Uyini iPemphigus? Izimpawu, Izimbangela, Nokwelapha

IPemphigus yisimo esingavamile sezempilo lapho izingxube zezimbodi zomzimba wakho zihlukunyezela ngephutha isikhumba esinempilo nezinhlangothi ze-mucous. Lokhu kuhlukunyezwa kubangela amabhabha obuhlungu neziqala ezikhula esikhumbeni sakho nangaphakathi emlonyeni wakho, ehlombe, noma kwezinye izindawo lapho kutholakala khona izinhlangothi ze-mucous.

Nakuba ipemphigus izwakala iyesabekayo, ukuqonda ukuthi iyini nokuthi isebenza kanjani kungakusiza uzizwe ulungile. Izingxube zezimbodi zakho, ezivamile ezikuvikela ekuthelelekeni, ziyadida futhi ziqala ukubheja amaprotheni ahlanganisa amaseli esikhumba sakho ndawonye. Uma le mihlangano ibuthakathaka, amabhabha agcwele amanzi akhula angaba buhlungu futhi aphuleke kalula.

Ziyini izimpawu zepemphigus?

Isimpawu esivelele kakhulu sepemphigus ukukhula kwamabhabha abuthambile, agcwele amanzi, abonakala esikhumbeni esibonakala sijwayelekile. La mabhabha abuthakathaka kakhulu futhi athanda ukuphuka kalula, eshiya izindawo ezinobuhlungu, eziluhlaza okwesibhakabhaka ezidinga isikhathi sokuphulukiswa.

Ake sihambe ngezimpawu ongazihlangabezana nazo, sikhumbula ukuthi okuhlangenwe nakho kwabo bonke kungabahlukile:

• Amabhabha obuhlungu aqala emlonyeni wakho, ehlombe, noma ekhanda lakho ngaphambi kokusabalala kwezinye izindawo
• Isikumba esibuthakathaka esibonakala sihlukaniswa noma siqothulwa uma ucindezela kancane
• Iziqala eziluhlaza okwesibhakabhaka, ezicaphukayo lapho amabhabha ephukile
• Ubunzima bokudla noma ukugwinya uma amabhabha ekhula emlonyeni wakho noma ehlombe
• Izindawo ezimuncu esikhumbeni sakho lapho iziqala zizama ukuphulukiswa
• Ukuvutha noma ukuvutha okubhebhethekayo ezindaweni ezihlaselekile

Kwezinye izimo ezingavamile, abanye abantu bakhula amabhabha emehlweni abo, ekhaleni, noma ezindaweni zabo zesondo. Iphethini nobunzima kungabahluka kakhulu kusuka kumuntu komunye. Okubaluleke kakhulu ukuqaphela ukuthi lezi zimpawu zidinga ukunakekelwa kwezokwelapha, ikakhulukazi uma ziqhubeka noma zibe zimbi ngokuhamba kwesikhathi.

Ziyini izinhlobo zepemphigus?

IPemphigus iza ngezindlela eziningi ezahlukene, ngayinye ihlasela umzimba wakho ngezindlela ezihlukile kancane. Izinhlobo eziyinhloko zihlukaniswa ukuthi amabhabha akhula kuphi nokuthi angena kangakanani ezinhlangothini zesikhumba sakho.

IPemphigus vulgaris uhlobo oluvamile kakhulu oluzohlangana nalo. Ngokuvamile iqala ngamabhabha obuhlungu ngaphakathi emlonyeni wakho ngaphambi kokusabalala esikhumbeni sakho. La mabhabha akhula ngaphakathi kwezinhlangothi zesikhumba sakho, okwenza kube buthakathaka kakhulu futhi kube kancane ukuphulukiswa.

IPemphigus foliaceus ihlasela izinhlangothi eziphezulu zesikhumba sakho futhi ayihlangene emlonyeni wakho noma ezinhlangothini ze-mucous. Amabhabha athanda ukuba ngaphezulu futhi ngokuvamile abonakala njengeziqeshana ezimuncu, ezinezikali kunokuba zibe yiziqala ezijulile ezibonakala ku-pemphigus vulgaris.

Izinhlobo ezingavamile zihlanganisa ipemphigus vegetans, lapho kukhula khona ukukhula okukhulu, okufana ne-wart ezindaweni zesikhumba, ne-paraneoplastic pemphigus, engase ibe khona kanye nezinye izifo zomdlavuza. IPemphigus ebangelwa imithi ingase ikhule njengomphumela wemithi ethile, nakuba lokhu kuphela uma imithi ebangela lokhu iyeka.

