1ee7a nang l\u00f4ng teo l\u1ea1i v\u00e0 l\u00f4ng trong nang b\u1ecb r\u1ee5ng. Sau \u0111\u00f3, th\u00f4ng qua s\u1ef1 t\u01b0\u01a1ng t\u00e1c gi\u1eefa trung m\u00f4 v\u1edbi c\u00e1c t\u1ebf b\u00e0o g\u1ed1c c\u1ee7a nang l\u00f4ng, m\u1ed9t ch\u1ea5t n\u1ec1n l\u00f4ng m\u1edbi \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh \u1edf \u0111\u00e1y nang l\u00f4ng v\u00e0 chu k\u1ef3 \u0111\u01b0\u1ee3c l\u1eb7p l\u1ea1i (H\u00ecnh 2.12). V\u00e0o b\u1ea5t k\u1ef3 th\u1eddi \u0111i\u1ec3m n\u00e0o, 80\u2013 90% t\u00f3c tr\u00ean da \u0111\u1ea7u \u1edf giai \u0111o\u1ea1n anagen v\u00e0 10\u201320% \u1edf giai \u0111o\u1ea1n telogen, do \u0111\u00f3 t\u1ef7 l\u1ec7 r\u1ee5ng b\u00ecnh th\u01b0\u1eddng l\u00e0 t\u1eeb 25 \u0111\u1ebfn 100 s\u1ee3i t\u00f3c m\u1ed7i ng\u00e0y.<\/p>\n
$\"H\u00ccNH$
H\u00ccNH 2.12 R\u1ee5ng t\u00f3c t\u1eebng v\u00f9ng \u2013 t\u00ecnh tr\u1ea1ng t\u1ef1 mi\u1ec5n d\u1eabn \u0111\u1ebfn c\u00e1c m\u1ea3ng r\u1ee5ng t\u00f3c h\u00ecnh tr\u00f2n kh\u00f4ng \u0111\u1ec3 l\u1ea1i s\u1eb9o.<\/figcaption><\/figure>\n
Th\u00f4ng th\u01b0\u1eddng, 25\u2013100 s\u1ee3i t\u00f3c b\u1ecb r\u1ee5ng kh\u1ecfi da \u0111\u1ea7u m\u1ed7i ng\u00e0y.<\/p>\n
Nh\u01b0 trong H\u00ecnh 2.11, nang l\u00f4ng n\u1eb1m \u1edf l\u1edbp b\u00ec v\u1edbi m\u1ed9t g\u00f3c nghi\u00eang. C\u01a1 d\u1ef1ng l\u00f4ng \u0111\u00ednh k\u00e8m kh\u00f4ng \u0111\u01b0\u1ee3c hi\u1ec3n th\u1ecb. Khi c\u01a1 n\u00e0y co l\u1ea1i, l\u00f4ng s\u1ebd m\u1ecdc th\u1eb3ng \u0111\u1ee9ng, khi\u1ebfn da tr\u00f4ng gi\u1ed1ng nh\u01b0 da ng\u1ed7ng. C\u00e1c t\u1ebf b\u00e0o g\u1ed1c c\u1ee7a nang l\u00f4ng n\u1eb1m \u1edf khu v\u1ef1c ‘t\u00fai ph\u00ecnh’ c\u1ee7a nang l\u00f4ng, n\u01a1i m\u00e0 c\u01a1 d\u1ef1ng l\u00f4ng ch\u00e8n v\u00e0o nang l\u00f4ng. C\u00e1c t\u1ebf b\u00e0o g\u1ed1c r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 t\u00e1i t\u1ea1o l\u1ea1i ph\u1ea7n kh\u00f4ng c\u1ed1 \u0111\u1ecbnh c\u1ee7a nang l\u00f4ng theo chu k\u1ef3.<\/p>\n
Tuy\u1ebfn b\u00e3 nh\u1eddn (Sebaceous Gland)<\/h3>\n
