Vitiligo

Vitiligo (vit-ih-LIE-go) chirwere chinokonzera kurasikwa kwemavara eganda muzvikamu. Nzvimbo dzine ruvara rwakasiyana kazhinji dzinowedzera kukura nekufamba kwenguva. Iyi mamiriro anogona kukanganisa ganda riri chero kupi muviri. Inogona kukanganisawo bvudzi ne mukati memukanwa.

Kazhinji, ruvara rwebvudzi neganda rinotemerwa ne melanin. Vitiligo inoitika kana masero anogadzira melanin afa kana kurega kushanda. Vitiligo inokanganisa vanhu vemarudzi ese eganda, asi inogona kuoneka zvakanyanya kune vanhu vane ganda rebrown kana dema. Iyi mamiriro haasi ngozi yehupenyu kana kuti anobatsira. Inogona kukonzera kushushikana kana kukugonesa kunzwa kusina kunaka pamusoro pako.

Kurapwa kwevitiligo kunogona kudzoreredza ruvara kune ganda rakakanganiswa. Asi haisi kudzivirira kurasikirwa kweruvara rweganda kana kudzokazve.

Zviratidzo zveVitiligo zvinosanganisira:

• Kurasikirwa nemuvara weganda, kazhinji kunotanga kutanga pamaoko, chiso, nenharaunda dziri pedyo nemuviri nepabonde
• Kuchena kana kucheuka kwevhudzi kumeso, eyelashes, maziso kana ndebvu
• Kurasikirwa nemuvara munyama inoputira mukati memumuromo nemuromo (mucous membranes)

Vitiligo inogona kutanga pazera ripi zvaro, asi kazhinji inoonekwa usati wasvika makore makumi matatu.

Zvichienderana nerudzi rwevitiligo raunaro, inogona kukanganisa:

• Anenge ese maziso eganda. Nerudzi urwu, runonzi universal vitiligo, kushayikwa kwemuvara kunokanganisa anenge ese maziso eganda.
• Zvikamu zvakawanda zvemuviri. Nerudzi iri rinozivikanwa zvikuru, rinonzi generalized vitiligo, mapachi asinganzwisisiki anowanzofambira mberi zvakafanana pane zvikamu zvemuviri zvakafanana (symmetrically).
• Rumwe rutivi kana chikamu chemuviri chete. Rudzi urwu, runonzi segmental vitiligo, runowanzoitika pazera duku, runofambira mberi kwemakore rimwe kana maviri, wobva ramira.
• Nzvimbo imwe chete kana shoma dzemuviri. Rudzi urwu runonzi localized (focal) vitiligo.
• Chiso nemaoko. Nerudzi urwu, runonzi acrofacial vitiligo, ganda rinokanganiswa riri pachiso nemaoko, uye pedyo nemuviri, senge maziso, mhuno nenzeve.

Zvakaoma kufanotaura kuti chirwere ichi chichafambira mberi sei. Dzimwe nguva mapachi anorega kuumbwa pasina kurapwa. Muzviitiko zvakawanda, kurasikirwa kwemuvara kunopararira uye pakupedzisira kunosanganisira ganda rakawanda. Dzimwe nguva, ganda rinowana ruvara rwaro zvakare.

Ona chiremba wako kana nzvimbo dzomuviri wako, bvudzi kana mamembrane emucous zvikapera ruvara. Vitiligo haina mushonga. Asi kurapwa kungamisa kana kunonoka maitiro ekusviba kwemavara uye kudzorera ruvara rwemukati rweganda rako.

Vitiligo inoitika kana masero anogadzira pigment (melanocytes) afa kana kurega kugadzira melanin — pigment inopa ganda rako, bvudzi nemaziso ruvara. Zvikamu zve ganda zvinobatanidzwa zvinova chiedza kana chena. Hazvina kujeka chaizvo zvinokonzera kuti masero aya pigment arege kushanda kana kufa. Zvinogona kunge zvine chekuita ne:

• Dambudziko rehurongwa hwekudzivirira muviri (autoimmune condition)
• Nhoroondo yemhuri (heredity)
• Chiitiko chinokonzera, sekushushikana, kuzvara kwakasimba kwezuva kana kukuvara kweganda, sekubata nekemikari

Munhu wese anogona kurwara vitiligo. Asi ungangokurumidza kurwara kana uine:

• Nhoroondo yemhuri yechirwere ichi.
• Kuonana kakawanda zvakananga nemakemikari ane phenol, akadai seaya ari mune dzimwe detergents.

