Iyini i-Psoriasis? Izimpawu Nezindlela Zokwelapha

Iyini i-Psoriasis?

I-Psoriasis, eyaziwa nangokuthi i-psoriasis, isifo esingelapheki futhi esingelapheki futhi sibonakala ngenani elicishe libe ngu-1-3% emhlabeni jikelele. Nakuba ngokuvamile iqala eminyakeni engamashumi amathathu, ingenzeka kunoma iyiphi iminyaka kusukela ekuzalweni. Kunomlando womndeni kuma-30% wamacala.

Ku-psoriasis, ama-antigen ahlukahlukene adalwa amaseli esikhumbeni. Lawa ma-antigen adlala indima ekwenzeni amasosha omzimba asebenze. Amaseli omzimba asebenzayo abuyela esikhumbeni futhi abangele ukwanda kwamangqamuzana kanye nokwakheka kwama-psoriasis-specific plaques esikhumbeni. Ngakho-ke, i-psoriasis yisifo esikhula umzimba ngokumelene nezicubu zawo. Izifo ezinjalo zihlukaniswa njengezifo ze-autoimmune.

Ezigulini ze-psoriasis, amaseli e-T lymphocyte amasosha omzimba ayasebenza futhi aqala ukunqwabelana esikhumbeni. Ngemva kokunqwabelana kwala mangqamuzana esikhumbeni, umjikelezo wokuphila kwamanye amangqamuzana esikhumba uyashesha futhi la mangqamuzana akha ukwakheka kwama-plaque aqinile. I-Psoriasis yenzeka ngenxa yenqubo yokwanda kwala maseli esikhumba.

Amaseli esikhumba akhiqizwa ezingxenyeni ezijulile zesikhumba, kancane kancane akhuphukele phezulu, futhi ngemva kwesikhathi esithile, aqeda umjikelezo wawo wokuphila futhi achithe. Umjikelezo wempilo wamaseli esikhumba uhlala cishe inyanga engu-1. Ezigulini ze-psoriasis, lo mjikelezo wempilo ungafinyezwa ngezinsuku ezimbalwa.

Amaseli aqeda umjikelezo wawo wokuphila awabi naso isikhathi sokuwa futhi aqale ukunqwabelana phezu kwamanye. Izilonda ezenzeka ngale ndlela zingase zibonakale njengama-plaque, ikakhulukazi ezindaweni ezihlangene, kodwa futhi ezandleni zesiguli, ezinyaweni, entanyeni, ekhanda noma esikhumbeni sobuso.

Yini Ebangela I-Psoriasis?

Imbangela eyisisekelo ye-psoriasis ayizange idalulwe ngokuqinisekile. Ucwaningo lwakamuva lugcizelela umbono wokuthi izici ezihlobene nezakhi zofuzo kanye nesistimu yokuzivikela komzimba zingase zisebenze ngokubambisana ekuthuthukiseni lesi sifo.

Ku-psoriasis, okuyisimo se-autoimmune, amangqamuzana avame ukulwa namagciwane angaphandle ahlanganisa amasosha omzimba ngokumelene nama-antigens amangqamuzana esikhumba futhi abangele ukuqubuka kwesici. Kucatshangwa ukuthi ezinye izici zendawo kanye nezakhi zofuzo zingase zibangele ukuthuthukiswa kwamangqamuzana esikhumba avuselela ngokushesha kunokujwayelekile.

Okuvame kakhulu kulezi zici ezibangela yilezi:

• Isifo somphimbo noma isikhumba
• Izimo zezulu ezibandayo nezomile
• Ukuhambisana nezifo ezahlukahlukene ze-autoimmune
• Ukuhlukumezeka kwesikhumba
• Ukucindezeleka
• Ukusebenzisa ugwayi noma ukuchayeka entuthuni kagwayi
• Ukusetshenziswa kotshwala ngokweqile
• Ngemuva kokuqedwa ngokushesha kwezidakamizwa ezitholakala kuma-steroid
• Ngemuva kokusebenzisa ezinye izidakamizwa ezisetshenziselwa ukwelapha umfutho wegazi noma umalaleveva

Embuzweni wokuthi ingabe i-psoriasis iyathathelana, impendulo inganikezwa ukuthi lesi sifo singenzeka kunoma ubani nokuthi ayikho into okuthiwa ukusabalala phakathi kwabantu. Umlando wokuqalwa kobuntwana ungatholwa engxenyeni eyodwa kwezintathu yamacala.

