I-Urticaria (imifantu) ibomvu, isikhumba esikhukhulayo esikhwameni esibangelwa ukusabela kokudla, imithi, nezinye izinto noma izimo. Ngokuvamile iqala ngesikhumba esilula futhi sikhule ibe ne-welt ephakanyiswe ngemingcele echazwe ngokucacile.
I-Urticaria ibangelwa impendulo engavamile yamasosha omzimba lapho ikhemikhali eyaziwa ngokuthi i-histamine ikhishwa emzimbeni. Nakuba lokhu kwenzeka ngokubangela ukungezwani komzimba, kunezimbangela ezingezona izifo, futhi.
Izimpawu zingaba nzima (ukubonakala nokuxazulula ngokushesha) noma okungapheli (okuhlala isikhathi eside kunamaviki ayisithupha).
I-urticaria esebenzayo ivame ukutholakala ngokubonakala kwayo. Iziqephu ezingapheli zingadinga uphenyo olwengeziwe, kuhlanganise nokuhlolwa kwesilwane, ukuvivinya umzimba, noma i-biopsy yesikhumba. Ama-antihistamine asetshenziselwa ukuphatha i-urticaria, nakuba i-H2 blockers, i-corticosteroids, i-anti-depressants, kanye nezidakamizwa eziphikisana nezifo zingahle zenziwe.
Izimpawu
I-Urticaria ingathinta abantu banoma yibuphi ubudala futhi ithuthukise kunoma iyiphi ingxenye yomzimba, kufaka phakathi izintende zezandla nemigqa. Izinyosi zizovela njengama-welts aphakanyisiwe (amasondo) futhi ziyohlala zikhona, ezinye zingaphezu kwamanye. Zingahluka ngokuma nesayizi kepha zizoba nomngcele ocacisiwe. Uma ucindezelwe, isikhungo sizo "blanch" (vula).
Iningi lezinyosi zinzima futhi zilinganiselwe, zixazulula zodwa zingakapheli amahora angu-24 kuya kwangu-48. Abanye bangathatha izinsuku noma amasonto ngaphambi kokuba baxazulule ngokugcwele.
Phakathi nalesi sikhathi, akuvamile ukuthi imifantu ibonakale futhi ibuye ivele. I-Urticaria ngezinye izikhathi ingase ihambisane nokuvuvukala kwezicubu ezibizwa ngokujulile njenge- angioedema , okuvame ukuthinta ubuso, izindebe, ulimi, umphimbo noma amajwabu amehlo.
Izinyosi ezingapheli zingaphikelela izinyanga noma ngisho neminyaka futhi zingabangela ukucindezeleka, ukushisa, ukubandayo nezinye izimbangela zomzimba.
I-Urticaria ihlukile e- eczema (atopic dermatitis) kuleso eczema ibonakala ngokumisa, ukuchotshoza, ukuphuza, ukuchoboza, ukuphuma noma ukuphuma. Ama-hives ajwayelekile ngokuchazwa ngalezi zindlela.
Izimbangela
Ngokuvamile, zonke izinhlobo ze-urticaria ziwumphumela wokuphendula okungavamile kamasosha omzimba. Ngenkathi i- allergies iyisibonelo esivame kakhulu, akusona imbangela kuphela. Izinhlobo ezithile ezingapheli ze-urticaria zikholelwa ngenxa yokuphendula okuzenzakalelayo . Ezinye ziyi-idiopathic ngokuphelele (okushiwo umsuka owaziwa).
I-Urticaria Yokunciphisa I-allergies
I-urticaria eyenziwe yi-allergies ibangelwa uma isimiso somzimba sokuzivikela sisabela ngendlela engavamile kuleso simo esingenakubungozi futhi sikhipha ikhemikhali ebizwa ngokuthi i- histamine egazini. I-Histamine yisisindo sokuvuvukala esibangela izimpawu zokungezwani komzimba, engathinti nje kuphela ipheshana lokuphefumula nesisu kodwa isikhumba, futhi.