Vanhu vane vitiligo vanogona kunge vari pangozi yakawedzera ye:

• Kusuwa kwepfungwa kana kwepanyama
• Kuve nechiso
• Matambudziko eziso
• Kurasikirwa kunzwa

Chiremba wenyu achakubvunza nezvematongerwo enyu emuviri uye achazotarisisa ganda renyu, zvichida achishandisa chiratidzo chakakosha. Kuongororwa kunogona kusanganisirawo biopsy yeganda nebvunzo yeropa.

Sarudzo yekurapa inotsamira pazera rako, huwandu hweganda rakabatwa nekwariri, kukurumidza kwesimba rechirwere, uye kuti riri kukanganisa sei hupenyu hwako.

Mishonga nekurapa kwakareruka-kwakavakirwa pane zviripo kuti kubatsira kudzorera ruvara rweganda kana kunyange kunze kweruvara rweganda, kunyangwe mhedzisiro ichasiyana uye haifanotaurwi. Uye kurapa kwakawanda kune zvinokonzeresa zvakakomba. Saka mushandi wako wehutano angakurudzira kuti utange wanyatso shandura chitarisiko cheganda rako nekushandisa chigadzirwa chekuzviita-tanning kana makeup.

Kana iwe nemupi wako wehutano makasarudza kurapa mamiriro ako nechinodhaka, kuvhiya kana kurapa, maitiro acho angatora mwedzi yakawanda kuongorora kushanda kwacho. Uye ungangoda kuedza nzira inopfuura imwe kana kusanganiswa kwenzira usati wawana kurapa kunokushandira iwe.

Kunyangwe kurapa kuchibudirira kwenguva, mhedzisiro ingasavepo kana mapepa matsva akaonekwa. Mupi wako wehutano angakurudzira mushonga unoshandiswa paganda sekuchengetedza kurapa kubatsira kudzivirira kudzokera.

Hapana mushonga unogona kumisa maitiro evitirigo - kurasikirwa nemaseli e pigment (melanocytes). Asi mimwe mishonga, inoshandiswa yekutanga, yakasanganiswa kana nekurapa kwechiedza, inogona kubatsira kudzorera ruvara rwakati.

Mishonga inodzora kuzvimba. Kushandisa kirimu ye corticosteroid paganda rakabatwa kunogona kudzorera ruvara. Izvi zvinonyanya kushanda kana vitiligo ichiri mumamiriro ayo ekutanga. Rudzi urwu rwekisirimu runoshanda uye nyore kushandisa, asi ungasione shanduko muvara reganda rako kwemavhiki mazhinji. Zvinokonzeresa zvinogona kusanganisira ganda rakapfava kana chitarisiko chemavara kana mitsara paganda rako.

Mafomu akapfava emushonga anogona kunyorerwa vana nevanhu vane nzvimbo huru dze ganda risina ruvara.

Mapiritsi e corticosteroid kana jekiseni zvinogona kunge iri sarudzo kune vanhu vane mamiriro avo ari kukurumidza kufambira mberi.

Kurapa kwechiedza. Phototherapy ine narrow band ultraviolet B (UVB) yakaratidzwa kumisa kana kunonoka kufambira mberi kwe vitiligo inoshanda. Inogona kunge ichinyanya kushanda kana ichishandiswa ne corticosteroids kana calcineurin inhibitors. Uchada kurapa kaviri kusvika katatu pavhiki. Zvinogona kutora mwedzi 1 kusvika ku3 usati waona shanduko ipi neipi, uye zvinogona kutora mwedzi 6 kana kupfuura kuti uwane mhedzisiro yakazara.

Tichipa yambiro yeFood and Drug Administration (FDA) pamusoro pengangova njodzi yekenza yeganda nekushandiswa kwe calcineurin inhibitors, taura nemupi wako wehutano nezvenjodzi uye mabhenefiti ekushandisa mishonga iyi ne phototherapy.

Kune vanhu vanogona kuenda kuchipatara chekurapa, midziyo midiki inotakurika kana midziyo yekutsvaga narrow band ultraviolet B therapy iripo kune kushandiswa kumba. Taura nemupi wako wehutano nezve sarudzo iyi zvakare kana zvichidiwa.

