Vitiligo

I-Vitiligo (vit-ih-LIE-go) yisifo esibangela ukulahleka kombala wesikhumba ngamaqatha. Izindawo ezingabonakali kahle ngokuvamile zikhula ngokuhamba kwesikhathi. Lesi simo singathinta isikhumba kunoma iyiphi ingxenye yomzimba. Singathinta futhi izinwele nangaphakathi komlomo.

Ngokuvamile, umbala wezinwele nesikhumba uqondwa yi-melanin. I-Vitiligo kwenzeka lapho amaseli akhiqiza i-melanin efa noma ayeka ukusebenza. I-Vitiligo ithonya abantu bazo zonke izinhlobo zesikhumba, kodwa ingabonakala kakhulu kubantu abanesikhumba esibomvu noma esimnyama. Lesi simo asiyingozi empilweni noma asidluliseki. Singakucindezela noma kukwenze uzizwe ungekuhle ngawe.

Ukuphathwa kwe-vitiligo kungabuye umbala wesikhumba esithintekile. Kodwa akukuvimbeli ukulahleka okuqhubekayo kombala wesikhumba noma ukubuyela kwakho.

Izimpawu zeVitiligo zihlanganisa:

• Ukulahlekelwa kombala wesikhumba ngamaqatha, okuvamise ukuqala emakhweni, ebusweni, nasezindaweni ezizungezile eziphuma emzimbeni nasezitho zangasese
• Ukumhlophe noma ukungwevu kwesinwele ngaphambi kwesikhathi ekhanda, eziphepheni, ezinzipeni noma ebeyadi
• Ukulahlekelwa kombala ezicutshwini ezifakela ngaphakathi komlomo nengqondo (imicu mucous)

IVitiligo ingaqala kunoma iyiphi iminyaka, kodwa ngokuvamile ivela ngaphambi kweminyaka engama-30.

Kuye ngohlobo lwevitiligo olukhona, kungenzeka ukuthi luthinta:

• Cishe zonke izindawo zesikhumba. Ngale ndlela, ebizwa ngokuthi yi-vitiligo ebanzi, ukuguquka kombala kuthinta cishe zonke izindawo zesikhumba.
• Izingxenye eziningi zomzimba. Ngale ndlela evamile kakhulu, ebizwa ngokuthi yi-vitiligo ejwayelekile, amaqatha anombala oluguqukile ngokuvamile aqhubeka ngendlela efanayo ezingxenyeni zomzimba ezifanayo (ngokulinganayo).
• Ohlangothini olulodwa noma ingxenye yomzimba kuphela. Lolu hlobo, oluthiwa yi-vitiligo ye-segmental, luvamise ukuvela ebuntwaneni, luqhubeke unyaka noma emibili, bese luphela.
• Indawo eyodwa noma ezimbalwa kuphela zomzimba. Lolu hlobo lubizwa ngokuthi yi-vitiligo eqondile (efocal).
• Ubuso nezikhombiso. Ngale ndlela, ebizwa ngokuthi yi-vitiligo ye-acrofacial, isikhumba esithintekayo sisebusweni nasezandleni, nasezindaweni ezizungezile eziphuma emzimbeni, njengeziso, khala nezinye.

Kunzima ukubikezela ukuthi leli gciwane lizoqhubeka kanjani. Ngezinye izikhathi amaqatha ayeka ukwakheka ngaphandle kokwelashwa. Ezimweni eziningi, ukulahleka kombala kuyaqhubeka futhi ekugcineni kuhilela iningi lesikhumba. Ngezinye izikhathi, isikhumba sibuyisela umbala waso.

Bona uhlinzeki wakho wezempilo uma izindawo zesikhumba sakho, izinwele noma imingxuma yomlomo zilahlekelwa umbala. I-Vitiligo ayinayo imithi. Kodwa ukwelashwa kungase kuyeke noma kunciphisa inqubo yokulahlekelwa umbala futhi kubuyisele umbala othile esikhumbeni sakho.

