Kwamanye Amacala, Ukwelashwa Kwezimo Ezibili Kungase Kuqhubekele
Abantu abanesifo sofuba (IBD) nesinye isikhathi bahlakulela ezinye izifo noma izimo ezibizwa ngokuthi ukubonakala kwamathumbu (noma ngezinye izikhathi ama-EIM) . Izimo zesikhumba zivame kakhulu kubantu abane-IBD, futhi okuvame ukuvela njalo kokubili kubantu abaningi futhi kubantu abane-IBD yi- psoriasis . Abantu abaningi bangase bacabange nge-psoriasis njenge-rash, kodwa empeleni kuyisimo se-systemic futhi bangase bahlanganyele ngendlela efanayo yokuvuvukala njengesifo sikaCrohn.
Ngenxa yokuthi lezi zimo ezimbili zingase zibangelwe inkinga ekusebenzeni kwesimiso somzimba sokuzivikela, bavame ukuphathwa ngemithi efanayo. Kubantu abane-IBD abane-psoriasis, zombili izimo zingase zibe yisici lapho ukhetha ukwelashwa.
Kunezinhlobo ezihlukahlukene zokwelashwa okuphumelelayo ze-psoriasis esivele itholakale kanti okuningi okwamanje kuthuthukiswa. Abantu abane-psoriasis ne-IBD bazofuna ukunakekelwa kudokotela wezidakamizwa onokuhlangenwe nakho neziguli ezine-IBD futhi bazosebenza eduze ne- gastroenterologist .
Kuyini i-Psoriasis?
I-Psoriasis yisifo esiyinkimbinkimbi esibangela ukuqhuma okukhulu, isikhumba esikhumbeni. Ukushona kungabonakala kunoma iyiphi ingxenye yomzimba, kodwa ngokuvamile kubonakala phezulu, emadolweni, nangesikhumba kodwa kungatholakala nasemilenzeni, izipikili, nesiqu. Uhlobo oluvame kakhulu lwe-psoriasis lubizwa ngokuthi i-plaque psoriasis kanye nama-plaques angabangela ukushisa noma ukushisa.
I-Psoriasis ihamba ngezikhathi zokwehla-ups nokukhululwa. Ezimweni eziningi, i-psoriasis iphathwa nge-creams.
Yeka ukuthi i-Psoriasis ejwayelekile kangakanani kubantu abane-IBD?
I-IBD ibhekwa njengesimo sokuzivikela emzimbeni. Kuyinto engavamile kubantu abanesifo esisodwa sokuzivikela-mzimba ukuthuthukisa esinye. I-IBD ne-psoriasis zombili izimo ezinezizathu ezingaziwa (ezibizwa ngokuthi i-idiopathic isifo) futhi zibangele ukuvuvukala.
Eminyakeni yamuva abacwaningi bathola kabanzi mayelana nokuxhumana phakathi kwe-IBD nezifo ze-psoriatic. I-Psoriasis emphakathini jikelele igijima cishe ngamaphesenti angu-2 kuya kuma-3 amaphesenti kodwa abantu abane-IBD bavame ukuba ngaphezulu. Ucwaningo lubonisa ukuthi abantu abanesifo sikaCrohn kanye nesifo sokulonda i-ulcerative colitis bangase bahlakulele i-psoriasis ngesilinganiso samaphesenti angaba ngu-13.
Indlela Ejwayelekile Yokuvutha
Njengoba abacwaningi bethola kabanzi ngezindlela zokuvuvukala ze-IBD ne-psoriasis, ezinye zezinkinga eziphakathi kwezifo ezimbili zivuliwe. Isifo sikaCrohn kanye ne-psoriasis zombili zombili zibhekwa njengezimo ezihambisanayo. I-Th1 iyiselula engumsizi ephakamisa impendulo yokuvuvukala lapho umzimba uhlaselwa yizinto zangaphandle ezifana ne-parasite, amabhaktheriya noma igciwane. I-colcer ulcerative ibhekwa njengesimo se-Th2-like mediated. Amaseli we-Th2 acushiwe uma kukhona amabhaktheriya, impendulo ye-allergen, noma i-toxin ekhona. Njengoba indima yale T cells iqondwa kangcono mayelana nokuthuthukiswa kwe-IBD ne-psoriasis, ingaholela ekwakheni ukwelashwa okuphumelelayo kulezi zifo.
Ingabe Ukuba ne-Psoriasis Yandisa Ingozi Yokuthuthukisa IBD?
Kunezifundo ezimbalwa kuphela ezibukeka engozini ye-IBD kubantu abaye bathola ukuthi bane psoriasis.