Zvinokonzeresa zvinogona kuitika zve narrow band ultraviolet B therapy zvinosanganisira kutsvuka, kukwakuka uye kupisa. Aya maitiro anowanzo bvisa mukati memaawa mashoma mushure mekurapa.

Kubvisa ruvara rakasara (depigmentation). Kurapa uku kunogona kunge kuri sarudzo kana vitiligo yako yakapararira uye kurapa kwakawanda hakushande. Mushonga we depigmenting unoshandiswa kune nzvimbo dzisina kubatwa dzeganda. Izvi zvinonyatsochenesa ganda kuitira kuti risanganiswe nenhamba dzisina ruvara. Kurapa kunoitwa kamwe kana kaviri pazuva kwemavhiki mapfumbamwe kana kupfuura.

Zvinokonzeresa zvinogona kusanganisira kutsvuka, kuzvimba, kukwakuka uye ganda rakaoma kwazvo. Depigmentation inogara.

Kana kurapa kwechiedza nemishonga zvisina kushanda, vamwe vanhu vane chirwere chakagadzikana vanogona kunge vari vanokodzera kuvhiya. Matekiniki anotevera anofanirwa kunyange kunze kweruvara rweganda nekudzorera ruvara:

Kugadzira ganda. Muitiro uyu, chiremba wako anofambisa zvikamu zvidiki zveganda rako rakasimba, rakaita ruvara kune nzvimbo dzakarasikirwa neruvara. Iyi nzira dzimwe nguva inoshandiswa kana uine mapepa maduku e vitiligo.

Njodzi dzinogona kuitika dzinosanganisira hutachiona, kuita mavara, chitarisiko che cobblestone, ruvara rwakapararira uye kukundikana kwenzvimbo yekudzorera ruvara.

Blister grafting. Muitiro uyu, chiremba wako anoita mablister paganda rako rakaita ruvara, kazhinji nesuction, uye wobva watamisa pamusoro pemablister kune ganda risina ruvara.

Njodzi dzinogona kuitika dzinosanganisira kuita mavara, chitarisiko che cobblestone uye kukundikana kwenzvimbo yekudzorera ruvara. Uye kukuvara kweganda kunokonzerwa ne suctioning kunogona kutanga chimwe chikamu che vitiligo.

Cellular suspension transplant. Muitiro uyu, chiremba wako anotora tishu pamusoro peganda rako rakaita ruvara, anoisa masero mumucherechedzo wobva awatamisa kune nzvimbo yakagadzirirwa yakabatwa. Mhedzisiro yemitiro iyi yekudzorera ruvara inotanga kuoneka mukati memavhiki mana.

Njodzi dzinogona kuitika dzinosanganisira kuita mavara, hutachiona uye ruvara rweganda rusina kunaka.

Kurapa kuri kudzidzwa kunosanganisira:

• Mishonga inodzora kuzvimba. Kushandisa kirimu ye corticosteroid paganda rakabatwa kunogona kudzorera ruvara. Izvi zvinonyanya kushanda kana vitiligo ichiri mumamiriro ayo ekutanga. Rudzi urwu rwekisirimu runoshanda uye nyore kushandisa, asi ungasione shanduko muvara reganda rako kwemavhiki mazhinji. Zvinokonzeresa zvinogona kusanganisira ganda rakapfava kana chitarisiko chemavara kana mitsara paganda rako.

  Mafomu akapfava emushonga anogona kunyorerwa vana nevanhu vane nzvimbo huru dze ganda risina ruvara.

  Mapiritsi e corticosteroid kana jekiseni zvinogona kunge iri sarudzo kune vanhu vane mamiriro avo ari kukurumidza kufambira mberi.

• Mishonga inokanganisa sisitimu yekudzivirira muviri. Calcineurin inhibitor ointments, senge tacrolimus (Protopic) kana pimecrolimus (Elidel) inogona kunge ichikosha kune vanhu vane nzvimbo diki dze depigmentation, kunyanya pachiso nemutsipa. U.S. Food and Drug Administration (FDA) yakanyevera nezve hukama hunogona kunge huripo pakati pemishonga iyi ne lymphoma nekenza yeganda.

• Kurapa kwechiedza. Phototherapy ine narrow band ultraviolet B (UVB) yakaratidzwa kumisa kana kunonoka kufambira mberi kwe vitiligo inoshanda. Inogona kunge ichinyanya kushanda kana ichishandiswa ne corticosteroids kana calcineurin inhibitors. Uchada kurapa kaviri kusvika katatu pavhiki. Zvinogona kutora mwedzi 1 kusvika ku3 usati waona shanduko ipi neipi, uye zvinogona kutora mwedzi 6 kana kupfuura kuti uwane mhedzisiro yakazara.