I-vitiligo livela lapho amaseli avelayo umbala (ama-melanocytes) efa khona noma ayeka ukukhiqiza i-melanin — umbala owenza isikhumba sakho, izinwele neziso zibe nombala. Izicucu zesikhumba ezihilelekile ziyaba lukhanya noma zimhlophe. Akucaci ukuthi yini ngempela ebangela ukuba la maseli ombala ehluleke noma afe. Kungase kuhlobene nokuthi:

• Ukuhlupheka kwesistimu yokukhusela umzimba (simo sokuzimela komzimba)
• Umlando womndeni (ilifa)
• Izehlakalo ezibangela, njengokucindezeleka, ukushisa okukhulu kwelanga noma ukulimala kwesikhumba, njengokuqhakambisana nekemikhali

Noma yini ongathuthukisa i-vitiligo. Kodwa ungase ube nethuba elikhulu lokuba uthuthukise uma:

• Unomlando womndeni wesimo.
• Uhlale uxhumana ngqo nezinto ezikhiqizwe yi-phenol, njengezo ezitholakala kwezinye izinto zokuhlanza.

Abantu abane-vitiligo bangase babe sengozini enkulu yokuba ne:

• Usizi lwentlalo noma lwengqondo
• Ukushisa kwelanga
• Izinkinga zamehlo
• Ukulahlekelwa ukuzwa

Umhlinzeki wakho wezempilo uzokubuza ngomlando wakho wezokwelapha bese ahlola isikhumba sakho, mhlawumbe ngelampesi ekhethekile. Ukuhlolwa kungafaka nokukhipha isibambo sesikhumba kanye nokuhlolwa kwegazi.

Ukukhethwa kokwelashwa kuncike ebudaleni bakho, izinga lokukhuluphala kwesikhumba, ukuthi kusekuphi, ukuthi isifo siqhubeka kangcono kangakanani, nokuthi sikuthinta kanjani impilo yakho.

Imithi kanye nezinye izindlela zokwelapha ezisebenzisa ukukhanya ziyatholakala ukusiza ekuvuseleleni umbala wesikhumba noma ukulinganisa umbala wesikhumba, nakuba imiphumela ihlukahlukene futhi ayiqikelelwe. Futhi ezinye izindlela zokwelapha zinezicubu ezingathi sína. Ngakho-ke umhlinzeki wakho wezempilo angase aphakamise ukuthi uqale uzame ukushintsha ukubonakala kwesikhumba sakho ngokusebenzisa umkhiqizo wokuzikhipha noma i-makeup.

Uma wena nomhlinzeki wakho wezempilo unquma ukwelapha isimo sakho ngemithi, ukuhlinzwa noma ukwelashwa, inqubo ingathatha izinyanga eziningi ukwahlulela ukuphumelela kwayo. Futhi ungase ube nesidingo sokuzama izindlela ezingaphezu kwesinye noma ukuhlanganiswa kwezindlela ngaphambi kokuthola ukwelashwa okusebenza kangcono kuwe.

Ngisho noma ukwelashwa kuphumelela isikhathi esithile, imiphumela ingase ingapheli noma amaqembu amasha angase avele. Umhlinzeki wakho wezempilo angase aphakamise imithi esetshenziswa esikhumbeni njengokwelashwa kokugcina ukusiza ukuvimbela ukubuyela emuva.

Ayikho imithi engayekisa inqubo yevitiligo - ukulahleka kwamaseli omkhiqizo (ama-melanocytes). Kepha ezinye izidakamizwa, ezisetshenziswa zodwa, ngokuhlanganyela noma ngokwelashwa kokukhanya, zingasiza ekuvuseleleni umbala othile.

Imithi elawula ukuvuvukala. Ukusebenzisa ikhilimu ye-corticosteroid esikhumbeni esithintekile kungase kubuyisele umbala. Lokhu kupumelela kakhulu uma i-vitiligo isesigabeni sayo sokuqala. Lolu hlobo lwekhilimu lupumelela futhi kulula ukulisebenzisa, kepha ungase ungaboni izinguquko kumbala wesikhumba sakho izinyanga eziningi. Imiphumela emibi engenzeka ihlanganisa ukuncipha kwesikhumba noma ukubonakala kwama-streaks noma imigqa esikhumbeni sakho.

