I-psoriatic arthritis

I-Psoriatic arthritis yinkinga ehlangene (i-arthritis) evame ukuvela ngesimo sesikhumba esibizwa nge-psoriasis.

I-Psoriasis yinkinga yesikhumba ejwayelekile edala amabala abomvu esikhunjeni. Isimo esiqhubekayo (esingapheli) sokuvuvukala. I-Psoriatic arthritis ivela kubantu ababalelwa ku-7% kuya ku-42% abane-psoriasis. I-Nail psoriasis ixhunyaniswe ne-psoriatic arthritis.

Ezimweni eziningi, i-psoriasis iza ngaphambi kwesifo samathambo. Kubantu abambalwa, isifo samathambo siza ngaphambi kwesifo sesikhumba. Kodwa-ke, ukuba ne-psoriasis ebanzi, esabalele kubonakala kukhulisa ithuba lokuthola isifo samathambo i-psoriatic.

Isizathu se-psoriatic arthritis asaziwa. Izakhi zofuzo, amasosha omzimba, kanye nezimo zemvelo kungadlala indima. Kungenzeka ukuthi izifo zesikhumba nezihlangene zingaba nezimbangela ezifanayo. Noma kunjalo, kungenzeka zenzeke ndawonye.

Isifo samathambo singaba mnene futhi sihlanganise amalunga ambalwa kuphela. Amalunga ekupheleni kweminwe noma izinzwane angathinteka kakhulu. I-Psoriatic arthritis ivame ukungalingani ibangele isifo samathambo ohlangothini olulodwa lomzimba.

Kwabanye abantu, lesi sifo singaba nzima futhi sithinte amalunga amaningi, kubandakanya nomgogodla. Izimpawu emgogodleni zifaka ukuqina nobuhlungu. Zivame ukwenzeka emgogodleni ophansi nase-sacrum.

Abanye abantu abane-psoriatic arthritis bangaba nokuvuvukala kwamehlo.

Isikhathi esiningi, abantu abane-psoriatic arthritis banezinguquko zesikhumba nezipikili ze-psoriasis. Imvamisa, isikhumba siba sibi ngasikhathi sinye nesifo samathambo.

Ama-tendon angase ahlaselwe yi-psoriatic arthritis. Izibonelo zifaka i-Achilles tendon, i-plantar fascia, ne-tendon sheath esesandleni.

Ngesikhathi sokuhlolwa komzimba, umhlinzeki wezokunakekelwa kwempilo uzobheka:

• Ukuvuvukala okuhlangene
• Amachashazi esikhumba (i-psoriasis) nokungena emigodini yezipikili
• Ubumnene
• Ukuvuvukala emehlweni

Ama-x-ray ahlangene angenziwa.

Azikho izivivinyo zegazi ezithile ze-psoriatic arthritis noma i-psoriasis. Ukuhlolwa kokukhipha ezinye izinhlobo zesifo samathambo kungenziwa:

• Isici se-rheumatoid
• Amasosha omzimba alwa ne-CCP

Umhlinzeki angahlola isakhi sofuzo esibizwa nge-HLA-B27 Abantu abanokubandakanyeka emuva kungenzeka babe ne-HLA-B27.

Umhlinzeki wakho anganikeza izidakamizwa ezingezona ukuvuvukala (i-NSAIDs) ukunciphisa ubuhlungu nokuvuvukala kwamalunga.

I-arthritis engathuthuki ngama-NSAID izodinga ukwelashwa ngemithi ebizwa ngokuthi yimishanguzo yokuguqula izifo (i-DMARDs). Lokhu kufaka phakathi:

• IMethotrexate
• Leflunomide
• I-Sulfasalazine

I-Apremilast ngomunye umuthi osetshenziselwa ukwelashwa kwe-psoriatic arthritis.

Imithi emisha ye-biologic iyasebenza kwi-psoriatic arthritis eqhubekayo engalawulwa ngama-DMARD. Le mithi ivimba iprotheni ebizwa nge-tumor necrosis factor (TNF). Zivame ukuba lusizo kuzo zombili izifo zesikhumba kanye nesifo esihlangene se-psoriatic arthritis. Le mithi inikezwa ngomjovo.

Eminye imishanguzo emisha ye-biologic iyatholakala ukwelapha i-psoriatic arthritis eqhubeka ngisho nokusetshenziswa kwama-DMARD noma ama-anti-TNF agents. Le mithi nayo inikezwa ngomjovo.

Amalunga abuhlungu kakhulu angaphathwa ngemijovo ye-steroid. Lokhu kusetshenziswa uma kuhlanganiswa ilunga elilodwa noma ambalwa kuphela. Ochwepheshe abaningi abancomi ama-corticosteroids omlomo we-psoriatic arthritis. Ukusetshenziswa kwabo kungahle kube kubi kakhulu i-psoriasis futhi kuphazamise umphumela wezinye izidakamizwa.

Ezimweni ezingavamile, ukuhlinzwa kungadingeka ukulungisa noma ukufaka amanye amalunga alimele.

Abantu abanokuvuvukala kweso kufanele babone udokotela wamehlo.

Umhlinzeki wakho angaphakamisa ukuhlanganiswa kokuphumula nokuzivocavoca umzimba. Ukwelashwa ngokomzimba kungasiza ukwandisa ukunyakaza okuhlangene. Ungasebenzisa futhi ukwelashwa kokushisa nokubanda.

Lesi sifo kwesinye isikhathi siba mnene futhi sithinta amalunga ambalwa kuphela. Kodwa-ke, kubantu abaningi abanokulimala kwe-psoriatic arthritis emajoyini kwenzeka eminyakeni embalwa yokuqala. Kwabanye abantu, isifo samathambo esibi kakhulu singadala ukukhubazeka ezandleni, ezinyaweni nasemgogodleni.

Iningi labantu abane-psoriatic arthritis elingathuthuki ngama-NSAID kufanele libone i-rheumatologist, uchwepheshe we-arthritis, kanye nodokotela wesikhumba we-psoriasis.

Ukwelashwa kusenesikhathi kungadambisa izinhlungu futhi kuvimbele ukulimala kwamalunga, noma ezimweni ezimbi kakhulu.

Shayela umhlinzeki wakho uma uba nezimpawu zesifo samathambo kanye ne-psoriasis.

I-arthritis - i-psoriatic; I-Psoriasis - i-psoriatic arthritis; I-Spondyloarthritis - i-psoriatic arthritis; I-PsA

• I-Psoriasis - i-guttate engalweni nasesifubeni
• I-Psoriasis - i-guttate esihlathini

UBruce IN, Ho PYP. Izici zomtholampilo ze-psoriatic arthritis. Ku: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, abahleli. I-Rheumatology. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2019: isahluko 128.

UGladman D, uRigby W, Azevedo VF, et al. I-Tofacitinib yesifo samathambo se-psoriatic ezigulini ezinempendulo enganele kuma-TNF inhibitors. N Engl J Med. 2017; 377:1525-1536.

USmolen JS, uSchöls M, uBraun J, et al. Ukwelapha i-axial spondyloarthritis kanye ne-peripheral spondyloarthritis, ikakhulukazi i-psoriatic arthritis, ukukhomba: Ukuvuselelwa kwezincomo zango-2017 yiqembu lamazwe omhlaba. U-Ann Rheum Dis. 2018; 77 (1): 3-17. I-PMID: 28684559 pubmed.ncbi.nlm.nih.gov/28684559/.

I-Veale DJ, i-Orr C. Ukuphathwa kwe-psoriatic arthritis. Ku: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, abahleli. I-Rheumatology. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2019: isahluko 131.