{"id":1139,"date":"2025-09-02T10:20:02","date_gmt":"2025-09-02T03:20:02","guid":{"rendered":"https:\/\/cdha.edu.vn\/cdha\/?p=1139"},"modified":"2025-09-02T10:26:38","modified_gmt":"2025-09-02T03:26:38","slug":"not-san-do-ap-luc-piezogenic-papules","status":"publish","type":"post","link":"https:\/\/cdha.edu.vn\/cdha\/not-san-do-ap-luc-piezogenic-papules\/","title":{"rendered":"N\u1ed1t s\u1ea7n do \u00e1p l\u1ef1c (Piezogenic papules)"},"content":{"rendered":"\n

Olivier Lebecque, Ana Falticeanu, Nicolas Mulquin<\/strong>
Khoa X quang, \u0110\u1ea1i h\u1ecdc C\u00f4ng gi\u00e1o Louvain, B\u1ec7nh vi\u1ec7n \u0110\u1ea1i h\u1ecdc UCL Namur, Yvoir, B\u1ec9<\/strong><\/p>\n\n\n\n

M\u1ed9t ph\u1ee5 n\u1eef 64 tu\u1ed5i \u0111\u01b0\u1ee3c chuy\u1ec3n \u0111\u1ebfn \u0111\u1ec3 si\u00eau \u00e2m sau khi b\u00e0 than phi\u1ec1n c\u00f3 nhi\u1ec1u n\u1ed1t s\u1ea7n g\u00e2y \u0111au \u1edf g\u00f3t ch\u00e2n. B\u00e1c s\u0129 da li\u1ec5u c\u1ee7a b\u00e0 \u0111\u00e3 \u0111\u1ec1 xu\u1ea5t ch\u1ea9n \u0111o\u00e1n l\u00e0 c\u00e1c n\u1ed1t s\u1ea7n do \u00e1p l\u1ef1c. B\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c n\u1ed1t s\u1ea7n c\u00f9ng m\u00e0u da, nh\u00f4 ra t\u1eeb ph\u00eda ngo\u00e0i c\u1ee7a c\u1ea3 hai g\u00f3t ch\u00e2n, \u0111\u1eb7c bi\u1ec7t l\u00e0 khi \u0111\u1ee9ng. Si\u00eau \u00e2m t\u1ea7n s\u1ed1 cao (18-5 MHz) \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n khi \u1edf t\u01b0 th\u1ebf \u0111\u1ee9ng. <\/p>\n\n\n\n

\u0110\u1ea7u ti\u00ean, \u0111\u1ea7u d\u00f2 \u0111\u01b0\u1ee3c \u0111\u1eb7t l\u00ean m\u00e0 kh\u00f4ng t\u1ea1o \u00e1p l\u1ef1c. K\u1ebft qu\u1ea3 cho th\u1ea5y m\u00f4 d\u01b0\u1edbi da c\u00f3 \u0111\u1ed9 h\u1ed3i \u00e2m th\u1ea5p nh\u1eb9 – ch\u1ee7 y\u1ebfu l\u00e0 c\u00e1c th\u00f9y m\u1ee1 – nh\u00f4 ra t\u1eeb 4 \u0111\u1ebfn 5 mm v\u00e0o l\u1edbp b\u00ec c\u00f3 \u0111\u1ed9 h\u1ed3i \u00e2m cao nh\u1eb9 (h\u00ecnh 1a), kh\u00f4ng c\u00f3 m\u1ea1ch m\u00e1u b\u1ea5t th\u01b0\u1eddng. Sau \u0111\u00f3, ch\u00fang t\u00f4i t\u1ea1o \u00e1p l\u1ef1c nh\u1eb9 b\u1eb1ng \u0111\u1ea7u d\u00f2, v\u00e0 m\u00f4 nh\u00f4 ra tr\u01b0\u1edbc \u0111\u00f3 \u0111\u00e3 tr\u1edf l\u1ea1i trong m\u00f4 t\u1ebf b\u00e0o d\u01b0\u1edbi da, gi\u1ed1ng nh\u01b0 m\u1ed9t tho\u00e1t v\u1ecb c\u00f3 th\u1ec3 n\u1eafn \u0111\u01b0\u1ee3c (h\u00ecnh 1b). Kh\u00f4ng t\u00ecm th\u1ea5y t\u1ed5n th\u01b0\u01a1ng n\u00e0o kh\u00e1c v\u00e0 ch\u1ea9n \u0111o\u00e1n c\u00e1c n\u1ed1t s\u1ea7n do \u00e1p l\u1ef1c do \u0111\u00f3 \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e1c nh\u1eadn.<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n

