Vitiligo

Vitiligo (vit-ih-LIE-go) ni indwara itera igihombo cy'irangi ry'uruhu mu duce duto duto. Uduce twahindutse ibara ubusanzwe twagura uko igihe gihita. Iyi ndwara ishobora kugira ingaruka ku ruhu rwo mu gice icyo ari cyo cyose cy'umubiri. Ishobora kandi kugira ingaruka ku musatsi no mu kanwa imbere.

Ubusanzwe, ibara ry'umusatsi n'uruhu rigena melanin. Vitiligo ibaho iyo uturemangingabo dukora melanin dupfa cyangwa ducika intege. Vitiligo ibagiraho abantu bose bafite ubwoko bw'uruhu, ariko ishobora kugaragara cyane ku bantu bafite uruhu rw'umukara cyangwa rw'ibibanza by'umukara. Iyi ndwara ntiyica kandi ntibandura. Ishobora gutera umunaniro cyangwa gutuma wumva nabi.

Ubuvuzi bwa vitiligo bushobora gusubiza ibara ku ruhu rwahuye n'iyi ndwara. Ariko ntibukumira igihombo gikomeza cy'irangi ry'uruhu cyangwa gusubira inyuma.

Ibimenyetso bya Vitiligo birimo:

• Kugabanuka kw'igicucu cy'uruhu, bisanzwe bigaragara bwa mbere ku ntoki, mu maso, no mu bice biri hafi y'imyanya y'umubiri n'ibitsina
• Gukura kweruye cyangwa guhinduka umweru kw'ubutsi bw'umutwe, amaso, ijoro cyangwa ubwanwa
• Kugabanuka kw'igicucu mu mubiri uri imbere mu kanwa no mu mazuru (ingingo z'imbere)

Vitiligo ishobora gutangira mu myaka yose, ariko isanzwe igaragara mbere y'imyaka 30.

Bitewe n'ubwoko bwa vitiligo ufite, bishobora kugira ingaruka kuri:

• Uruhu hafi ya rwose. Muri ubwo bwoko, bwitwa vitiligo rusange, ihindagurika ry'igicucu rigira ingaruka kuri hafi y'uruhu rwose.
• Ibice byinshi by'umubiri. Muri ubwo bwoko busanzwe, bwitwa vitiligo rusange, ibice byanduye bikunze gutera imbere kimwe ku bice by'umubiri bisabana (kimwe kimwe).
• Uruhande rumwe cyangwa igice kimwe cy'umubiri. Ubwo bwoko, bwitwa vitiligo y'igice, busanzwe buza mu myaka mike, bugatera imbere umwaka cyangwa ibiri, hanyuma bugahagarara.
• Igice kimwe cyangwa ibyiciro bike by'umubiri. Ubwo bwoko bwitwa vitiligo y'ahantu runaka (ibanze).
• Imaso n'amaboko. Muri ubwo bwoko, bwitwa vitiligo ya acrofacial, uruhu rwanduye ruri mu maso no mu ntoki, no mu bice biri hafi y'imyanya y'umubiri, nko mu maso, mu mazuru no mu matwi.

Biragoye kumenya uko iyi ndwara izatera imbere. Rimwe na rimwe ibice bihagarara bidakize. Mu bihe byinshi, igihombo cy'igicucu gikwirakwira kandi amaherezo kigira ingaruka ku ruhu rwinshi. Rimwe na rimwe, uruhu rusubira mu ibara ryarwo.

Jya kwa muganga niba ibice by'uruhu rwawe, umusatsi cyangwa imikaya y'inyuma y'umunwa byabuze ibara. Vitiligo nta muti ifite. Ariko, ubuvuzi bushobora guhagarika cyangwa kugabanya umuvuduko wo guhinduka kw'ibara, kandi bugasubiza ibara ku ruhu rwawe.

Vitiligo ibaho iyo utwicyeya dukora ibara (melanocytes) dupfa cyangwa ducika burundu gukora melanin—ikintu gitera uruhu, umusatsi n'amaso ibara. Ibice by'uruhu birebwa birahinduka byera cyangwa byijimye. Ntabwo birasobanutse neza icyatera ibyo bicye byo gukora ibara gupfa cyangwa gucika. Bishobora kuba bifitanye isano na:

• Ikibazo cy'urwego rw'umubiri rushinzwe kurwanya indwara (indwara y'umubiri urwanya ubwawo)
• Amateka y'umuryango (kuba warazwe)
• Icyabiteye, urugero nk'umunaniro, izuba rikabije cyangwa ikibazo cy'uruhu, nko guhura n'imiti mibi

Umuntu wese arashobora kurwara ikigaga. Ariko ushobora kurwara cyane iyo:

• ufite amateka y'uburwayi mu muryango.
• ukora cyane n'ibintu birimo phenol, nka bimwe mu bisukura.