Yini ebangela ipemphigus?

IPemphigus ikhula uma izingxube zezimbodi zomzimba wakho zikhiqiza ama-antibodies abheja ngephutha amaprotheni abizwa ngama-desmogleins. La maprotheni asebenza njengengxube yemolekyuli, ehlanganisa amaseli esikhumba sakho ndawonye ukuze enze isivikelo.

Isizathu esiqondile sokuthi kungani izingxube zezimbodi zakho zenza le phutha asiqondakali ngokuphelele. Abacwaningi bakholelwa ukuthi cishe kuhilela ukuxubana kwezinto ezihlobene ne-genetic ezenza ube sengozini kakhulu nezinto ezingaphandle ezingase zivuselele lesi simo.

Izinto eziningi zingase zivuselele ipemphigus kubantu abanesizungu se-genetic:

• Imithi ethile, kuhlanganise ne-ACE inhibitors, ama-antibiotics afana ne-penicillin, nezinye izidakamizwa zobuhlungu
• Ukutheleleka kwe-viral okungase kudida izingxube zezimbodi zakho
• Ukuhlupheka okukhulu ngokomzwelo noma ngokomzimba
• Ukuvezwa ezintweni ezithile zekhemikhali noma ezinobuthi
• Ezinye izimo ze-autoimmune ezingase zikhulise ingozi yakho

Kwezinye izimo ezingavamile, ipemphigus ingase ikhule kanye nezinhlungu, ikakhulukazi izinhlobo ezithile ze-lymphomas. Lolu hlobo, oluthiwa yi-paraneoplastic pemphigus, luthuthuka uma umdlavuza oyisisekelo uphathwa ngempumelelo.

Nini okufanele ubona udokotela ngepemphigus?

Kufanele ubona udokotela ngokushesha uma ukhula amabhabha noma iziqala ezingaphuli ngaphakathi kwezinsuku ezimbalwa, ikakhulukazi uma evela emlonyeni wakho noma isabalala ezindaweni eziningi zomzimba wakho. Ukuxilongwa kwasekuqaleni nokuphathwa kungasiza ukuvimbela izinkinga nokunciphisa ubuhlungu.

Funani ukunakekelwa kwezokwelapha ngokushesha uma uhlangabezana nobunzima bokugwinya, izinkinga zokuphefumula, noma izimpawu zokutheleleka okubanzi njengobushushu, ukuthithimba, noma ukusabalala okusheshayo kokubomvu ezindaweni zakho eziqalile. Lezi zimpawu zingase zibonise ukuthi lesi simo sihlukunyezela imisebenzi ebalulekile noma ukuthi kutheleleke okwesibili kuye kwakhula.

Ungalindi uma uqaphela ukuthi isikhumba sakho siqala ukuhlukaniswa noma siqothulwa ngokucindezela kancane, njengoba lokhu kungaba yisibonakaliso sepemphigus enzima edinga ukwelashwa okusheshayo. Udokotela wakho angenza izivivinyo ezithile ukuze aqinisekise ukuxilongwa aqale ukwelashwa okufanele ukuze asize izimpawu zakho zibe ngcono.

Ziyini izinto ezikhuphula ingozi yepemphigus?

Izinto ezithile zingase zikhulise amathuba akho okukhula ipemphigus, nakuba ukuba nalezi zinto ezikhuphula ingozi akusho ukuthi uzothola ngokuqinisekile lesi simo. Ukuziqonda kungakusiza uhlale uqaphele izimpawu ezingase zikhule.

Nazi izinto eziyinhloko ezitholakele ucwaningo:

• Iminyaka phakathi kweminyaka engu-40 no-60, nakuba ingase ibe khona kunoma iyiphi iminyaka
• Ubuzwe be-Jewish noma i-Mediterranean, ikakhulukazi ifa le-Ashkenazi Jewish
• Umbukiso womlando wemindeni yezimo ze-autoimmune
• Ukuthatha imithi ethile eyaziwayo ngokuvuselela ipemphigus
• Ukuba nezinye izifo ze-autoimmune njenge-rheumatoid arthritis noma i-lupus
• Ukuvezwa ezintweni ezithile zekhemikhali noma ezinobuthi

Kwezinye izimo ezingavamile, izinto ezihlobene ne-genetic zidlala indima eqondile, ngezinye izinguquko ze-HLA gene ezenza abanye abantu babe sengozini kakhulu. Noma kunjalo, ngisho nalapho kunesizungu se-genetic, abantu abaningi abakhule ipemphigus, okubonisa ukuthi izinto ezingaphandle ngokuvamile zidingeka ukuze kuvuswe lesi simo.