Izimbangela ezivamile ze-urticaria ezibangelwa ukungena emzimbeni zihlanganisa ukudla (kufaka phakathi i-shellfish, amaqanda, kanye nom nut), izidakamizwa (kubandakanya i-aspirin nemithi elwa namagciwane), nokulunywa kwezinambuzane (izinyosi ikakhulukazi izintuthwane zomlilo).
I-Idiopathic Urticaria engapheli
I-urticaria engapheli kaningi idiopathic futhi ingase ihoxiswe ukucindezeleka noma enye into engokomzimba. Ngenkathi indlela eqondile yalesi simo engaziwa, kukholelwa ukuthi ukuqaliswa kwama- autoantibodies (ama-immune amaprotheni ahlose amangqamuzana omzimba) kungase futhi kubangele ukukhululwa kwe-histamine namanye ama-pro-inflammatory compounds.
Ngakho-ke, ngenkathi imbangela ebangela i-urticaria engapheli ingase ihluke ku-urticaria eyenziwe yi-allergies, umphumela uyoba okufanayo (noma kube isikhathi eside). Abesifazane bavame ukuthinteka ngaphezu kwamadoda.
Ngaphandle kokucindezeleka, izinto ezivame ukwenziwa ngokomzimba zihlanganisa ukuvezwa kokushisa , ukushisa , ukukhanya kwelanga , ukucindezelwa , ukudlidliza , amanzi , noma ukungqubuzana . Izinhlobo ezithile ze-urticaria ezenzelwe ukuvivinya umzimba zivele kuphela nge-tandem nokudla okubangelwa ukudla.
Ezinye Izimbangela
Izifo nezifo ezinjenge-hepatitis, isifo esingenasifo sezinso, i-lymphoma, nanoma yiliphi inani lezinkinga ezizimele (kuhlanganise i-lupus, i-Hashimoto's thyroiditis, nesifo se-rheumatoid arthritis) singabonakala nangama-hive acute noma angapheliyo.
Ukuxilongwa
I-Urticaria ingavame ukutholakala ngokususelwa ekubuyekezweni komlando wakho wezokwelapha kanye nokubukeka kwesimo se-rash. I-Lab nokuhlolwa kwama-imaging ngokuvamile akudingekile ngaphandle kokuthi imbangela eyimbangela iyasolwa (njengomdlavuza).
Ubukhulu be-eruption bungacaciswa ngokusekelwe ithuluzi lokuhlola elibizwa ngokuthi uphawu lomsebenzi we-urticaria (UAS). Ngenxa yalokhu, udokotela wayezobe esebenzisa izimpawu ezimbili eziyinhloko-amasondo nama- pruritus -ngesilinganiso se-0 (umsebenzi wesifo esiphansi) kuya ku-3 (umsebenzi wesifo esibi kakhulu). Amaphesenti angu-6 aphezulu aveza ukuqhuma okukhulu okudinga ukwelashwa okunonya.
Uma kuhlolwa okudingekayo, kungabandakanya okukodwa kokulandelayo:
- Ukuhlolwa kokungezwani komzimba kunganconywa uma uye waba nokuphendula okukhulu kwe-hypersensitive kokudla, imithi noma ukugaya izinambuzane. Isivivinyo sesikhumba noma i- radioallergosorbent testay test (RAST) yizinhlobo ezimbili ezivame kakhulu zokuhlolwa kokunciphisa umzimba.
- Ukuhlolwa kwezinselele zomzimba kusetshenziselwa ukuqinisekisa ukuthi ama-hives akho angapheli ayenziwa ngokomzimba. Lokhu kuhilela ukusetshenziselwa isenzo esicatshangelwayo-njengeqhwa, ukushisa, ukudlidliza, ukukhanya, noma ukungqubuzana-esikhumbeni. Ukuhlolwa kokuzivocavoca kungasetshenziswa futhi.
- I-skin biopsy (ukususwa kwesampula sesisindo sokuhlola kwebhu) kuboniswa kuphela uma imifantu ihluleka ukuthuthukisa futhi akukho minye imbangela engatholakala. Ngaphandle kokuba kukhona incazelo engavamile yamagundane, i-biopsy yomhlathi ingavame ukuveza noma yini engavamile.