Abantu bafite vitiligo bashobora kuba bafite ibyago byiyongereye byo kugira:

• Uburibwe bw'imitekerereze cyangwa imitekerereze
• Kwikomeretsa izuba
• Ibibazo by'amaso
• Kubura kumva

Umuganga wawe azakubaza amateka yawe y'ubuzima kandi agusuzuma uruhu, bishoboka ko akoresheje itara ryihariye. Isuzuma rishobora kandi kuba ririmo no gupima igice cy'uruhu (biopsie) no gupima amaraso.

Guhitamo uburyo bwo kuvura biterwa n'imyaka yawe, ubwinshi bw'uruhu rwafashwe n'aho, uburyo indwara itera vuba, n'uko ikubangamiye. Imiti n'uburyo bwo kuvura hakoreshejwe umucyo biriho kugira ngo bifashe gusubiza ibara ry'uruhu cyangwa kugorora ibara ry'uruhu, nubwo ibyavuye bitandukanye kandi bidashobora kumenyekana. Kandi bimwe mu buryo bwo kuvura bifite ingaruka mbi zikomeye. Nuko umuvuzi wawe ashobora kugusaba kubanza kugerageza guhindura isura y'uruhu rwawe ukoresheje umusaruro wo kwisiga cyangwa ibirungo byo kwisiga. Niba wowe n'umuvuzi wawe mufata icyemezo cyo kuvura uburwayi bwawe hakoreshejwe imiti, kubaga cyangwa kuvura, uburyo bwo kuvura bushobora kumara amezi menshi kugira ngo hamenyekane niba bugira akamaro. Kandi ushobora kugomba kugerageza uburyo burenze bumwe cyangwa guhuza uburyo burenze bumwe mbere yo kubona uburyo bwo kuvura bukubereye. Nubwo kuvura bigira akamaro igihe runaka, ibyavuye bishobora kutabamo igihe kirekire cyangwa ibice bishya bishobora kugaragara. Umuvuzi wawe ashobora kugusaba imiti ishyirwa ku ruhu nk'uburyo bwo kuvura kugira ngo afashe gukumira gusubira inyuma. Nta muti ushobora guhagarika gukura kw'indwara ya vitiligo - gutakaza uturemangingo tw'ibara (melanocytes). Ariko imiti imwe, ikoreshwa yonyine, ifatanije cyangwa ifatanije no kuvura hakoreshejwe umucyo, ishobora gufasha gusubiza ibara rimwe. Imiti igenzura kubabara. Gushyira amavuta ya corticosteroid ku ruhu rwafashwe bishobora gusubiza ibara. Ibi bigira akamaro cyane iyo vitiligo ikiri mu ntangiriro. Ubu bwoko bw'amavuta bugira akamaro kandi byoroshye kubukoresha, ariko ushobora kutazabona impinduka mu ibara ry'uruhu rwawe mu mezi menshi. Ingaruka zishoboka mbi harimo kugabanyuka kw'uruhu cyangwa kugaragara kw'imigozi cyangwa imirongo ku ruhu rwawe. Ubwoko buke bw'imiti bushobora kwandikwa ku bana no ku bantu bafite ibice binini by'uruhu rutabara neza. Amapasipile cyangwa inshinge za corticosteroid bishobora kuba amahitamo ku bantu uburwayi bwabo buzamuka vuba. Kuvura hakoreshejwe umucyo. Phototherapy ikoresheje ultraviolet B (UVB) yerekanye ko ihagaritse cyangwa igabanya iterambere rya vitiligo ikora. Bishobora kugira akamaro cyane iyo ikoreshwa hamwe na corticosteroids cyangwa calcineurin inhibitors. Uzakeneye kuvurwa kabiri cyangwa gatatu mu cyumweru. Bishobora kumara amezi 1 kugeza kuri 3 mbere yo kubona impinduka, kandi bishobora kumara amezi 6 cyangwa arenga kugira ngo ubone ingaruka zuzuye. Ukurikije umuburo wa Food and Drug Administration (FDA) ku bijyanye n'ingaruka zishoboka za kanseri y'uruhu ikoresha calcineurin inhibitors, uganire n'umuvuzi wawe ku ngaruka nziza n'izimbi zo gukoresha iyi miti hamwe na phototherapy. Ku bantu badashobora kujya kwa muganga kuvurwa, ibikoresho bito byoroheje cyangwa bito bya narrow band ultraviolet B therapy biriho kugira ngo bikoreshe mu rugo. Uganire n'umuvuzi wawe kuri ubu