C\u00e1c tuy\u1ebfn b\u00e3 nh\u1eddn t\u1ea1o ra m\u1ed9t ch\u1ea5t d\u1ea7u \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 b\u00e3 nh\u1eddn (sebum), ch\u1ee9c n\u0103ng c\u1ee7a n\u00f3 v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c bi\u1ebft r\u00f5. Tr\u00ean th\u1ef1c t\u1ebf, da c\u1ee7a tr\u1ebb em v\u00e0 da l\u00f2ng b\u00e0n tay v\u00e0 l\u00f2ng b\u00e0n ch\u00e2n c\u1ee7a ng\u01b0\u1eddi l\u1edbn ho\u1ea1t \u0111\u1ed9ng t\u1ed1t m\u00e0 kh\u00f4ng c\u1ea7n b\u00e3 nh\u1eddn.<\/p>\n
Tuy\u1ebfn b\u00e3 nh\u1eddn l\u00e0 m\u1ed9t ph\u1ea7n c\u1ee7a \u0111\u01a1n v\u1ecb nang l\u00f4ng tuy\u1ebfn b\u00e3 v\u00e0 do \u0111\u00f3 \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y \u1edf b\u1ea5t c\u1ee9 n\u01a1i n\u00e0o c\u00f3 nang l\u00f4ng. Ngo\u00e0i ra, c\u00e1c tuy\u1ebfn b\u00e3 nh\u1eddn l\u1ea1c ch\u1ed7 th\u01b0\u1eddng \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y tr\u00ean ni\u00eam m\u1ea1c, h\u00ecnh th\u00e0nh c\u00e1c s\u1ea9n nh\u1ecf m\u00e0u v\u00e0ng g\u1ecdi l\u00e0 Fordyce spot. \u1ede da, tuy\u1ebfn b\u00e3 n\u1ed5i b\u1eadt nh\u1ea5t tr\u00ean da \u0111\u1ea7u v\u00e0 m\u1eb7t, v\u00e0 trung b\u00ecnh \u1edf v\u00f9ng th\u00e2n tr\u00ean. K\u00edch th\u01b0\u1edbc v\u00e0 ho\u1ea1t \u0111\u1ed9ng b\u00e0i ti\u1ebft c\u1ee7a c\u00e1c tuy\u1ebfn n\u00e0y ch\u1ecbu s\u1ef1 ki\u1ec3m so\u00e1t c\u1ee7a androgen. C\u00e1c tuy\u1ebfn b\u00e3 nh\u1eddn \u1edf tr\u1ebb s\u01a1 sinh to ra do hormon c\u1ee7a m\u1eb9, nh\u01b0ng trong v\u00f2ng v\u00e0i th\u00e1ng, c\u00e1c tuy\u1ebfn n\u00e0y s\u1ebd co l\u1ea1i (H\u00ecnh 2.13). Ch\u00fang to tr\u1edf l\u1ea1i \u1edf tu\u1ed5i tr\u01b0\u1edbc v\u1ecb th\u00e0nh ni\u00ean do k\u00edch th\u00edch b\u1edfi c\u00e1c androgen tuy\u1ebfn th\u01b0\u1ee3ng th\u1eadn v\u00e0 \u0111\u1ea1t k\u00edch th\u01b0\u1edbc \u0111\u1ea7y \u0111\u1ee7 \u1edf tu\u1ed5i d\u1eady th\u00ec, khi c\u00e1c androgen tuy\u1ebfn sinh d\u1ee5c \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t.<\/p>\n
Tuy\u1ebfn b\u00e3 nh\u1eddn ph\u1ee5 thu\u1ed9c androgen.<\/p>\n
C\u00e1c t\u1ebf b\u00e0o ch\u1ee9a nhi\u1ec1u lipid trong c\u00e1c tuy\u1ebfn b\u00e3 nh\u1eddn \u0111\u01b0\u1ee3c ti\u1ebft ra ho\u00e0n to\u00e0n (b\u00e0i ti\u1ebft holocrine) \u0111\u1ec3 t\u1ea1o th\u00e0nh b\u00e3 nh\u1eddn. Triglyceride chi\u1ebfm ph\u1ea7n l\u1edbn lipid \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y trong c\u00e1c t\u1ebf b\u00e0o tuy\u1ebfn b\u00e3 nh\u1eddn. T\u1eeb c\u00e1ctuy\u1ebfn b\u00e3nh\u1eddn, b\u00e3 nh\u1eddn \u0111\u1ed5v\u00e0o nang l\u00f4ng (H\u00ecnh 2.11), t\u1eeb \u0111\u00f3 tho\u00e1t ra tr\u00ean b\u1ec1 m\u1eb7t da.<\/p>\n