  Tichipa yambiro yeFood and Drug Administration (FDA) pamusoro pengangova njodzi yekenza yeganda nekushandiswa kwe calcineurin inhibitors, taura nemupi wako wehutano nezvenjodzi uye mabhenefiti ekushandisa mishonga iyi ne phototherapy.

  Kune vanhu vanogona kuenda kuchipatara chekurapa, midziyo midiki inotakurika kana midziyo yekutsvaga narrow band ultraviolet B therapy iripo kune kushandiswa kumba. Taura nemupi wako wehutano nezve sarudzo iyi zvakare kana zvichidiwa.

  Zvinokonzeresa zvinogona kuitika zve narrow band ultraviolet B therapy zvinosanganisira kutsvuka, kukwakuka uye kupisa. Aya maitiro anowanzo bvisa mukati memaawa mashoma mushure mekurapa.

• Kusanganisa psoralen ne kurapa kwechiedza. Kurapa uku kunosanganisa chinhu chinobva kumuti chinonzi psoralen ne kurapa kwechiedza (photochemotherapy) kudzorera ruvara kune mapepa akareruka. Mushure mekunge watora psoralen mumuromo kana kuishandisa paganda rakabatwa, unowanikwa ne ultraviolet A (UVA) chiedza. Nzira iyi, kunyangwe ichikosha, yakaoma zvakanyanya kuita uye yakamiswa muzviitiko zvakawanda ne narrow band ultraviolet B (UVB) therapy.

• Kubvisa ruvara rakasara (depigmentation). Kurapa uku kunogona kunge kuri sarudzo kana vitiligo yako yakapararira uye kurapa kwakawanda hakushande. Mushonga we depigmenting unoshandiswa kune nzvimbo dzisina kubatwa dzeganda. Izvi zvinonyatsochenesa ganda kuitira kuti risanganiswe nenhamba dzisina ruvara. Kurapa kunoitwa kamwe kana kaviri pazuva kwemavhiki mapfumbamwe kana kupfuura.

  Zvinokonzeresa zvinogona kusanganisira kutsvuka, kuzvimba, kukwakuka uye ganda rakaoma kwazvo. Depigmentation inogara.

• Kugadzira ganda. Muitiro uyu, chiremba wako anofambisa zvikamu zvidiki zveganda rako rakasimba, rakaita ruvara kune nzvimbo dzakarasikirwa neruvara. Iyi nzira dzimwe nguva inoshandiswa kana uine mapepa maduku e vitiligo.

  Njodzi dzinogona kuitika dzinosanganisira hutachiona, kuita mavara, chitarisiko che cobblestone, ruvara rwakapararira uye kukundikana kwenzvimbo yekudzorera ruvara.

• Blister grafting. Muitiro uyu, chiremba wako anoita mablister paganda rako rakaita ruvara, kazhinji nesuction, uye wobva watamisa pamusoro pemablister kune ganda risina ruvara.

  Njodzi dzinogona kuitika dzinosanganisira kuita mavara, chitarisiko che cobblestone uye kukundikana kwenzvimbo yekudzorera ruvara. Uye kukuvara kweganda kunokonzerwa ne suctioning kunogona kutanga chimwe chikamu che vitiligo.

• Cellular suspension transplant. Muitiro uyu, chiremba wako anotora tishu pamusoro peganda rako rakaita ruvara, anoisa masero mumucherechedzo wobva awatamisa kune nzvimbo yakagadzirirwa yakabatwa. Mhedzisiro yemitiro iyi yekudzorera ruvara inotanga kuoneka mukati memavhiki mana.

  Njodzi dzinogona kuitika dzinosanganisira kuita mavara, hutachiona uye ruvara rweganda rusina kunaka.

• Mushonga we kukurudzira masero anogadzira ruvara (melanocytes). Inonzi afamelanotide, kurapa uku kunogona kuiswa pasi peganda kukurudzira kukura kwe melanocytes.

• Mushonga unobatsira kudzora melanoctyes. Prostaglandin E2 iri kuongororwa senzira yekudzorera ruvara rweganda kune vanhu vane vitiligo isingaparariri kana kupararira. Inoshandiswa paganda segel.