Ngokuvamile umdlavuza wesikhumba obulalayo uvame ukungazi
I-melanoma ye-subungual ebizwa nangokuthi umdlavuza weyunithi yezinzipho, uhlobo lokulimala okuvela ezinhlakeni zombhede we-nail. I-melanoma uhlobo lomdlavuza ovela emaqenjini okuthiwa i-melanocytes. Ama-melanocytes amangqamuzana akhiqiza i-melanin, i-pigment enika isikhumba, izinwele, nombala umbala wabo.
Ngenkathi ama-melanomas angama-subungual avame ukutholakala esifundeni noma ezinzwaneni ezinkulu, angenzeka kunoma yimiphi iminwe noma izinsipho.
Zivame ukubhekwa ngokungaqondakali njenge-infection fungal ngenxa yezinguquko zesimo sabo emgqeni nasendwangu yezinzipho.
I-melanoma ye-subungual yinto engavamile futhi ijwayele ukuvela kubantu abaningi abanobumnyama. E-Asia, kucatshangwa ukuthi amaphesenti angama-20 ama-melanomas angama-melanomas angaphansi kwe-subungual. Zenzeka kaningi kubantu abaphakathi kweminyaka engama-40 no-70.
Izimpawu
Ama-melanomas e-subungual ngokuvamile avela njengama-streaks amnyama agijima isikhathi eside (i-perticendicular to the cuticle). Cishe isigamu salezi zinhlayiya zinsundu, ziluhlaza okwesibhakabhaka, noma zimnyama, kanti enye ingxenye ayinayo i-pigmented.
Njengoba umdlavuza uqhubeka, izitshalo eziningi zingabonakala, kaningi ngeemibala ehlukene. Njengoba isikhathi siqhubeka, isabelo esiseduze ne-cuticle singase sibe sikhulu.
Uphawu lukaHutchinson luyinto evamile ekutholeni ama-melanomas amaningi. Lokhu kubhekisela ekubukeni kwe-streak esukela phezulu phezulu kwesisindo kuze kufike embhedeni wesipikili (lapho i-nail iqalisa khona) futhi ku-cuticle uqobo.
Lokhu kusihlukanisa nezinye izimo ezihlobene ne-nail ngokuhambisana kwayo, ukuguqulwa kwe-longitudinal nokuzibandakanya kwe-cuticle.
Njengoba i-melanoma iqhubeka ikhula, ingabangela ukuphuma kwegazi, ukwakhiwa kwe-nodule, noma ukukhubazeka kwesikhali ngokwayo.
Ukuxilongwa
Ukuxilongwa kwegazi kuzovame ukuhlolwa ngokucophelela kwe-nail nesilonda.
I-Dermatologists izosebenzisa ithuluzi elibizwa ngokuthi i-dermascope elibanikeza umbono ophakeme we-nail kanye nezicubu ezizungezile.
Ekugcineni, ukuhlola okubukwayo kunomkhawulo, ikakhulukazi njengoba kubonakala njalo. Ngenxa yalokho, kuvame ukuphutha ngenye indlela, izimo ezivame kakhulu, njenge:
- I-subungual hematoma , ukulimaza ngaphansi kwesipikili esingenalo ukufana kwe-melanoma engaphansi
- Ukutheleleka kwe-Fungal (onychomycosis) okuvame ukuba nomswakama omnyama, ongewona longitudinal ohambisane nemifudlana ephuzi noma emhlophe
- Ama-moles (nevi) angenakwenzeka kakhulu ukuba avele ku-streaks
- Ama-deposit of melanin ngaphansi kwesipikili esingaba khona ngenxa yokukhulelwa (kanye nokwelashwa kwamakhemikhali noma imithi)
Ukuxilongwa okuqondile kungenziwa kuphela nge-biopsy (ukususwa nokuhlolwa kwezicubu ezithintekayo).
Uma kucatshangwa ukuthi i-melanoma, i-biopsy yokuxuba iyovame ukukwenziwa ukuze isuswe lonke lesi sifo kanye nezinye izicubu ezizungezile. I-punch encane encane noma i-biopsy engaqondakali ingasetshenziswa uma ukuxilongwa okubukwayo kungapheli kancane.
Isiteji se-Melanoma
Ngokuya ngobukhulu nokujula kwe-melanoma ye-subungual, kuzodingeka ukuhlolwa okwengeziwe ukuze kunqume isigaba sesifo. Njengamanye amahlobo omdlavuza, isiteji singahluka kusuka ku- carcinoma in situ (ngaphambi komdlavuza) kuze kube sesiteji sesine-4 metastatic (lapho umdlavuza usakazeke kwezinye izitho).
Ukuze unqume ukuthi ngabe i-melanoma ihlelwe kanjani, kunezivivinyo ezihlukahlukene i-oncologist ingashintsha ekufakeni i-biopsy yama-lymph nodes (ama-node eseduzane ne-tumor) namasu okucabanga njengamakhompyutha we-tomography (CT scan) noma i-positron emission tomography (i-PET scan) .
Izingozi Zezingozi
Nakuba singasazi ukuthi yini ebangelwa i-subungual melanoma, siyazi eziningi zezinto ezibeka ingozi ezihlobene nentuthuko yayo.