$\"H\u00ccNH$
H\u00ccNH 2.13 M\u1ee5n tr\u1ee9ng c\u00e1 \u1edf tr\u1ebb s\u01a1 sinh \u2013 m\u1ed9t r\u1ed1i lo\u1ea1n ph\u1ed5 bi\u1ebfn \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn \u0111\u01a1n v\u1ecb nang l\u00f4ng tuy\u1ebfn b\u00e3. Androgen c\u1ee7a m\u1eb9 c\u00f3 \u1ea3nh h\u01b0\u1edfng.<\/figcaption><\/figure>\n
$\"H\u00ccNH$
H\u00ccNH 2.14 M\u00f3ng b\u00ecnh th\u01b0\u1eddng.<\/figcaption><\/figure>\n
M\u00f3ng (Nail)<\/h3>\n
M\u00f3ng, gi\u1ed1ng nh\u01b0 t\u00f3c, \u0111\u01b0\u1ee3c l\u00e0m b\u1eb1ng ch\u1ea5t s\u1eebng, \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh t\u1eeb m\u1ed9t ch\u1ea5t n\u1ec1n c\u1ee7a c\u00e1c c\u00e1c t\u1ebf b\u00e0o bi\u1ec3u b\u00ec ph\u00e2n chia (H\u00ecnh 2.14). Tuy nhi\u00ean, m\u00f3ng c\u1ee9ng, ph\u1eb3ng v\u00e0 n\u1eb1m song song v\u1edbi b\u1ec1 m\u1eb7t da. N\u1eb1m \u1edf \u0111\u1ea7u ng\u00f3n tay v\u00e0 ng\u00f3n ch\u00e2n, ch\u00fang t\u1ea1o \u0111i\u1ec1u ki\u1ec7n thu\u1eadn l\u1ee3i cho c\u00e1c thao t\u00e1c n\u1eafm v\u00e0 k\u1eb9p.<\/p>\n
M\u00f3ng \u0111\u01b0\u1ee3c l\u00e0m b\u1eb1ng ch\u1ea5t s\u1eebng \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t trong ch\u1ea5t n\u1ec1n.<\/p>\n
Phi\u1ebfn m\u00f3ng l\u00e0 m\u1ed9t c\u1ea5u tr\u00fac c\u1ee9ng, trong m\u1edd, g\u1ed3m ch\u1ea5t s\u1eebng, c\u00f3 \u0111\u1ed9 d\u00e0y t\u1eeb 0,3 \u0111\u1ebfn 0,65 mm.<\/p>\n
$\"H\u00ccNH$
H\u00ccNH 2.15 Lichen ph\u1eb3ng \u2013 m\u1ed9t t\u00ecnh tr\u1ea1ng vi\u00eam th\u01b0\u1eddng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn da v\u00e0 ni\u00eam m\u1ea1c, nh\u01b0ng c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ch\u1ea5t n\u1ec1n c\u1ee7a m\u00f3ng v\u00e0 g\u00e2y ra t\u00ecnh tr\u1ea1ng m\u00f3ng b\u1ecb lo\u1ea1n d\u01b0\u1ee1ng.<\/figcaption><\/figure>\n
M\u00f3ng tay m\u1ecdc v\u1edbi t\u1ed1c \u0111\u1ed9 li\u00ean t\u1ee5c kho\u1ea3ng 0,1 mm\/ng\u00e0y v\u00e0 m\u00f3ng ch\u00e2n v\u1edbi t\u1ed1c \u0111\u1ed9 ch\u1eadm h\u01a1n m\u1ed9t ch\u00fat.<\/p>\n
B\u1ed1n v\u00f9ng bi\u1ec3u m\u00f4 \u0111\u01b0\u1ee3c li\u00ean k\u1ebft v\u1edbi m\u00f3ng:<\/p>\n
\n
