Bullous Pemphigoid
Uhlolojikelele
Abantu abane-bullous pemphigoid bangase bathuthukise izilonda eziningi. Uma izilonda zidiliza, ziyashiya isifo esivamise ukuphulukisa ngaphandle komkhondo.
Bullous pemphigoid (BUL-us PEM-fih-goid) iyisimo esingavamile sesikhumba esibangela izilonda ezinkulu ezizele ngamanzi. Zivame ukuvela esikhumbeni eduze kwezimpinda, njengezinyawo eziphezulu nezikhumba. Ngezinye izikhathi, abantu bathola isihlungu esikhulu esikhulu kunokuba kube izilonda. Izindawo ezihlaselekile zingaba buhlungu futhi ngokuvamile zikhahlela kakhulu. Izilonda noma amaqhuzu angase futhi akheke emlonyeni, kodwa lokhu kuyinto engavamile.
Bullous pemphigoid kwenzeka uma uhlelo lokuphepha lomzimba luhlasela izingxenye zezicubu zesikhumba. Isizathu salolu baphendulo lwezimboni zokuphepha lomzimba aluqondakali kahle. Kwabanye abantu, lesi simo sibangelwa imithi ethile.
Bullous pemphigoid ngokuvamile ihamba yodwa ngezinyanga ezimbalwa, kodwa kungathatha iminyaka emihlanu ukuze ihambe ngokuphelele. Ukwelashwa ngokuvamile kusiza ekuphulukiseni izilonda nokuvimbela ezintsha ukuba zenzeke.
Lesi simo sivame kakhulu kubantu abadala kuno-60.
Izimpawu
Izimpawu ze-bullous pemphigoid zingafaka: Ukukhahlela, okungaqala amasonto noma izinyanga ngaphambi kokuba kube khona amabhabhu. Amabhabhu amakhulu angaphuki kalula, avame ukubonakala emadolobheni olukhuni. Olunwabu olukhulu, amabhabhu angase abe pinki emnyama, abomvu noma amnyama. Olunwabu olukhulu, angase abe bomvu, pinki noma obomvu. Ubuhlungu. Isibazi. Amabhabhu amancane noma izihlamba emlonyeni noma kwamanye amalunga omzimba. Lena yimpawu yesigaba esingavamile sesifo esibizwa ngokuthi i-mucous membrane pemphigoid. Bheka ochwepheshe bezempilo uma una: Amabhabhu angachaziwe. Amabhabhu emehlweni akho. Ukutheleleka. Amabhabhu avulekile futhi aphuma.
Isikhathi sokubona udokotela
Bona ubungcweti bezempilo uma une:
- Isibhoshongo esingachazwanga.
- Isibhoshongo emehlweni akho.
- Ukutheleleka.
- Isibhoshongo esivuleka futhi siphethule.
Izimbangela
Amasimptomu e-bullous pemphigoid avele uma isimo sokuvikela somzimba sihlasela ingxenye yethishu kwisihlungu. Imbangela yale nkinga ayiqondakali kahle. Ezimweni ezithile, isimo sibangelwa yi:
- Imithi. Imithi eminingi iyaziwa ngokuthi ikhuphula ingozi ye-bullous pemphigoid. Isibonelo yi-diuretics enjenge-furosemide; ama-antibiotics enjenge-amoxicillin, i-penicillin ne-ciprofloxacin; ama-NSAIDs enjenge-aspirin ne-ibuprofen; imithi yokwelapha isifo sikashukela enjenge-sitagliptin (Januvia); kanye nemithi yokwelapha umdlavuza enjenge-nivolumab ne-pembrolizumab.
- Ukukhanya nokuphathwa kweradieysheni. Ukwelashwa kokukhanya kwe-ultraviolet ukuze kuphathwe izimo ezithile zesikhumba kungaletha i-bullous pemphigoid. Futhi, ukwelashwa kweradieysheni ukuze kuphathwe umdlavuza kungabangela isimo.
- Izimo zezokwelapha. I-psoriasis, i-lichen planus, i-dementia, isifo se-Parkinson, isifo sokushaya kanye ne-multiple sclerosis zingabala phakathi kwezimo ezingahlobene ne-bullous pemphigoid.
Isimo aliyona ukutheleleka futhi aliwumkhuhlane.
Izici eziyingozi
I-Bullous pemphigoid ivame kakhulu kubantu abadala kuno-60, futhi ingozi iyakhula njengoba ubudala buyanda. Lesi simo singaba yingozi eyingozi kubantu abadala abanezinye izimo ngesikhathi esifanayo.
Izingqinamba
Izingozi ezingase zenzeke ngenxa ye-bullous pemphigoid zihlanganisa:
- Ukutheleleka.