H\u00ecnh 1.<\/strong> a) H\u00ecnh \u1ea3nh si\u00eau \u00e2m thang x\u00e1m g\u00f3t ch\u00e2n khi kh\u00f4ng c\u00f3 \u00e1p l\u1ef1c \u0111\u1ea7u d\u00f2 cho th\u1ea5y m\u1ed9t n\u1ed1t s\u1ea7n do \u00e1p l\u1ef1c l\u00e0 m\u00f4 d\u01b0\u1edbi da c\u00f3 \u0111\u1ed9 h\u1ed3i \u00e2m th\u1ea5p nh\u1eb9 (*) nh\u00f4 ra 4,5 milim\u00e9t v\u00e0o l\u1edbp b\u00ec (b\u1ec7nh nh\u00e2n \u0111ang \u0111\u1ee9ng); b) Khi t\u1ea1o \u00e1p l\u1ef1c nh\u1eb9, m\u00f4 nh\u00f4 ra tr\u01b0\u1edbc \u0111\u00f3 \u0111\u00e3 tr\u1edf l\u1ea1i khoang ban \u0111\u1ea7u c\u1ee7a n\u00f3; c) H\u00ecnh th\u00e1i l\u00e2m s\u00e0ng c\u1ee7a c\u00e1c n\u1ed1t s\u1ea7n c\u00f9ng m\u00e0u da v\u00e0 h\u01a1i v\u00e0ng (m\u0169i t\u00ean) khi b\u1ec7nh nh\u00e2n \u0111ang \u0111\u1ee9ng; d) H\u00ecnh th\u00e1i l\u00e2m s\u00e0ng c\u1ee7a g\u00f3t ch\u00e2n khi ngh\u1ec9 ng\u01a1i (kh\u00f4ng ti\u1ebfp x\u00fac v\u1edbi m\u1eb7t \u0111\u1ea5t).<\/p>\n\n\n\n

S\u1ea7n do \u00e1p l\u1ef1c (Piezogenic papules) l\u00e0 c\u00e1c tho\u00e1t v\u1ecb nh\u1ecf c\u1ee7a m\u00f4 m\u1ee1 d\u01b0\u1edbi da v\u00e0o l\u1edbp b\u00ec. Khi th\u0103m kh\u00e1m th\u1ef1c th\u1ec3, ch\u00fang xu\u1ea5t hi\u1ec7n d\u01b0\u1edbi d\u1ea1ng c\u00e1c n\u1ed1t s\u1ea7n ch\u1eafc, m\u00e0u v\u00e0ng \u0111\u1ebfn c\u00f9ng m\u00e0u da \u1edf g\u00f3t ch\u00e2n v\u00e0\/ho\u1eb7c m\u1eb7t l\u00f2ng c\u1ed5 tay (h\u00ecnh 1c, d), tr\u1edf n\u00ean r\u00f5 h\u01a1n khi c\u00f3 \u00e1p l\u1ef1c . Th\u01b0\u1eddng kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng, nh\u1eefng t\u1ed5n th\u01b0\u01a1ng n\u00e0y r\u1ea5t ph\u1ed5 bi\u1ebfn, v\u1edbi t\u1ef7 l\u1ec7 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o l\u00ean t\u1edbi 76-86% trong d\u00e2n s\u1ed1 n\u00f3i chung . Ch\u1ea9n \u0111o\u00e1n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1eb1ng l\u00e2m s\u00e0ng, nh\u01b0ng si\u00eau \u00e2m t\u1ea7n s\u1ed1 cao c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 x\u00e1c nh\u1eadn n\u1ebfu c\u1ea7n, cho th\u1ea5y m\u00f4 d\u01b0\u1edbi da b\u1ecb tho\u00e1t v\u1ecb v\u00e0o trong l\u1edbp b\u00ec. Sinh thi\u1ebft th\u01b0\u1eddng kh\u00f4ng c\u1ea7n thi\u1ebft.<\/p>\n\n\n\n