Ziyini izinkinga ezingase zikhule ngepemphigus?

Nakuba ipemphigus ilawulwa ngokwelashwa okufanele, izinkinga eziningi zingase zikhule uma lesi simo singalawulwa kahle. Ukukhathazeka okuvamile kakhulu ukutheleleka kwe-bacterial okwesibili ezindaweni eziqalile lapho amabhabha ephukile.

Ake sihambe ngezinkinga okufanele uzazi:

• Ukutheleleka kwesikhumba okungasabalala uma ama-bacteria engena ngamabhabha aphukile
• Ukulimala ezindaweni lapho iziqala ezijulile ziye zaphulile
• Ukuphelelwa amanzi ngokulahlekelwa amanzi ngenxa yomonakalo omkhulu wesikhumba
• Izinkinga zokudla uma iziqala zomlomo zenza ukudla kube nzima
• Ukungahlangani kahle kwama-electrolyte ngokulahlekelwa amanzi naminerali
• Izinselele zokuxhumana nomphakathi nangokomzwelo ngenxa yokushintsha okubonakalayo kwesikhumba

Kwezinye izimo ezinzima, ezinzima, ipemphigus ebanzi ingase iholele ezinkingeni ezingase zisongela impilo ezifana nokushisa okukhulu, kuhlanganise nokutheleleka okukhulu noma ukwehluleka komzimba. Ngaphezu kwalokho, ezinye zezidakamizwa ezisetshenziswayo ukwelapha ipemphigus zingaba nemiphumela yazo, udokotela wakho uzoyilandelela ngokucophelela ngesikhathi sokwelashwa.

IPemphigus ixilongwa kanjani?

Ukuxilongwa kwepemphigus kudinga izivivinyo ezikhethekile ngoba lesi simo singase sibukeke sifana nezinye izifo zesikhumba ezibhabha. Udokotela wakho uzoqala ngokuhlola ngokucophelela isikhumba sakho futhi abuze imibuzo eminingi mayelana nokuthi izimpawu zakho zaqala nini nokuthi zishintshe kanjani ngokuhamba kwesikhathi.

Isivivinyo esibaluleke kakhulu sokuthola ukuxilongwa yi-biopsy yesikhumba, lapho udokotela wakho ekhipha khona isampula encane yesikhumba esihlaselekile ukuze ihlalwe e-laboratory. Izinhlobo ezimbili ze-biopsies ngokuvamile zenziwa: eyodwa yokuhlolwa okujwayelekile ngaphansi komkhiqizo kanye nezinye zokuhlolwa okuqondile kwe-immunofluorescence.

Ukuhlolwa okuqondile kwe-immunofluorescence kubheka ama-antibodies athile abangela ipemphigus. Lesi sivivinyo singabonisa iphethini ebonakalayo yokubeka ama-antibody phakathi kwamaseli esikhumba, okusisiza ukuqinisekisa ukuxilongwa nokwahlukanisa ipemphigus kwezinye izimo.

Udokotela wakho angase futhi a-ode izivivinyo zegazi ukuze alinganise amazinga ama-antibodies epemphigus ekujikelezeni kwakho. Lezi zivino, ezibizwa ngokuthi yi-indirect immunofluorescence noma i-ELISA tests, zingasiza ukulandelela ukuthi lesi simo sakho sisebenza kangakanani nokuthi ukwelashwa kusebenza kangakanani.

Uyini ukwelashwa kwepemphigus?

Ukwelashwa kwepemphigus kugxile ekuthuthukiseni izingxube zezimbodi zakho ezikhulu ukuze kuvinjwe amabhabha amasha ukuba akhule futhi kusize iziqala ezikhona ziphulukiswe. Imithi ebaluleke kakhulu esetshenziswayo yi-corticosteroids nezinye izidakamizwa eziqeda izingxube zezimbodi ezingalawula lesi simo ngempumelelo.

Abantu abaningi baqala ukwelashwa nge-corticosteroids yomlomo njenge-prednisone, engase iyanciphise ukutheleleka ngokushesha futhi iyeke ukwakheka kwamabhabha amasha. Nakuba kunomphumela, le mithi idinga ukulandelelwa ngokucophelela ngenxa yemiphumela engase ibe khona uma isetyenziswa isikhathi eside.