Ukuba nomlando womndeni kuyisici esibalulekile esiyingozi. Ukuba nalesi sifo emalungwini omndeni asondelene kungaholela ekwandeni kwamathuba omuntu ophethwe yi-psoriasis. I-psoriasis ezuzwe ngofuzo itholakala cishe ku-10% wabantu abaseqenjini labasengozini. Kulokhu 10%, i-2-3% ithuthukisa i-psoriasis.

Ucwaningo oluhlukahlukene luye lwembula ukuthi kungase kube nezifunda zenhliziyo ezihlukene ezingu-25 ezihlobene nobungozi be-psoriasis. Izinguquko kulezi zifunda zofuzo zingabangela ama-T cell ukuthi aziphathe ngendlela ehlukile kunokujwayelekile. Ukuqubuka ngendlela yokwandiswa kwemithambo yegazi, ukusheshisa komjikelezo wamaseli kanye nenkwethu kwenzeka esikhumbeni esihlaselwe ama-T cell.

Yiziphi Izimpawu Nezinhlobo Ze-Psoriasis?

I-Psoriasis inenkambo engapheli futhi iziguli eziningi ziba nama-plaque esikhumba kanye ne-dandruff. Lesi sifo sivame kakhulu engxenyeni yesine yamacala. Ukululama okuzenzakalelayo kuyivelakancane, kodwa kwezinye izimo, izikhathi zokuxolelwa kanye nokwanda kungenzeka. Ingcindezi, utshwala, izifo ezibangelwa amagciwane noma amagciwane zingadala ukuqubuka. Ukusebenzisa ugwayi nakho kuphakathi kwezinto ezingabhebhethekisa lesi sifo.

Iziguli eziningi zinokulunywa kanye nama-plaque esikhumbeni. Esifweni esivamile, kungase kube nobunzima ekugcineni izinga lokushisa lomzimba, ukugodola, ukuqhaqhazela, kanye nokwanda kokusetshenziswa kwamaprotheni. Kwezinye izimo, i-rheumatism ingase ithuthuke ngenxa ye-psoriasis. Ku-rheumatism ehlobene ne-psoriasis, ingase yenzeke esihlakaleni, iminwe, idolo, iqakala nentamo. Kulezi zimo, kukhona nezilonda zesikhumba.

Izimpawu ze-psoriasis zingavela noma yikuphi emzimbeni, kodwa ngokuvamile zivela emadolweni, ezindololwaneni, ekhanda nasezithweni zangasese. Lapho i-psoriasis yenzeka ezinziphoni, imigodi emincane, ukushintsha kombala ophuzi-nsundu kanye nokujiya kwezinzipho kungase kwenzeke.

I-Psoriasis inezinhlobo ezahlukene kuye ngokuthi uhlobo lwezilonda zesikhumba:

• I-Psoriasis ye-Plaque

I-Plaque psoriasis, noma i-psoriasis vulgaris, iwuhlobo oluncane oluvame kakhulu lwe-psoriasis futhi ilandisa cishe ku-85% weziguli. Ibonakala ngokuqubuka okumpunga noma okumhlophe kuma-plaque abomvu aminyene. Izilonda zivame ukuvela emadolweni, ezindololwaneni, esifundeni se-lumbar nasekhanda.

Lezi zilonda, ezihluka ngosayizi ukusuka ku-1 kuya ku-10 amasentimitha, zingafinyelela ubukhulu obumboza ingxenye yomzimba kwabanye abantu. Ukuhlukumezeka okubangelwa izenzo ezifana nokunwaya esikhumbeni esingaguquki kungase kubangele ukwakheka kwezilonda kuleyo ndawo. Lesi simo, esibizwa nge-Koebner phenomenon, singase sibonise ukuthi lesi sifo siyasebenza ngaleso sikhathi.