N\u1ebfp g\u1ea5p m\u00f3ng g\u1ea7n gi\u00fap b\u1ea3o v\u1ec7 ch\u1ea5t n\u1ec1n. L\u1edbp s\u1eebng \u0111\u01b0\u1ee3c t\u1ea1o ra \u1edf \u0111\u00f3 t\u1ea1o th\u00e0nh l\u1edbp bi\u1ec3u b\u00ec.<\/li>\n
Ch\u1ea5t n\u1ec1n t\u1ea1o ra phi\u1ebfn m\u00f3ng t\u1eeb c\u00e1c t\u1ebf b\u00e0o ph\u00e2n chianhanh ch\u00f3ng,s\u1eebng h\u00f3ac\u1ee7an\u00f3. H\u1ea7u h\u1ebft ch\u1ea5t n\u1ec1n n\u1eb1m d\u01b0\u1edbi n\u1ebfp g\u1ea5p m\u00f3ng g\u1ea7n nh\u1ea5t, nh\u01b0ng tr\u00ean m\u1ed9t s\u1ed1 ng\u00f3n (\u0111\u1eb7c bi\u1ec7t l\u00e0 ng\u00f3n tay c\u00e1i), n\u00f3 k\u00e9o d\u00e0id\u01b0\u1edbi phi\u1ebfnm\u00f3ng, n\u01a1i n\u00f3 c\u00f3 th\u1ec3nh\u00ecn th\u1ea5y r\u00f5 d\u01b0\u1edbi d\u1ea1ng lunula m\u00e0u tr\u1eafng. Ph\u1ea7n g\u1ea7n nh\u1ea5t c\u1ee7a ch\u1ea5t n\u1ec1n t\u1ea1o th\u00e0nh \u0111\u1ec9nh c\u1ee7a phi\u1ebfn m\u00f3ng; ph\u1ea7n xa nh\u1ea5t t\u1ea1o th\u00e0nh \u0111\u00e1y c\u1ee7a phi\u1ebfn m\u00f3ng (H\u00ecnh 2.15).<\/li>\n
Bi\u1ec3u m\u00f4 c\u1ee7a gi\u01b0\u1eddng m\u00f3ng t\u1ea1o ra m\u1ed9t l\u01b0\u1ee3ng ch\u1ea5t s\u1eebng t\u1ed1i thi\u1ec3u, ch\u1ea5t n\u00e0y s\u1ebd b\u00e1m ch\u1eb7t v\u00e0o \u0111\u00e1y c\u1ee7a phi\u1ebfn m\u00f3ng. M\u00e0u h\u1ed3ng c\u1ee7a m\u00f3ng l\u00e0 do m\u1ea1ch m\u00e1u \u1edf l\u1edbp b\u00ec c\u1ee7a gi\u01b0\u1eddng m\u00f3ng.<\/li>\n
L\u1edbp bi\u1ec3u b\u00ec c\u1ee7a hyponychium l\u00e0m n\u1ec1n cho b\u1edd xa t\u1ef1 do c\u1ee7a phi\u1ebfn m\u00f3ng. L\u1edbp s\u1eebng \u0111\u01b0\u1ee3c t\u1ea1o ra \u1edf \u0111\u00f3 t\u1ea1o th\u00e0nh m\u1ed9t l\u1edbp bi\u1ec3u b\u00ec \u0111\u1ec3 b\u1ecbt k\u00edn ph\u1ea7n ti\u1ebfp gi\u00e1p c\u1ee7a gi\u01b0\u1eddng m\u00f3ng v\u00e0 phi\u1ebfn m\u00f3ng.<\/li>\n<\/ol>\n
M\u1ee1 d\u01b0\u1edbi da (Subcutaneous Fat)<\/h2>\n
M\u1ed9t l\u1edbp m\u1ee1 d\u01b0\u1edbi da n\u1eb1m gi\u1eefa l\u1edbp b\u00ec v\u00e0 l\u1edbp c\u00e2n c\u01a1 b\u00ean d\u01b0\u1edbi. N\u00f3 gi\u00fap c\u00e1ch ly c\u01a1 th\u1ec3 kh\u1ecfi l\u1ea1nh, \u0111\u1ec7m c\u00e1c m\u00f4 s\u00e2u kh\u1ecfi ch\u1ea5n th\u01b0\u01a1ng va \u0111\u1eadp v\u00e0 \u0111\u00f3ng vai tr\u00f2 l\u00e0 ngu\u1ed3n n\u0103ng l\u01b0\u1ee3ng d\u1ef1 tr\u1eef cho c\u01a1 th\u1ec3. C\u00e1c t\u1ebf b\u00e0o m\u1ee1 c\u00f3 ho\u1ea1t t\u00ednh sinh h\u1ecdc \u0111\u00f3ng m\u1ed9t vai tr\u00f2 trong vi\u1ec7c truy\u1ec1n tin hormone, b\u1eb1ng ch\u1ee9ng