Izinhlobo ezithambile zemithi zingase ziqokwe kubantwana nakwabantu abanamazinga amakhulu esikhumba esingabonakali kahle.

Amapilisi noma ukugonywa kwe-corticosteroid kungase kube yindlela yokwelapha abantu isimo sabo siqhubeka ngokushesha.

Ukwelashwa kokukhanya. I-phototherapy ene-ultraviolet B (UVB) ebanzi ecinyiwe iboniswe ukuthi imisa noma iyancipha ukuqhubeka kwe-vitiligo esebenzayo. Kungase kube nemiphumela emihle uma kusetshenziswa ne-corticosteroids noma ama-calcineurin inhibitors. Uzodinga ukwelashwa izikhathi ezimbili kuya kwezintathu ngesonto. Kungathatha izinyanga eziyi-1 kuya kwezi-3 ngaphambi kokuthi uqaphele noma yiluphi ushintsho, futhi kungathatha izinyanga eziyi-6 noma ngaphezulu ukuthola umphumela ophelele.

Ngenxa yesixwayiso se-Food and Drug Administration (FDA) mayelana nobungozi obungase bube khona bomdlavuza wesikhumba ngokusetshenziswa kwama-calcineurin inhibitors, khuluma nomhlinzeki wakho wezempilo ngengozi kanye nezinzuzo zokusebenzisa le miithi nge-phototherapy.

Kwabantu abangakwazi ukuya ekliniki yokwelashwa, amadivayisi amancane aphathekayo noma aphathekayo we-ultraviolet B ebanzi ecinyiwe ayatholakala ukusetshenziswa ekhaya. Khuluma nomhlinzeki wakho wezempilo ngale ndlela uma kudingeka.

Imiphumela emibi engenzeka ye-ultraviolet B ebanzi ecinyiwe ihlanganisa ubovu, ukukhahlela nokushisa. Le miphumela emibi ivame ukuhlanzwa ngaphakathi kwamahora ambalwa ngemuva kokwelashwa.

Ukususa umbala osale khona (ukunciphisa umbala). Lokhu ukwelashwa kungase kube yindlela yokwelapha uma i-vitiligo yakho iyasabalala futhi ezinye izindlela zokwelapha azisebenzi. Isinyathelo sokuncipha umbala sisetshenziswa ezindaweni zesikhumba ezingathintekile. Lokhu kancane kancane kuqandisa isikhumba ukuze sihlangane nezindawo ezingabonakali kahle. Ukwelashwa kwenziwa kanye noma kabili ngosuku izinyanga eziyisishiyagalolunye noma ngaphezulu.

Imiphumela emibi ingase ihlanganise ubovu, ukukhula, ukukhahlela nesikhumba esomile kakhulu. Ukunciphisa umbala kuhlala njalo.

Uma ukwelashwa kokukhanya kanye nemithi ayisebenzi, abanye abantu abanesifo esiqinile bangase babe yiziguli zokuhlinzwa. Lezi zindlela zilandelayo zihloselwe ukulinganisa umbala wesikhumba ngokubuyisela umbala:

Ukuhlinzwa kwesikhumba. Kule nqubo, udokotela wakho uthuthukisa izingxenye ezincane kakhulu zesikhumba sakho esinempilo, esinombala ezindaweni ezilahlekile umbala. Le nqubo ngezinye izikhathi isebenza uma uneziqephu ezincane ze-vitiligo.

Izingozi ezingase zenzeke zihlanganisa ukutheleleka, ukwenzakala, ukubonakala kwe-cobblestone, umbala ongaphansi kanye nokungaphumeleli kwendawo yokubuyisela umbala.