- Ukushintsha kombala wesikhumba ngemva kokuba isikhumba esithintekile siphilisile. Lesi shintsho sombala wesikhumba sibizwa ngokuthi i-post-inflammatory hyperpigmentation uma isikhumba simnyama kakhulu, ne-post-inflammatory hypopigmentation uma isikhumba sililahlekelwe umbala. Abantu abanesikhumba esimnyama noma abamnyama banengozi enkulu yokushintsha kombala wesikhumba isikhathi eside.
- Imiphumela emibi yemithi ebizwa ngokuthi i-bullous pemphigoid.
Ukuxilongwa
Uchwepheshe wakho wezokunakekelwa kwezempilo uzoxoxa nawe ngezimpawu zakho kanye nomlando wakho wezokwelapha futhi enze ukuhlolwa komzimba. Ungase udinga ukuhlolwa ukuqinisekisa ukuxilongwa kwe-bullous pemphigoid. Lokhu kungafaka ukuhlolwa kwegazi, i-biopsy yesikhumba noma kokubili. I-biopsy inqubo yokususa isampula yethishu ukuze ihlolwe elabhoratri.
Uchwepheshe wakho wezokunakekelwa kwezempilo angase akuqondise esiqeshini sokuqondisa izimo zesikhumba. Lo mqondo ubizwa ngokuthi yi-dermatologist.
Ukwelashwa
Ukuphathwa kwe-bullous pemphigoid kugxilwe ekwelapheni kwesikhumba, ukunciphisa ukukhahlela nobuhlungu, nokuvimbela amabhabhu amasha. Uchwepheshe wakho wezokunakekelwa kwezempilo cishe uzokunikeza imithi enye noma ukuhlanganiswa kwemithi:
- I-Corticosteroids. Ukwelashwa okuyinhloko kwe-bullous pemphigoid yimithi ye-corticosteroid efake endaweni eathintekile. Ngokuvamile kuyasetshenziswa i-cream eqinile ye-steroid efana ne-clobetasol propionate. Ukusetshenziswa kwemithi yalolu hlobo isikhathi eside kuza nezingozi zokuncipha kwesikhumba nokukhahlela okulula. Uchwepheshe wakho wezokunakekelwa kwezempilo angase futhi aphakamise imithi ye-steroid ethathwa ngomlomo. I-steroids yomlomo iza nezingozi zemiphumela emibi eyingozi, njengezitho ezibuthakathaka, isifo sikashukela, izihlungu zesisu nezingqinamba zamehlo.
- Ama-Antibiotics. Imithi yomlomo i-dapsone ne-doxycycline ikusiza ukulawula amabhabhu.
- Imithi ehlose uhlelo lokukhulisa umzimba. Eminye imithi ingayeka uhlelo lwakho lokukhulisa umzimba ekulweni nezinhlangothi ezempilo. Izibonelo yi-azathioprine (Azasan, Imuran), i-rituximab (Rituxan), i-mycophenolate (CellCept) ne-methotrexate (Trexall). Le mithi nayo inengozi yemiphumela emibi eyingozi, kufaka phakathi ukutheleleka. Abantu abathatha le mithi badinga ukulandelelwa eduze, ngezinye izikhathi, ukuhlolwa kwegazi okuphindaphindwayo ukuqapha imiphumela emibi.
I-Corticosteroids. Ukwelashwa okuyinhloko kwe-bullous pemphigoid yimithi ye-corticosteroid efake endaweni eathintekile. Ngokuvamile kuyasetshenziswa i-cream eqinile ye-steroid efana ne-clobetasol propionate. Ukusetshenziswa kwemithi yalolu hlobo isikhathi eside kuza nezingozi zokuncipha kwesikhumba nokukhahlela okulula. Uchwepheshe wakho wezokunakekelwa kwezempilo angase futhi aphakamise imithi ye-steroid ethathwa ngomlomo. I-steroids yomlomo iza nezingozi zemiphumela emibi eyingozi, njengezitho ezibuthakathaka, isifo sikashukela, izihlungu zesisu nezingqinamba zamehlo.
Kuye ngokuthi uzophendula kanjani emithini yokuqala oyizamayo, uchwepheshe wakho wezokunakekelwa kwezempilo angase aphakamise okuthile ngaphandle kwe-steroids.
I-bullous pemphigoid ngokuvamile iyahamba ngokuhamba kwesikhathi. Izilonda zingathatha amasonto ukuphulukisa, futhi kuvamile ukuba kube khona ezintsha ezakhiwa.
Umshwana wokuzihlangula: I-August iyinkundla yolwazi lwezempilo futhi izimpendulo zayo azihlanganisi iseluleko sezokwelapha. Njalo thintana nochwepheshe bezokwelapha onelayisensi eduze nawe ngaphambi kokwenza noma yiluphi ushintsho.