Ukutholwa ukopha kwe-punctate kumasampula athathwe ezilonda ezigulini ze-plaque psoriasis kubizwa ngokuthi uphawu lwe-Auspitz futhi kubalulekile ekuxilongweni komtholampilo.

• I-Psoriasis yesisu

I-Guttate psoriasis yakha izilonda ngendlela yemibuthano emincane ebomvu esikhumbeni. Iwuhlobo lwesibili oluvame kakhulu lwe-psoriasis ngemva kwe-plaque psoriasis futhi lukhona cishe ku-8% weziguli. I-Guttate psoriasis ivame ukuqala ebuntwaneni nasebudaleni obuncane.

Izilonda ezibangelwayo zincane, zihlukanisiwe futhi zimise okweconsi. Ama-rashes, avela kaningi esiqwini nasemaphethelweni, angavela nasebusweni nasekhanda. Ubukhulu bokuqubuka bungaphansi kobe-plaque psoriasis, kodwa bungase bushube ngokuhamba kwesikhathi.

Kungase kube nezici ezihlukahlukene ezibangela ukuthuthukiswa kwe-guttate psoriasis. Ukutheleleka komphimbo wamagciwane, ukucindezeleka, ukulimala kwesikhumba, ukutheleleka kanye nemithi ehlukahlukene kuphakathi kwalezi zici ezibangela. Isici esivame kakhulu esitholwa ezinganeni yizifo eziphezulu zokuphefumula ezibangelwa amagciwane e-streptococcus. I-Guttate psoriasis iyindlela ye-psoriasis ene-prognosis engcono kakhulu kuzo zonke izinhlobo ezincane.

• I-Pustular Psoriasis

I-pustular psoriasis, enye yezinhlobo ezinzima ze-psoriasis, ikhiqiza ama-pustules abomvu, njengoba igama libonisa. Izilonda zingenzeka ezingxenyeni eziningi zomzimba, okuhlanganisa izindawo eziqhelile njengezintende zezandla nezinyawo, futhi zingafinyelela osayizi abahlanganisa indawo enkulu. I-pustular psoriasis, njengamanye ama-subtypes, ingathinta izindawo ezihlangene futhi ibangele i-dandruff esikhumbeni. Izilonda ze-pustular eziwumphumela zisesimweni samabhamuza amhlophe, agcwele ubomvu.

Kwabanye abantu, isikhathi sokuhlasela lapho ama-pustules esenzeka khona kanye nesikhathi sokuxolelwa singalandelana ngomjikelezo. Lapho kwakheka ama-pustules, umuntu angase abe nezimpawu ezinjengomkhuhlane. Imfiva, ukugodola, ukushaya kwenhliziyo okusheshayo, ubuthakathaka bemisipha nokulahlekelwa ukudla kuphakathi kwezimpawu ezingase zenzeke phakathi nalesi sikhathi.

• I-Intertriginous Psoriasis

Lolu hlobo oluncane lwe-psoriasis, olubizwa nangokuthi i-flexural noma i-psoriasis ephambene, ngokuvamile luvela esikhumbeni sebele, ikhwapha kanye ne-groin lapho isikhumba sigoqeka khona. Izilonda eziwumphumela zibomvu futhi ziyacwebezela.

Ezigulini ezine-intertriginous psoriasis, ukuqubuka kungase kungenzeki ngenxa yomswakama ezindaweni lapho izilonda zivela khona. Kufanele kuqashelwe njengoba lesi simo singase sidideke nezifo ezibangelwa amagciwane noma isikhunta kwabanye abantu.

Abantu abanale psoriasis batholakala behambisana nezinhlobo ezincane ezihlukene kwezinye izingxenye zomzimba. Ukuqapha kufanele kusetshenziswe njengoba izilonda zingaba zimbi kakhulu uma kukhuhlana.