Ukuhlinzwa kwe-blister. Kule nqubo, udokotela wakho udala ama-blisters esikhumbeni sakho esinombala, ngokuvamile ngokusebenzisa ukucisha, bese uthuthukisa izindawo eziphezulu zama-blisters esikhumbeni esingabonakali kahle.

Izingozi ezingase zenzeke zihlanganisa ukwenzakala, ukubonakala kwe-cobblestone kanye nokungaphumeleli kwendawo yokubuyisela umbala. Futhi ukonakala kwesikhumba okubangelwa ukucisha kungase kubangele enye i-patch ye-vitiligo.

Ukuthuthukiswa kwe-cellular suspension. Kule nqubo, udokotela wakho uthatha ingxenye yethishu esikhumbeni sakho esinombala, ufake amaseli esixubeni bese uwathuthukisa endaweni ethintekile elungiselelwe. Imiphumela yale nqubo yokubuyisela umbala iqala ukubonakala ngaphakathi kwamasonto amane.

Izingozi ezingase zenzeke zihlanganisa ukwenzakala, ukutheleleka kanye nombala wesikhumba olungenani.

Izindlela zokwelapha ezifundwayo zihlanganisa:

• Imithi elawula ukuvuvukala. Ukusebenzisa ikhilimu ye-corticosteroid esikhumbeni esithintekile kungase kubuyisele umbala. Lokhu kupumelela kakhulu uma i-vitiligo isesigabeni sayo sokuqala. Lolu hlobo lwekhilimu lupumelela futhi kulula ukulisebenzisa, kepha ungase ungaboni izinguquko kumbala wesikhumba sakho izinyanga eziningi. Imiphumela emibi engenzeka ihlanganisa ukuncipha kwesikhumba noma ukubonakala kwama-streaks noma imigqa esikhumbeni sakho.

  Izinhlobo ezithambile zemithi zingase ziqokwe kubantwana nakwabantu abanamazinga amakhulu esikhumba esingabonakali kahle.

  Amapilisi noma ukugonywa kwe-corticosteroid kungase kube yindlela yokwelapha abantu isimo sabo siqhubeka ngokushesha.

• Imithi ethonya isimiso somzimba sokuvikela. Ama-ointments e-calcineurin inhibitor, njenge-tacrolimus (Protopic) noma i-pimecrolimus (Elidel) angase abe nemiphumela emihle kwabantu abanamazinga amancane okuqandisa umbala, ikakhulukazi ebusweni nasekhoneni. I-U.S. Food and Drug Administration (FDA) ixwayise ngokuxhumana okungenzeka phakathi kwale miithi ne-lymphoma nomdlavuza wesikhumba.

• Ukwelashwa kokukhanya. I-phototherapy ene-ultraviolet B (UVB) ebanzi ecinyiwe iboniswe ukuthi imisa noma iyancipha ukuqhubeka kwe-vitiligo esebenzayo. Kungase kube nemiphumela emihle uma kusetshenziswa ne-corticosteroids noma ama-calcineurin inhibitors. Uzodinga ukwelashwa izikhathi ezimbili kuya kwezintathu ngesonto. Kungathatha izinyanga eziyi-1 kuya kwezi-3 ngaphambi kokuthi uqaphele noma yiluphi ushintsho, futhi kungathatha izinyanga eziyi-6 noma ngaphezulu ukuthola umphumela ophelele.

  Ngenxa yesixwayiso se-Food and Drug Administration (FDA) mayelana nobungozi obungase bube khona bomdlavuza wesikhumba ngokusetshenziswa kwama-calcineurin inhibitors, khuluma nomhlinzeki wakho wezempilo ngengozi kanye nezinzuzo zokusebenzisa le miithi nge-phototherapy.

  Kwabantu abangakwazi ukuya ekliniki yokwelashwa, amadivayisi amancane aphathekayo noma aphathekayo we-ultraviolet B ebanzi ecinyiwe ayatholakala ukusetshenziswa ekhaya. Khuluma nomhlinzeki wakho wezempilo ngale ndlela uma kudingeka.