Ukwelapha
Iningi lezinyosi ezinzima zizozixazulula zodwa phakathi nezinsuku ezimbalwa futhi zingadinga kuphela ukucindezela okumanzi, okupholile ukunciphisa itchki nokuvuvukala.
Abanye bangathatha amasonto ambalwa futhi badinga antihistamine yomlomo ukusiza ukunciphisa izimpawu. Ama-antihistamine angaphezu kwamakhompiyutha afana ne- Allegra (fexofenadine) , i- Claritin (i-loratadine) , ne- Zyrtec (cetirizine) ngokuvamile ihlinzeka ngokukhululeka okukhulu. Izidakamizwa ezinamandla ze-antihistamine zingatholakala nge-odokotela.
Uma ama-antihistamine kuphela ekwazi ukunikeza usizo, ezinye izidakamizwa zingase zengezwe noma zishintshwe, ikakhulukazi uma imbangela ingeyona ingozi. Phakathi kwazo:
- Abakhi be-H2 , njenge- Pepcid (i-famotidine) , i- Tagamet (cimetidine) , ne- Zantac (ranitidine) , ingasetshenziswa ngokuhlanganiswa nama-antihistamine ukunciphisa ukuvuvukala kwe-vascular.
- Ama-corticosteroids , njenge- Prednisone , anganciphisa impendulo yomzimba futhi ngokushesha anciphise ukutshaya nokuvuvukala uma ama-antihistamine engasebenzi.
- Ama-modifiers e-Leukotriene afana ne-Accolate (zafirlukast) ne- Singulair (i-montelukast) asetshenziselwa ukuphulukisa i-asthma kodwa futhi anganciphisa izinhlobo ezithile ze-idiopathic urticaria.
- I-Doxepin i-tricyclic antidepressant esebenza njenge-antihistamine enamandla uma isetshenziselwa ukulinganisa okuphansi.
- I-Xolair (i-omalizumab) i -antibody ejoqayo ejoqayo ephumelelayo ekuphatheni izinhlobo ezingapheli ze-urticaria ezingaphenduli kwezinye izindlela zokwelapha.
Izwi elivela
Ngenkathi imifantu ingaba ingqondakali futhi ingakhululekile, ngokuvamile ayiyona ingathà sina. Kodwa-ke, uma beqala ukuphazamisa ikhwalithi yakho yokuphila, cela udokotela wakho ukuthi abuyele emuva unogada ongenza izivivinyo ukuze akhombe imbangela. Uma i-trigger-trigger iyatholakala, uchungechunge lwezidakamizwa zokungalingani lunganikezwa kancane kancane ukuze lwenzeke kancane kancane.
Ezimweni ezingavamile, imifantu ingase ihlakulele njengengxenye yengozi yokubulawa komzimba eyaziwa ngokuthi i- anaphylaxis . Uma izinkukhu zakho zihambisana nokuvuvukala ebusweni, ukuphefumula ubunzima, ukushaya kwenhliziyo ngokushesha, ukuhlanza noma ukudideka, shayela u-911 noma omunye umuntu akugibele ekamelweni eliphuthumayo eliseduzane. Uma ishiywe ingalashwa, i-anaphylaxis ingabangela ukwethuka, i-coma, inhliziyo noma ukuhluleka kokuphefumula, nokufa.
> Imithombo:
> Ferrer, M .; Bastra, J .; UGimenez-Arnau, A. et al. Ukuphathwa kwe-urticaria: akuyona inkimbinkimbi kakhulu, hhayi elula. Ukwelashwa kokuhlolwa kwemitholampilo. 2014; 45 (4): 731-43. I-DOI: 10.1111 / cea.12465.
> Schaefer, P. I-Urticaria Ephuthumayo Neyengunaphakade: Ukuhlolwa Nokunakekelwa. Am Fam Physician. 2017; 95 (11): 717-724.