• I-Erythrodermic Psoriasis

I-Erythrodermic psoriasis, eyaziwa nangokuthi i-exfoliative psoriasis, iwuhlobo oluncane lwe-psoriasis olungajwayelekile olwakha izilonda ezinjengokushisa. Lesi sifo singaba sibi kangangokuthi sidinga ukunakekelwa okuphuthumayo. Ukulawulwa kokushisa komzimba okungalungile kungenye yezizathu ezibaluleke kakhulu zokulaliswa esibhedlela ezigulini ezinjalo.

Ku-erythrodermic psoriasis, engamboza ingxenye enkulu yomzimba ngesikhathi, isikhumba sibukeka njengoba senza ngemva kokushiswa yilanga. Izilonda zingase ziqhume ngokuhamba kwesikhathi futhi ziwe njengesikhunta esikhulu. Ukuqubuka okwenzeka kulolu hlobo oluncane lwe-psoriasis oluyivelakancane luyaluma futhi lungabangela ubuhlungu obuvuthayo.

• I-Psoriatic Arthritis

I-Psoriatic arthritis yisifo se-rheumatological esibuhlungu kakhulu futhi esivimbela imisebenzi yomuntu engokomzimba, futhi sithinta cishe isiguli esisodwa kwezi-3 ze-psoriasis. I-Psoriatic arthritis ihlukaniswe yaba ama-subgroups angu-5 ahlukene kuye ngezimpawu. Njengamanje, awukho umuthi noma enye indlela yokwelapha engaqeda lesi sifo.

I-Psoriatic arthritis ezigulini ezine-psoriasis, okuyisifo esizimele, senzeka ngemva kokuba amasosha omzimba eqondise amalunga kanye nesikhumba. Lesi simo, esingathinta kakhulu amalunga esandla, singenzeka kunoma yiliphi ilunga emzimbeni. Ukubonakala kwezilonda zesikhumba ezigulini ngokuvamile kwenzeka ngaphambi kokuvela kwezikhalazo ezihlangene.

Itholakala Kanjani I-Psoriasis?

Ukuxilongwa kwesifo kuvame ukwenziwa ngokubonakala kwezilonda zesikhumba. Ukuba khona kwe-psoriasis emndenini kusiza ukuxilongwa. Ezimweni eziningi, i-psoriasis ingatholwa ngokuhlolwa ngokomzimba nokuhlolwa kwezilonda kuphela. Ngaphakathi kokuhlolwa ngokomzimba, ukuba khona kwezimpawu ezihlobene ne-psoriasis kuyabuzwa. Ezimweni ezisolisayo, i-biopsy yesikhumba yenziwa.

Ngesikhathi senqubo ye-biopsy, kuthathwa isampula elincane lesikhumba bese amasampula athunyelwa elabhorethri ukuze ahlolwe ngesibonakhulu. Ngenqubo ye-biopsy, uhlobo lwe-psoriasis lungacaciswa.

Ngaphandle kwenqubo ye-biopsy, ukuhlolwa okuhlukahlukene kwe-biochemical kungenziwa futhi ukusekela ukutholakala kwe-psoriasis. Isibalo segazi eliphelele, izinga le-rheumatoid factor, izinga le-erythrocyte sedimentation (ESR), izinga le-uric acid, ukuhlolwa kokukhulelwa, imingcele yesifo sokusha kwesibindi kanye nokuhlolwa kwesikhumba kwe-PPD kuphakathi kwamanye amathuluzi okuxilonga angasetshenziswa.

Yelashwa Kanjani I-Psoriasis (I-Psoriasis)?

Imibono yomuntu siqu yesiguli nayo iyacatshangelwa lapho kunqunywa ukwelashwa kwe-psoriasis. Njengoba ukwelashwa kuzoba isikhathi eside, ukuthobela kwesiguli ukuhlela ukwelashwa kubaluleke kakhulu. Iziguli eziningi nazo zinezinkinga ze-metabolic ezifana nokukhuluphala, umfutho wegazi ophakeme kanye ne-hyperlipidemia. Lezi zimo nazo ziyacatshangelwa lapho kuhlelwa ukwelashwa. Ukuhlelwa kokwelashwa kwenziwa ngokuhambisana nobukhulu besifo kanye nokuthi kulimaza yini izinga lempilo.