l\u00e0 r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a \u1edf tr\u1ebb v\u00e0 thanh thi\u1ebfu ni\u00ean b\u00e9o ph\u00ec v\u1edbi t\u00ecnh tr\u1ea1ng kh\u00e1ng insulin ngo\u1ea1i bi\u00ean. Trong l\u1edbp m\u1ee1 d\u01b0\u1edbi da, c\u00e1c t\u1eadp h\u1ee3p t\u1ebf b\u00e0o m\u1ee1 \u0111\u01b0\u1ee3c ng\u0103n c\u00e1ch b\u1edfi c\u00e1c v\u00e1ch ng\u0103n d\u1ea1ng s\u1ee3i \u0111\u01b0\u1ee3c c\u00e1c m\u1ea1ch m\u00e1u v\u00e0 d\u00e2y th\u1ea7n kinh \u0111i qua (H\u00ecnh 2.16).<\/p>\n
$\"H\u00ccNH$
H\u00ccNH 2.16 H\u1ed3ng ban n\u00fat. C\u00e1c n\u1ed1t d\u01b0\u1edbi da th\u01b0\u1eddng th\u1ea5y nh\u1ea5t \u1edf c\u1eb3ng ch\u00e2n c\u1ee7a ph\u1ee5 n\u1eef sau khi b\u1eaft \u0111\u1ea7u d\u00f9ng thu\u1ed1c tr\u00e1nh thai do t\u00ecnh tr\u1ea1ng vi\u00eam t\u1eadp trung\u1edf v\u00e1ch x\u01a1 ng\u0103n c\u00e1ch c\u00e1c t\u1ebf b\u00e0o m\u1ee1 ho\u1eb7c ti\u1ec3u th\u00f9y m\u1ee1.<\/figcaption><\/figure>\n
M\u1ee1 d\u01b0\u1edbi da:<\/p>\n
\n
C\u00e1ch nhi\u1ec7t<\/li>\n
H\u1ea5p th\u1ee5 ch\u1ea5n th\u01b0\u01a1ng<\/li>\n
Ngu\u1ed3n n\u0103ng l\u01b0\u1ee3ng d\u1ef1 tr\u1eef<\/li>\n
Ho\u1ea1t \u0111\u1ed9ng sinh h\u1ecdc<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"
Bi\u00ean d\u1ecbch: B\u00e1c s\u0129 Tr\u01b0\u01a1ng T\u1ea5n Minh V\u0169\u00a0 vnras.com\/drug – \u0110\u1ec3 t\u1ea3i file PDF c\u1ee7a b\u00e0i vi\u1ebft C\u1ea5u tr\u00fac v\u00e0 ch\u1ee9c n\u0103ng c\u1ee7a da, xin vui l\u00f2ng click v\u00e0o link \u1edf \u0111\u00e2y. N\u1ed9i dung Bi\u1ec3u b\u00ec K\u1ebft c\u1ea5u C\u00e1c th\u00e0nh ph\u1ea7n t\u1ebf b\u00e0o kh\u00e1c L\u1edbp n\u1ed1i b\u00ec v\u00e0 bi\u1ec3u b\u00ec – V\u00f9ng m\u00e0ng \u0111\u00e1y \u2022B\u00ec […]\n","protected":false},"author":1,"featured_media":34738,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-34691","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/34691","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=34691"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/34691\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/34738"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=34691"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=34691"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=34691"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}