Uhlelo lwakho lokwelashwa lungase luhlanganise izindlela eziningi ezisebenza ndawonye:

• I-corticosteroids yomlomo ukulawula ngokushesha isifo esisebenzayo
• Imithi ecindezela izingxube zezimbodi njenge-methotrexate noma i-azathioprine ukunciphisa ukuncika kwi-steroid
• Ukwelashwa kwe-topical ukuze kusize ukuphulukisa iziqala ezikhona nokuvimbela ukutheleleka
• Ama-antibiotics uma kutheleleka kwe-bacterial okwesibili kuvela
• IRituximab ezimweni ezinzima ezingaphenduli ekwelapheni okujwayelekile
• I-Plasmapheresis ukususa ama-antibodies abangela ubuhlungu egazini lakho ezimweni eziphuthumayo

Kwezinye izimo ezinzima noma ezingaphenduli ekwelapheni, imithi emisha ye-biologic noma ukwelashwa kwe-intravenous immunoglobulin kungase kubhekwe. Udokotela wakho uzohlangana nawe ukuthola ukuxubana okulungile kokwelashwa okulawula izimpawu zakho ngenkathi unciphise imiphumela engase ibe khona.

Indlela yokuphatha ipemphigus ekhaya?

Ukukhathalela wena ekhaya kudlala indima ebalulekile ekuphatheni ipemphigus kanye nokwelashwa kwakho kwezokwelapha. Ukukhathalela isikhumba esimnene nokuvikela isikhumba sakho esibuthakathaka ekunyakazeni okwengeziwe kungasiza ukuvimbela izinkinga nokwenza ukhululeke.

Gcina isikhumba sakho sihlanzekile futhi siwomile, kodwa gwema amasoseji amakhulu noma ukuhlanza okungalimaza izindawo ezibuthakathaka. Sebenzisa amanzi afudumele ukugeza futhi uthinte isikhumba sakho siwomile kunokuba usikwese ngethawula.

Nazi izinyathelo eziwusizo ongazithatha nsuku zonke:

• Faka imithi e-topical e-prescribed ngokuqondile njengoba kuqondiswe
• Sebenzisa ama-moisturizers amnene, angenamphunga ukuze ugcine isikhumba esingathintekile siphilile
• Gqoka izingubo ezimnene, eziqondile ukuze ugweme ukusabela esikhumbeni sakho
• Dla ukudla okumnene, okungelona okunamuncu uma uneziqala zomlomo
• Hlala uthola amanzi, ikakhulukazi uma unesikhumba esibanzi esithintekile
• Gwema imisebenzi engase ibe yimbangela yokulimaza noma ukulimala kwesikhumba

Qaphela izimpawu zokutheleleka njengokwanda kokubomvu, ubushushu, i-pus, noma ukusabalala okubomvu ezindaweni zakho eziqalile. Xhumana nodokotela wakho ngokushesha uma uqaphela lezi zinguquko, njengoba ukwelashwa okusheshayo kokutheleleka kubalulekile kubantu abanepemphigus.

Kufanele ulungiselele kanjani i-appointment yakho yokuya kudokotela?

Ukulungiselela i-appointment yakho kungasiza ukuqinisekisa ukuthi uthola ukunakekelwa okuphelele okungenzeka. Letha uhlu lwemithi yonke oyithathayo njengamanje, kuhlanganise nemithi yokuthengwa ngaphandle kokubhalwa komtholampilo kanye nezinye izinto, njengoba ezinye zingase zivuselele noma zenzima ipemphigus.

Bhala phansi ukuthi izimpawu zakho zaqala nini nokuthi zishintshe kanjani ngokuhamba kwesikhathi. Qaphela noma yiziphi izinto ezingase zibe yimbangela ongayikhumbula, njengemithi emisha, ukutheleleka, noma izehlakalo ezikhathazayo ezenzeka ngaphambi kokuba izimpawu zakho ziqale.

Thatha izithombe ezicacile zezindawo ezithintekile uma kungenzeka, ikakhulukazi uma izimpawu zakho ziya futhi ziye. Lokhu kubhalwa kwemifanekiso kungasiza udokotela wakho ukuqonda iphethini nobunzima besimo sakho ngisho nalapho izimpawu zingasebenzi ngesikhathi sokuvakasha kwakho.

Lungisa imibuzo mayelana nesimo sakho, izinketho zokwelashwa, nokuthi yini okulindelekile ukuqhubeka. Unganqikazi ukubuza ngemiphumela engase ibe khona yokwelashwa okusikwelelwe nokuthi bazoyilandelela kanjani intuthuko yakho ngokuhamba kwesikhathi.