Ezimweni ezibekwe endaweni ethile yomzimba, kusetshenziswa okhilimu besikhumba abafanele. Amakhilimu aqukethe i-cortisone avame ukuthandwa. Ama-creams anconywa ukugcina isikhumba simanzi. Abesifazane abakhulelwe belashwa ngokhilimu be-cortisone kanye ne-phototherapy enamandla amancane. Ngaphambi kwalokhu, kungathintana nodokotela wezifo zabesifazane ukuze bathole ulwazi lokuthi ukwelashwa ngeke kudale umonakalo.

Ukhilimu, ijeli, igwebu noma imithi esuselwe kwisifutho equkethe i-corticosteroids ingase ibe usizo ezimeni ze-psoriasis ethambile noma emaphakathi. Le mithi isetshenziswa nsuku zonke ngesikhathi sokukhushulwa, futhi isetshenziswa isikhathi eside phakathi nezikhathi lapho lesi sifo singekho. Ukusetshenziswa isikhathi eside kwezidakamizwa eziqinile ze-corticosteroid kungabangela ukuncipha kwesikhumba. Enye inkinga eyenzeka ngokusetshenziswa isikhathi eside ukuthi umuthi ulahlekelwa ukusebenza kwawo.

Lapho kwenziwa ukwelashwa okukhanyayo (i-phototherapy), kokubili imisebe yemvelo ne-ultraviolet yamaza ahlukahlukene asetshenziswa. Le misebe ingaqeda amangqamuzana amasosha omzimba ahlasele amangqamuzana anempilo esikhumba. Ezimweni ezithambile nezilingene ze-psoriasis, imisebe ye-UVA ne-UVB ingaba nomthelela omuhle ekulawuleni izikhalazo.

Ku-phototherapy, ukwelashwa kwe-PUVA (Psoralen + UVA) kusetshenziswa kuhlanganiswe ne-psoralen. Imisebe engasetshenziswa ekwelapheni i-psoriasis imisebe ye-UVA enobude obungama-nanometers angu-311 kanye nemisebe yebhande elincane le-UVB enobude obungama-nanometer angu-313. Imisebe ye-Narrow band ultraviolet B (UVB) ingasetshenziswa ezinganeni, kwabesifazane abakhulelwe, abesifazane abancelisa ibele noma abantu abadala. I-subtype ye-psoriasis ephendula kangcono ku-phototherapy i-guttate psoriasis.

Kwezinye izimo, odokotela bangase bakhethe imithi equkethe uvithamini D. Itiyela lamalahle liphinde libe phakathi kwezindlela zokwelapha. Amakhilimu aqukethe uvithamini D anomthelela ekwehliseni izinga lokuvuselelwa kwamaseli esikhumba. Imikhiqizo equkethe amalahle ingasetshenziswa kukhilimu, amafutha noma amafomu e-shampoo.

Ezimweni ezimbi kakhulu ze-psoriasis, imishanguzo ye-systemic isetshenziswa ngaphezu kwe-phototherapy kanye nama-creams afakwe ngezihloko nawo angeziwe ekwelapheni. Kubalulekile ukugcina isikhumba simanzi futhi sithambile. Ukwelashwa kwezidakamizwa okuhlelekile kukhethwa ikakhulukazi ezimweni zokuvuvukala kwamalunga kanye nokubandakanyeka kwezinzipho.

Izidakamizwa zomdlavuza ezifana ne-methotrexate ne-cyclosporine, amafomu kavithamini A aziwa ngokuthi ama-retinoids kanye nezidakamizwa ezitholakala ku-fumarate ziphakathi kwezidakamizwa ezihlelekile ezisetshenziswa ekwelapheni i-psoriasis. Ezigulini lapho kuqalwa khona ukwelashwa okuhleliwe, ukuhlolwa kwegazi okujwayelekile kufanele kwenziwe futhi ukusebenza kwesibindi nezinso kufanele kuqashwe ngeso elibukhali.