buryo niba ari ngombwa. Ingaruka zishoboka mbi za narrow band ultraviolet B therapy harimo uburakari, gukorora no gutwika. Izi ngaruka mbi zisanzwe zikira mu masaha make nyuma yo kuvurwa. Kuvura ibara risigaye (depigmentation). Ubu buryo bwo kuvura bushobora kuba amahitamo niba vitiligo yawe ikwirakwira cyane kandi ubundi buryo bwo kuvura butabashije kugira akamaro. Icyiciro cyo kuvura gishyirwa mu bice by'uruhu bitarwara. Ibi bigorora uruhu buhoro buhoro kugira ngo bihuze n'ibice bitarwara neza. Ubu buryo bwo kuvura bukorwa rimwe cyangwa kabiri ku munsi igihe cy'amezi icyenda cyangwa arenga. Ingaruka mbi zishobora kuba harimo uburakari, kubyimba, gukorora n'uruhu rwumye cyane. Depigmentation irambaho. Niba kuvura hakoreshejwe umucyo n'imiti bitabashije kugira akamaro, bamwe mu bantu bafite uburwayi buhagaze bashobora kuba abakandida bo kubagwa. Ubu buryo bukurikira bugamije kugorora ibara ry'uruhu hagarurwa ibara: Kubaga uruhu. Muri ubu buryo, muganga wawe yimura ibice bito cyane by'uruhu rwawe rwiza, rufite ibara mu bice byabuze ibara. Ubu buryo bukoreshwa rimwe na rimwe niba ufite ibice bito bya vitiligo. Ingaruka zishoboka mbi harimo kwandura, inkovu, isura y'amabuye, ibara ry'ibice, no kunanirwa kw'agace kugira ibara. Kubaga hakoreshejwe ibibyimba. Muri ubu buryo, muganga wawe akora ibibyimba ku ruhu rwawe rufite ibara, akenshi akoresheje igisimba, hanyuma agashyira hejuru y'ibibyimba ku ruhu rutabara neza. Ingaruka zishoboka mbi harimo inkovu, isura y'amabuye no kunanirwa kw'agace kugira ibara. Kandi ibyangiritse by'uruhu byatewe no gukurura bishobora gutera ikindi gice cya vitiligo. Kubaga hakoreshejwe uburyo bwo gukuramo utwenge. Muri ubu buryo, muganga wawe afata umubiri ku ruhu rwawe rufite ibara, ashyira utwenge mu muti hanyuma akabushyira mu gice cyarwaye cyateguwe. Ibyavuye muri ubu buryo bwo gusubiza ibara bigenda bigaragara mu gihe cy'ibyumweru bine. Ingaruka zishoboka mbi harimo inkovu, kwandura n'ibara ry'uruhu ritari ryo. Uburyo bwo kuvura buri kwiga harimo: Imiti igenzura kubabara. Gushyira amavuta ya corticosteroid ku ruhu rwafashwe bishobora gusubiza ibara. Ibi bigira akamaro cyane iyo vitiligo ikiri mu ntangiriro. Ubu bwoko bw'amavuta bugira akamaro kandi byoroshye kubukoresha, ariko ushobora kutazabona impinduka mu ibara ry'uruhu rwawe mu mezi menshi. Ingaruka zishoboka mbi harimo kugabanyuka kw'uruhu cyangwa kugaragara kw'imigozi cyangwa imirongo ku ruhu rwawe. Ubwoko buke bw'imiti bushobora kwandikwa ku bana no ku bantu bafite ibice binini by'uruhu rutabara neza. Amapasipile cyangwa inshinge za corticosteroid bishobora kuba amahitamo ku bantu uburwayi bwabo buzamuka vuba. Imiti igira ingaruka ku mikorere y'umubiri. Amavuta ya calcineurin inhibitor, nka tacrolimus (Protopic) cyangwa pimecrolimus (Elidel) bishobora kugira akamaro ku bantu bafite ibice bito by'uruhu rutabara neza, cyane cyane mu maso no mu ijosi. Ikigo cy'Amerika gishinzwe ibiryo n'imiti (FDA) cyatanze umuburo ku bijyanye n'isano ishoboka iri hagati y'iyi miti na lymphoma na kanseri y'uruhu. Kuvura hakoreshejwe umucyo. Phototherapy ikoresheje ultraviolet B (UVB) yerekanye ko ihagaritse cyangwa igabanya iterambere rya vitiligo ikora. Bishobora kugira akamaro cyane iyo ikoreshwa hamwe na corticosteroids