M\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 nguy c\u01a1 \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh (b\u00e9o ph\u00ec, b\u00e0n ch\u00e2n b\u1eb9t, \u0111\u1ee9ng trong th\u1eddi gian d\u00e0i, c\u00e1c v\u1eadn \u0111\u1ed9ng vi\u00ean nh\u01b0 v\u1eadn \u0111\u1ed9ng vi\u00ean ch\u1ea1y \u0111\u01b0\u1eddng d\u00e0i), v\u00e0 c\u00e1c m\u1ed1i li\u00ean h\u1ec7 \u0111\u00e3 \u0111\u01b0\u1ee3c nghi ng\u1edd v\u1edbi c\u00e1c r\u1ed1i lo\u1ea1n collagen nh\u01b0 h\u1ed9i ch\u1ee9ng Ehlers-Danlos. C\u00e1c n\u1ed1t s\u1ea7n \u1edf b\u00e0n ch\u00e2n c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf m\u1ecdi l\u1ee9a tu\u1ed5i, v\u00e0 c\u00f3 m\u1ed9t bi\u1ebfn th\u1ec3 b\u1ea5t th\u01b0\u1eddng \u1edf tr\u1ebb s\u01a1 sinh kh\u00f4ng ch\u1ecbu tr\u1ecdng l\u01b0\u1ee3ng. V\u00ec h\u1ea7u h\u1ebft b\u1ec7nh nh\u00e2n kh\u00f4ng b\u1ecb \u0111au, t\u00ecnh tr\u1ea1ng n\u00e0y ch\u1ee7 y\u1ebfu l\u00e0 m\u1ed1i b\u1eadn t\u00e2m v\u1ec1 th\u1ea9m m\u1ef9. N\u1ebfu c\u00e1c t\u1ed5n th\u01b0\u01a1ng g\u00e2y \u0111au, n\u00ean xem x\u00e9t c\u00e1c bi\u1ec7n ph\u00e1p qu\u1ea3n l\u00fd b\u1ea3o t\u1ed3n (v\u00ed d\u1ee5: \u0111i\u1ec1u ch\u1ec9nh h\u00e0nh vi, gi\u1ea3m c\u00e2n, tr\u00e1nh \u0111\u1ee9ng l\u00e2u) tr\u01b0\u1edbc ti\u00ean, sau \u0111\u00f3 l\u00e0 mang v\u1edb n\u00e9n, \u0111\u1ec7m g\u00f3t ch\u00e2n v\u00e0 d\u1ee5ng c\u1ee5 ch\u1ec9nh h\u00ecnh. C\u00e1c k\u1ef9 thu\u1eadt x\u00e2m l\u1ea5n h\u01a1n n\u00ean \u0111\u01b0\u1ee3c d\u00e0nh cho nh\u1eefng tr\u01b0\u1eddng h\u1ee3p kh\u00f3.<\/p>\n\n\n\n

\n

L\u01b0\u1ee3c d\u1ecbch t\u1eeb medultrason.ro<\/p>\n<\/blockquote>\n","protected":false},"excerpt":{"rendered":"

S\u1ea7n do \u00e1p l\u1ef1c (Piezogenic papules) l\u00e0 c\u00e1c tho\u00e1t v\u1ecb nh\u1ecf c\u1ee7a m\u00f4 m\u1ee1 d\u01b0\u1edbi da v\u00e0o l\u1edbp b\u00ec. Khi th\u0103m kh\u00e1m th\u1ef1c th\u1ec3, ch\u00fang xu\u1ea5t hi\u1ec7n d\u01b0\u1edbi d\u1ea1ng c\u00e1c n\u1ed1t s\u1ea7n ch\u1eafc, m\u00e0u v\u00e0ng \u0111\u1ebfn c\u00f9ng m\u00e0u da \u1edf g\u00f3t ch\u00e2n v\u00e0\/ho\u1eb7c m\u1eb7t l\u00f2ng c\u1ed5 tay tr\u1edf n\u00ean r\u00f5 h\u01a1n khi c\u00f3 \u00e1p l\u1ef1c<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":"[]"},"categories":[2,7,5],"tags":[],"class_list":["post-1139","post","type-post","status-publish","format-standard","hentry","category-doc-sach-cho-vui","category-phan-mem-cxk","category-sieu-am"],"_links":{"self":[{"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/posts\/1139","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/comments?post=1139"}],"version-history":[{"count":3,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/posts\/1139\/revisions"}],"predecessor-version":[{"id":1144,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/posts\/1139\/revisions\/1144"}],"wp:attachment":[{"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/media?parent=1139"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/categories?post=1139"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/tags?post=1139"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}