Baye babonisa imiphumela ephikisanayo: Abanye baye babonisa ingozi enkulu ye-IBD kulabo abane-psoriasis nabanye abaye babonisa okuphambene. Ukwengeza, izindlela ezazisetshenziswa kulezi zifundo zazingekho ngaphandle kokushiyeka kwazo, okwenza iziphetho zibe nzima ukuma. Njengamanje, awaziwa ukuthi ingozi iyini, kepha kubonakala sengathi kuyindlela eqondiswa abantu abane psoriasis abanengozi eyengeziwe yokuthuthukisa isifo sikaCrohn. Okufanayo akulona iqiniso nge-ulcerative colitis: Kukhona ubufakazi obuncane bokuthi abantu abane-psoriasis bangase babe engozini enkulu yokwenza i-ulcerative colitis.
Ukwelashwa Okusuka Ezingqungqutheleni Nezikhanyiso ze-Psoriasis
Kunezinhlobo eziningana zokwelashwa kwe-psoriasis, kuhlanganise nokwelashwa okulula, ukwelashwa kwama-topical, kanye nemithi. Ezimweni eziningi, ukwelashwa okungaphezu kweyodwa kungasetshenziswa ngesikhathi esifanayo ukulwa nezimpawu ze-psoriasis. Ngokuvamile, izindlela zokwelashwa ezingokomzimba zingase zivivinywe kuqala, ngaphambi kokuba ziqhubekele ekwelapheni ukukhanya noma imithi yesistimu.
- Imithi yokwelapha. Kunezinhlobo ezihlukahlukene ze-creams namafutha okugcoba angasetshenziselwa i-psoriasis, kokubili nge-counter kanye nemithi kadokotela. Ezinye izithako ezisebenzayo zihlanganisa i- corticosteroids , i- vitamin D , i-retinoids, i- anthralin , i- calcinurin inhibitors (i-Protopic ne-Elidel) , i-salicylic acid, ne- tar yamalahle . Kwezinye izimo ama-moisturizers angase asetshenziselwe ukulwa nokomisa.
- Ukwelapha okukhanyayo. Ukukhanya okuqukethe i-ultraviolet A ne-ultraviolet B nakho kungasetshenziswa ukuphatha i-psoriasis. Lokhu kuvame ukusetshenziswa kanye nezinye izifo. I-Sunlight evela ngaphandle ingase isetshenziswe, isikhathi esifushane. Imisebe ye-ultraviolet ingasetshenziswa futhi nge-phototherapy ngephaneli elikhanyayo, ibhokisi, noma idokodo. Ezimweni ezimbi, imithi eyenza isikhumba sizwele kakhulu ekukhanyeni kwe-ultraviolet ingase isetshenziswe ngesikhathi esisodwa njengendlela yokwelapha ukukhanya ukuze iphumelele kakhulu. Uhlobo lwama-laser lubuye lusetshenziswe ngezinye izikhathi ngoba lungabhekisela ezindaweni ezithile emzimbeni onomthamo onamandla we-ultraviolet B.
Imithi Esetshenziselwa Ukwelapha I-Psoriasis
Ngenxa yokuthi i-psoriasis yisifo sesistimu, imithi enikezwa ngomlomo noma ngomjovo ingasetshenziswa futhi. Kwezinye izimo, imishanguzo evunyelwe ukwelapha i-psoriasis nayo inikezwa ukuphatha uhlobo olulodwa noma ngaphezulu lwe-IBD, kuhlanganise ne-methotrexate, i-cyclosporine, nezinye zezinto eziphilayo:
- I-Cosentyx (secukinumab) : I- Cosentyx i-anti-monoglonal antibody evunyelwe ukwelapha i-psoriasis, i-psoriatic arthritis, nesimo se-arthritis ehambisana ne-IBD okuthiwa i-ankylosing spondylitis, nakuba engavunyelwe ukuphatha noma yiluphi uhlobo lwe-IBD. I-Cosentyx inikezwa ekhaya nge-injection nge-pen or syringe ekhethiwe. Imiphumela emibi evamile ihlanganisa izimpawu ezibandayo, isifo sohudo, nezifo ezingaphezulu zokuphefumula.
- I-Cyclosporine : I- Cyclosporine iyisidakamizwa esingenakuzivikela esisetshenziselwa ukwelapha amacala amakhulu kakhulu we-psoriasis futhi ngezinye izikhathi isetshenziselwa isifo sikaCrohn. Eminye imiphumela emibi ejwayelekile ihlanganisa ikhanda lokukhanda, ukukhungatheka kokugaya ukudla, ukucindezela kwegazi eliphezulu nokukhathala. Akuvumi ukusetshenziselwa ukusetshenziswa kwesikhathi eside uma kwenzeka i-psoriasis, futhi ngokuvamile ivaliwe ngaphansi konyaka.