Into eyodwa engabonakali iyisici - futhi ihlukanisa nayo yonke iminye imithi ye-melanoma - ukukhanya kwelanga. Imisebe ye-Ultraviolet (UV) evela elangeni noma eminye imithombo ayinalo ekuthuthukisweni kwayo futhi ayikhulisi ijubane eliyiphuthumayo.
Izici eziyingozi ezidlala ingxenye zihlanganisa:
- Ukuhlukunyezwa kwangaphambili kuminwe noma iminwe (ukutholakala okuvamile)
- Umlando womuntu siqu noma womndeni we-melanoma
- Ama-moles amaningi
- Ukunciphisa umzimba, kuhlanganise nabamukeli begciwane kanye nabantu abane-HIV ephakeme
- I-Genetics, njengalabo abanesimo sokufa xeroderma pigmentosa (ukuzwela ngokweqile emisebeni ye-UV)
Ukwelapha
Ukwelashwa kwe-subungual melanomas kushintshile kakhulu eminyakeni yamuva. Esikhathini esidlule, ukukhishwa kwento yonke yomunwe noma umunwe kwakubhekwa njengendlela yokwelashwa.
Namuhla, ama-melanomas amaningi angaphansi kwe-subungual aphathwa ngokucophelela ngokususwa kwendawo kuphela kwesisu. Uma i-amputation ibonisiwe, ngokuvamile ihilela kuphela ukujoyina okuqala eduze nomunwe. Ngezintambo, ukuxoshwa kokujoyina kwesibili kuvamile kakhulu.
Ukubuyekezwa kuka-2014 kwezincwadi zezokwelapha kwaphakamisa ukuthi indlela engavamile yokusebenza ingasebenza kanye nokukhishwa okuphelele; Ngaphezu kwalokho, ukukhishwa okuphelele akubonwanga ukuthuthukisa ukusinda.
Ukuze uthole i-subungual melanoma yangaphambili, ezinye izinhlobo zokwelapha zingadingeka, kufaka phakathi:
- I-Chemotherapy, enikezwa ngokuhlelekile nge-vein noma ngokuqondile emzimbeni
- Ukwelashwa kwezidakamizwa, okusetshenziselwa ngokuyinhloko njengendlela yokwelashwa okulula ukunciphisa ubuhlungu
- I-Immunotherapy , uhlobo olusha lomuthi wokwelapha oluhlose ukugqugquzela amasosha omzimba ukulwa namangqamuzana anomdlavuza
- Imithi ehlosiwe, izidakamizwa ezikwazi ukukhomba ukuguqulwa kwe-BRAF okwenzeka kuma-50 amaphesenti ama-tumoroma
Impendulo yokwelashwa ingahlukahluka ngokuyinhloko esiteji somdlavuza. Imiphumela yabantu abane-melanoma subungual iba mpofu kunezinye izinhlobo ze-melanoma, ngokuvamile ngenxa yokulibaleka ekufuneni ukuxilongwa nokuphathwa.
Lokhu kuphela kugcizelela isidingo sesenzo uma uthola noma yikuphi ushintsho kwi-nail noma isikhumba esibonakala singavamile noma sehluleka ukuphucula. Ukwelashwa kwangasese kuyindlela eqinisekile yokuthola impumelelo yokwelapha.
Izwi elivela
Uma uthola ukuthi une-melanoma ye-subungual, kubalulekile ukuthola isazi esithole lesi sifo. Ama-melanoma ama-subungual ajwayelekile, futhi ukungabi nolwazi kungabangela ukwelashwa okungenasidingo sokwelashwa.
Ngenkathi kunesigceme esihle sokunakekelwa okuzungezile kubalulekile, uhlala ubaluleke kakhulu kulolo qembu. Funda okuningi ngangokunokwenzeka ngomdlavuza wakho. Cela usizo futhi wamukele usizo. Yibandakanyeka emiphakathini yokusekela inthanethi engabelana ngokuhlangenwe nakho nokuqonda kwabo.
Futhi wenze iphuzu lokuba ngummeli wakho siqu ekunakekeleni umdlavuza wakho. Kwenza ngempela umehluko.
> Imithombo
- > Cochran, A .; Buchanan, P .; Bueno, R .; et al. "I-Melanoma ye-Subungual: Ukubuyekeza Kwamanje Ukwelapha." Ukuhlinzwa Kweplastiki Nezokuvuselela . 2014; 134 (2): 259-73.
- > Nguyen, J .; I-Bakri, K .; Nguyen, E .; et al. "Ukuphathwa Okuhlinzekwa Kwe-Subungual Melanoma: I-Mayo Clinic Ukutholakala Kwamacala angu-124." Ama-Annal of Surgery Plastic . 2013; 71 (4): 346-54.
- > Ohn, J .; Khetha, Y .; Ipaki, J .; et al. "Ama-Dermoscopic Patterns of Melanoychia Fungal: Isifundo Esiqhathanisa Nezinye Izimbangela ZaseMelanonychia." Umagazini we-American Academy of Dermatology . Ngo-Okthoba 25, 2016 (i-Epub ngaphambi kokuphrinta).