  Imiphumela emibi engenzeka ye-ultraviolet B ebanzi ecinyiwe ihlanganisa ubovu, ukukhahlela nokushisa. Le miphumela emibi ivame ukuhlanzwa ngaphakathi kwamahora ambalwa ngemuva kokwelashwa.

• Ukuhlanganisa i-psoralen kanye nokwelashwa kokukhanya. Lokhu ukwelashwa kuhlanganisa isisindo esitholakala ezitshalweni esibizwa nge-psoralen ngokwelashwa kokukhanya (i-photochemotherapy) ukubuyisela umbala ezindaweni ezilula. Ngemva kokuthatha i-psoralen ngomlomo noma ukuyisebenzisa esikhumbeni esithintekile, uvezwa ekukhanyeni kwe-ultraviolet A (UVA). Le ndlela, nakuba iphumelela, kunzima ukuyiphatha futhi iye yasetshenziswa ezindleleni eziningi yi-ultraviolet B (UVB) ebanzi ecinyiwe.

• Ukususa umbala osale khona (ukunciphisa umbala). Lokhu ukwelashwa kungase kube yindlela yokwelapha uma i-vitiligo yakho iyasabalala futhi ezinye izindlela zokwelapha azisebenzi. Isinyathelo sokuncipha umbala sisetshenziswa ezindaweni zesikhumba ezingathintekile. Lokhu kancane kancane kuqandisa isikhumba ukuze sihlangane nezindawo ezingabonakali kahle. Ukwelashwa kwenziwa kanye noma kabili ngosuku izinyanga eziyisishiyagalolunye noma ngaphezulu.

  Imiphumela emibi ingase ihlanganise ubovu, ukukhula, ukukhahlela nesikhumba esomile kakhulu. Ukunciphisa umbala kuhlala njalo.

• Ukuhlinzwa kwesikhumba. Kule nqubo, udokotela wakho uthuthukisa izingxenye ezincane kakhulu zesikhumba sakho esinempilo, esinombala ezindaweni ezilahlekile umbala. Le nqubo ngezinye izikhathi isebenza uma uneziqephu ezincane ze-vitiligo.

  Izingozi ezingase zenzeke zihlanganisa ukutheleleka, ukwenzakala, ukubonakala kwe-cobblestone, umbala ongaphansi kanye nokungaphumeleli kwendawo yokubuyisela umbala.

• Ukuhlinzwa kwe-blister. Kule nqubo, udokotela wakho udala ama-blisters esikhumbeni sakho esinombala, ngokuvamile ngokusebenzisa ukucisha, bese uthuthukisa izindawo eziphezulu zama-blisters esikhumbeni esingabonakali kahle.

  Izingozi ezingase zenzeke zihlanganisa ukwenzakala, ukubonakala kwe-cobblestone kanye nokungaphumeleli kwendawo yokubuyisela umbala. Futhi ukonakala kwesikhumba okubangelwa ukucisha kungase kubangele enye i-patch ye-vitiligo.

• Ukuthuthukiswa kwe-cellular suspension. Kule nqubo, udokotela wakho uthatha ingxenye yethishu esikhumbeni sakho esinombala, ufake amaseli esixubeni bese uwathuthukisa endaweni ethintekile elungiselelwe. Imiphumela yale nqubo yokubuyisela umbala iqala ukubonakala ngaphakathi kwamasonto amane.

  Izingozi ezingase zenzeke zihlanganisa ukwenzakala, ukutheleleka kanye nombala wesikhumba olungenani.

• Imithi yokukhuthaza amaseli avelisa umbala (ama-melanocytes). Ebizwa nge-afamelanotide, lokhu ukwelashwa okungenzeka kufakwa phansi kwesikhumba ukuze kukhuthazwe ukukhula kwama-melanocytes.

• Imithi esiza ukulawula ama-melanoctyes. I-Prostaglandin E2 iyahlolwa njengendlela yokubuyisela umbala wesikhumba kwabantu abane-vitiligo engasabalali noma engasabalali. Isetshenziswa esikhumbeni njengejeli.