Iyini into ebaluleke kakhulu mayelana nepemphigus?

IPemphigus yisimo esinzima kodwa esilawuleka se-autoimmune esidinga ukunakekelwa kwezokwelapha okuqhubekayo nokubekezela njengoba wena neqembu lakho lokukhathalela impilo nithola indlela efanele yokwelashwa. Ngokwelashwa okufanele, abantu abaningi bangafinyelela ekulawuleni okuhle kwezimpawu zabo futhi bagcine ikhwalithi enhle yokuphila.

Ukulawula okuphumelelayo ukuxilongwa kwasekuqaleni, ukwelashwa okuqhubekayo, nokusebenzisana eduze nabaphakeli bezempilo abaqonda lesi simo esiyinkimbinkimbi. Nakuba ipemphigus ingase izwakale iyisongela ekuqaleni, khumbula ukuthi ukwelashwa okuphumelelayo kukhona futhi abantu abaningi baphila impilo egcwele, esebenzayo ngenkathi beqondisa lesi simo.

Hlala uxhumene neqembu lakho lokukhathalela impilo, landela uhlelo lwakho lokwelashwa ngokucophelela, futhi unganqikazi ukuxhumana uma unemibuzo noma ukukhathazeka. Ngesikhathi nokunakekelwa okufanele, ungafunda ukuphatha ipemphigus ngempumelelo futhi ugxile ezintweni ezibaluleke kakhulu kuwe.

Imibuzo evamile ebuzwayo mayelana nepemphigus

Q1: Ingabe ipemphigus iyadluliseka?

Cha, ipemphigus ayidluliseki nhlobo. Awukwazi ukuyithola komunye umuntu noma uyisabalalise kwabanye abantu ngokuxhumana. Yisimo se-autoimmune esikhula uma izingxube zezimbodi zakho zihlukunyezela ngephutha isikhumba sakho, hhayi ukutheleleka okubangelwa ama-bacteria, ama-viruses, noma ezinye izinambuzane.

Q2: Ingabe ipemphigus ingaphuliwa ngokuphelele?

Okwamanje, ayikho indlela yokwelapha ipemphigus, kodwa lesi simo singalawulwa ngempumelelo ngokwelashwa okufanele. Abantu abaningi bafinyelela ekuphumuleni isikhathi eside lapho bengenawo ama-symptoms asebenzayo izinyanga noma iminyaka. Abanye abantu bangase ekugcineni banciphise noma bayeke imithi yabo ngenkathi begcina ukulawula okuhle, nakuba lokhu kudinga ukunakekelwa kwezokwelapha okucophelelekile.

Q3: Ingabe ngizodinga ukuthatha imithi impilo yami yonke?

Akuyona into eqinisekile. Nakuba abanye abantu bedinga imithi yesikhathi eside ukuze baqondisa ipemphigus yabo, abanye bangase kancane kancane banciphise ukwelashwa kwabo ngokuhamba kwesikhathi futhi ekugcineni bayeke imithi ngenkathi behlala bephumule. Izidingo zakho zokwelashwa ngokukhethekile zizoxhomekeka ekuphenduleni komzimba wakho ekwelapheni nokuthi isimo sakho sihlala siqine kangakanani.

Q4: Ingabe ukushintsha ukudla kungasiza ngepemphigus?

Nakuba ayikho indlela ethile yokudla ipemphigus engase iwelaphe lesi simo, ukudla kahle kungasekele impilo yakho jikelele nokuphulukiswa. Uma uneziqala zomlomo, ukugwema ukudla okunamuncu, okunomsoco, noma okukhulu kunganciphisa ubuhlungu. Abanye abantu bathola ukuthi ukudla okuthile kubonakala kuvuselela ukukhula, nakuba lokhu kuhluka kakhulu kusuka kumuntu komunye.

Q5: Ingabe kuphephile ukukhulelwa uma nginepemphigus?

Abesifazane abaningi abanepemphigus bangaba nokukhulelwa okuphumelelayo, kodwa kudinga ukuhlelwa ngokucophelela nokulandelwa kokubili ngudokotela wakho we-dermatologist nodokotela wakho we-obstetrician. Imithi ethile yepemphigus idinga ukulungiswa noma ukushintshwa ngesikhathi sokukhulelwa, futhi isimo sakho singase sishintshe ngesikhathi nangemva kokukhulelwa. Ukubonisana kwasekuqaleni neqembu lakho lokukhathalela impilo kubalulekile ekuhleleni.