- I-Enbrel (etanercept) : I- Enbrel imithi ye-biologic evunyelwe ukuphatha i-psoriasis kanye ne-anondlosing spondylitis. I-blocker ye-TNF, kodwa ayisetshenziselwa ukuphatha noma yiluphi uhlobo lwe-IBD. I-Enbrel ijojelwe ekhaya futhi umphumela ovame kakhulu ohlangothini lwe-injection, njengobomvu noma ubuhlungu.
- Humira (adalimumab) : I- Humira iyimithi ejojelwayo esetshenziselwa ukwelapha isifo sikaCrohn nesifo sokulonda kwesilonda kanye ne-psoriasis. Iziguli zingazinikela eHuma ekhaya ngoba zifika epeni elikhethekile lokujola. Le mithi i-antibody monoclonal futhi ihlukaniswa njenge-TNF-inhibitor. Umphumela ovame ukwedlula wonke ubuhlungu noma ukucasuka endaweni yomjovo, ephathwa ekhaya ngeqhwa noma ama-antihistamine.
- I-Methotrexate : Le mithi inganikezwa ngomlomo noma ngomjovo, futhi isetshenziselwa ukwelapha i-psoriasis kanye nesifo sikaCrohn nesipulylitis e-ankylosing. Eminye yemiphumela emibi ihlanganisa ukuhlanzeka, ikhanda nokulala. Abesifazane abathola i-methotrexate kumele bagweme ukukhulelwa ngoba lesi sidakamizwa singabangela ukungalingani kwe-fetal. I-Methotrexate ivame ukunikezwa kanye neminye imithi ye-IBD kanye / noma i-psoriasis.
- I-Otezla (apremilast) : I- Otezla imithi yomlomo futhi iyona yokuqala evunyelwe ukuba isetshenziswe ekwelapheni i-psoriatic arthritis kubantu abadala futhi ivunyelwe ukusetshenziswa ku-plaque psoriasis. Imiphumela emibi kakhulu ebikiwe ngesikhathi sokuhlolwa kwemithi kwakuyizinyosi, ukukhanda ikhanda, nokuhuda, kodwa lokhu kuvame ukuthuthuka ngemuva kwamasonto ambalwa okwelashwa.
- I-Stelara (ustekinumab) : UStera uqale wamukelwa ukuba aphathe i-psoriasis futhi manje uvunyelwe ukuphatha isifo sikaCrohn. I-Stelara imithi ye-biologic eyisivimbela se-interleukin (IL) -12 ne-IL-23. I-Stelara ekuqaleni inikezwa yi-IV kodwa ngemuva kokuthola umthamo wokuqala ekhaya nge-injection. Imiphumela emibi yabezindaba ihlanganisa ukuzwa ukukhathala, ukusabela endaweni yokujola, ukuphathwa ikhanda, nezimpawu ezibandayo.
Izwi elivela
Ubufakazi buyakhula ukuthi i-psoriasis ne-IBD ijwayele ukuvela ndawonye kaningi kunokucatshangwa emashumini eminyaka edlule. Akukacaci ukuthi uma i-psoriasis yenza kube lula ukuthi umuntu uzophinde ahlakulele uhlobo lwe-IBD. Kwezinye izimo imithi ephathwayo yokuphatha i-IBD nayo isetshenziselwa ukuphatha i-psoriasis. Amacala amaningi we-psoriasis abhekwa njengenobumnene ukulinganisa futhi angaphathwa ngelashwa lokukhanya noma imithi yokwelapha. Ngezinye izimo ezinzima ze-psoriasis, lapho amaphesenti angu-5 kuya kwezingu-10 noma ngaphezulu komzimba ethinteka, imithi yomlomo noma i-biologics ingasetshenziswa futhi. Njengoba nje nge-IBD, kubalulekile ukuqhubeka ukwelashwa kwe-psoriasis ukuze kuvimbele ukuhlaselwa. Kunezinhlobo eziningi zokwelapha ezintsha ze-psoriasis okwamanje ezicwaningwayo, futhi ikusasa lokuphathwa kwe-psoriasis likhanya.
> Imithombo:
> Gisondi P, Del Giglio M, Cozzi A, Girolomoni G. "I-Psoriasis, isibindi, kanye nomgudu wamathumbu." Dermatol Ther . 2010 Mar-Apr; 23: 155-159.
> Li WQ, Han JL, Chan AT, Qureshi AA. "I-Psoriasis, i-psoriatic arthritis kanye nengozi yokwanda kwesigameko sesifo sikaCrohn abesifazane base-US." Izikhangiso zezifo ze-rheumatic . 2013; 72: 1200-1205.
> DJ Najarian, uGottlieb AB. "Ukuxhumana phakathi kwe-psoriasis nesifo sikaCrohn." J Am Acad Dermatol . 2003 Jun; 48 (6): 805-821; Imibuzo 822-824.
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