Imithi ye-retinoid icindezela ukukhiqizwa kwamaseli esikhumba. Akufanele kukhohlwe ukuthi izilonda ze-psoriasis zingase zenzeke ngemva kokuyeka ukusetshenziswa kwalezi zidakamizwa. Izidakamizwa ezitholakala ku-retinoid nazo zinemiphumela emibi ehlukahlukene, njengokuvuvukala kwezindebe nokulahlekelwa izinwele. Abesifazane abakhulelwe noma abesifazane abafuna ukukhulelwa kungakapheli iminyaka emi-3 akufanele basebenzise imithi equkethe ama-retinoids ngenxa yokukhubazeka okungenzeka kokuzalwa.

Inhloso yokusebenzisa izidakamizwa ze-chemotherapy njenge-cyclosporine ne-methotrexate ukucindezela impendulo yamasosha omzimba. I-Cyclosporine iphumelela kakhulu ekulawuleni izimpawu ze-psoriasis, kodwa umphumela wayo wokunciphisa umzimba ungase ubeke umuntu ezifweni ezihlukahlukene ezithathelwanayo. Le mithi ibuye ibe neminye imiphumela engemihle, njengezinkinga zezinso nomfutho wegazi ophakeme.

Kuye kwaqashelwa ukuthi imiphumela emibi embalwa ivela lapho usebenzisa i-methotrexate ngemithamo ephansi, kodwa akufanele ikhohlwe ukuthi imiphumela emibi kakhulu ingase yenzeke ngokusetshenziswa isikhathi eside. Le miphumela emibi kakhulu ihlanganisa ukulimala kwesibindi nokuphazamiseka kokukhiqizwa kwamangqamuzana egazi.

Ku-psoriasis, kunezimo ezidala lesi sifo futhi zibangele ukuthi siqhume. Lokhu kuhlanganisa i-tonsillitis, izifo zomgudu womchamo, ukubola kwamazinyo, ukulimala kwesikhumba ngokuklwebheka, imihuzuko nokuklwebheka, izinkinga ezingokomzwelo, izehlakalo ezibuhlungu nokucindezeleka. Zonke lezi zimo kufanele ziphathwe ngendlela efanele. Iziguli ezithola ukwesekwa ngokwengqondo kodokotela bengqondo noma izazi zokusebenza kwengqondo nazo ziphakathi kwezindlela ezingase zibe usizo.

I-Psoriasis yisifo esivame ukuvela kakhulu. Imizwa emihle yesiguli mayelana nokuba ngcono ingabathinta eduze inkambo yesifo. Kuyavunywa ukuthi lezi zindlela ezihlukile ezisetshenziswa ezigulini ziyazikhulula ngokwengqondo futhi zibe nomphumela wokusikisela. Ngalesi sizathu, kubalulekile ukuthi abantu abane-psoriasis babe ngaphansi kokuqondisa kukadokotela futhi bazuze ezindleleni zendabuko.

Ubudlelwano phakathi kwemikhuba yokudla nendlela yokuphila kanye ne-psoriasis abukacaciswa ngokugcwele. Ukuqeda isisindo esiningi, ukugwema ukusetshenziswa kwemikhiqizo equkethe amafutha e-trans noma emvelo, kanye nokunciphisa ukuphuza utshwala yizinguquko zohlelo lokudla okunempilo oluphendula umbuzo wokuthi yini enhle nge-psoriasis. Ngesikhathi esifanayo, iziguli kufanele ziqaphele ukuthi yikuphi ukudla ezikudlayo okudala ukuthi lesi sifo sigqame.

Ukucindezeleka kuyisici esiyinhloko esibangela i-psoriasis. Ukubhekana nokucindezeleka kokuphila kungaba yinzuzo kukho kokubili ukunciphisa ukushuba kanye nokulawula izimpawu. Izivivinyo zokuphefumula, ukuzindla kanye nemikhuba ye-yoga kuphakathi kwezindlela ezingasetshenziswa ukulawula ukucindezeleka.