cyangwa calcineurin inhibitors. Uzakeneye kuvurwa kabiri cyangwa gatatu mu cyumweru. Bishobora kumara amezi 1 kugeza kuri 3 mbere yo kubona impinduka, kandi bishobora kumara amezi 6 cyangwa arenga kugira ngo ubone ingaruka zuzuye. Ukurikije umuburo wa Food and Drug Administration (FDA) ku bijyanye n'ingaruka zishoboka za kanseri y'uruhu ikoresha calcineurin inhibitors, uganire n'umuvuzi wawe ku ngaruka nziza n'izimbi zo gukoresha iyi miti hamwe na phototherapy. Ku bantu badashobora kujya kwa muganga kuvurwa, ibikoresho bito byoroheje cyangwa bito bya narrow band ultraviolet B therapy biriho kugira ngo bikoreshe mu rugo. Uganire n'umuvuzi wawe kuri ubu buryo niba ari ngombwa. Ingaruka zishoboka mbi za narrow band ultraviolet B therapy harimo uburakari, gukorora no gutwika. Izi ngaruka mbi zisanzwe zikira mu masaha make nyuma yo kuvurwa. Guhuza psoralen na kuvura hakoreshejwe umucyo. Ubu buryo buhuza ibintu bivuye mu bimera byitwa psoralen hamwe na kuvura hakoreshejwe umucyo (photochemotherapy) kugira ngo bisubize ibara mu bice byera. Nyuma yo kunywa psoralen mu kanwa cyangwa kuyishyira ku ruhu rwafashwe, uzashyirwa mu mucyo wa ultraviolet A (UVA). Ubu buryo, nubwo bugira akamaro, bugoye gukoresha kandi bwarasimbuwe mu mwuga mwinshi na narrow band ultraviolet B (UVB) therapy. Kuvura ibara risigaye (depigmentation). Ubu buryo bwo kuvura bushobora kuba amahitamo niba vitiligo yawe ikwirakwira cyane kandi ubundi buryo bwo kuvura butabashije kugira akamaro. Icyiciro cyo kuvura gishyirwa mu bice by'uruhu bitarwara. Ibi bigorora uruhu buhoro buhoro kugira ngo bihuze n'ibice bitarwara neza. Ubu buryo bwo kuvura bukorwa rimwe cyangwa kabiri ku munsi igihe cy'amezi icyenda cyangwa arenga. Ingaruka mbi zishobora kuba harimo uburakari, kubyimba, gukorora n'uruhu rwumye cyane. Depigmentation irambaho. Kubaga uruhu. Muri ubu buryo, muganga wawe yimura ibice bito cyane by'uruhu rwawe rwiza, rufite ibara mu bice byabuze ibara. Ubu buryo bukoreshwa rimwe na rimwe niba ufite ibice bito bya vitiligo. Ingaruka zishoboka mbi harimo kwandura, inkovu, isura y'amabuye, ibara ry'ibice, no kunanirwa kw'agace kugira ibara. Kubaga hakoreshejwe ibibyimba. Muri ubu buryo, muganga wawe akora ibibyimba ku ruhu rwawe rufite ibara, akenshi akoresheje igisimba, hanyuma agashyira hejuru y'ibibyimba ku ruhu rutabara neza. Ingaruka zishoboka mbi harimo inkovu, isura y'amabuye no kunanirwa kw'agace kugira ibara. Kandi ibyangiritse by'uruhu byatewe no gukurura bishobora gutera ikindi gice cya vitiligo. Kubaga hakoreshejwe uburyo bwo gukuramo utwenge. Muri ubu buryo, muganga wawe afata umubiri ku ruhu rwawe rufite ibara, ashyira utwenge mu muti hanyuma akabushyira mu gice cyarwaye cyateguwe. Ibyavuye muri ubu buryo bwo gusubiza ibara bigenda bigaragara mu gihe cy'ibyumweru bine. Ingaruka zishoboka mbi harimo inkovu, kwandura n'ibara ry'uruhu ritari ryo. Imiti ishishikariza uturemangingo dukora ibara (melanocytes). Izwi nka afamelanotide, ubu buryo bwo kuvura bushobora gushyirwa munsi y'uruhu kugira ngo bushishikarize gukura kwa melanocytes. Imiti ifasha kugenzura melanoctyes. Prostaglandin E2 irimo gupimwa nk'uburyo bwo gusubiza ibara ry'uruhu ku bantu bafite vitiligo idakwirakwira cyangwa idakwirakwira. Ishyirwa ku ruhu nk'amavuta.