I-Calcinosis Cutis

-Delile

• Izinhlobo ze-calcinosis cutis
• Izimpawu ze-calcinosis cutis
• Izimbangela ze-calcinosis cutis
• Ukubalwa kweDystrophic
• Ukubalwa kwe-Metastatic
• Ukubalwa kwe-Idiopathic
• Ukubalwa kwe-Iatrogenic
• I-Calciphylaxis
• Ngokuhlanganiswa ne-scleroderma
• Ukuxilongwa kwe-calcinosis cutis
• Ukwelashwa kwe-calcinosis cutis
• Izidakamizwa
• Ukuhlinzwa
• Ezinye izindlela zokwelapha
• Umbono we-calcinosis cutis

Ukubuka konke

I-calcinosis cutis ukunqwabelana kwamakristalu kasawoti e-calcium esikhunjeni sakho. Ukufakwa kwe-calcium kungamaqhubu aqinile angancibiliki. Ukuma nobukhulu bezilonda kuyahlukahluka.

Lesi yisimo esingajwayelekile esinezimbangela eziningi ezahlukene. Lokhu kusuka ekuthelelekeni nasekulimaleni ezifweni zesistimu njengokuhluleka kwezinso.

Imvamisa i-calcinosis cutis ayinazo izimpawu. Kepha kwezinye izimo, kungaba buhlungu kakhulu. Ukwelashwa kuyatholakala, kufaka phakathi ukuhlinzwa, kepha izilonda ze-calcium zingahle zibuye.

Izinhlobo ze-calcinosis cutis

Kunezinhlayiyana ezinhlanu ze-calcinosis cutis:

• Ukubalwa kweDystrophic. Lolu uhlobo oluvame kakhulu lwe-calcinosis. Kwenzeka lapho isikhumba sonakalisiwe noma savuvukala. Akubandakanyi amazinga angajwayelekile we-calcium noma i-phosphorus emzimbeni.
• Ukubalwa kwe-Metastatic. Lokhu kwenzeka kubantu abanamazinga e-calcium ne-phosphorus aphakeme ngokungajwayelekile.
• Ukubalwa kwe-Idiopathic. Lolu hlobo lwe-calcinosis cutis alunaso isizathu esibonakalayo. Imvamisa kwenzeka endaweni eyodwa yomzimba kuphela.
• Ukubalwa kwe-Iatrogenic. Lolu hlobo lwe-calcinosis cutis luvela enkambisweni yezokwelapha noma ekwelashweni, imvamisa ngengozi. Isibonelo, izingane ezisanda kuzalwa zingaba nokubalwa kwe-iatrogenic esithendeni, okubangelwa yizinti zezithende zokuthatha igazi.
• I-Calciphylaxis. Lolu hlobo olungavamile nolubi lwe-calcinosis cutis luvamise ukwenzeka kubantu abanenkinga yezinso, abathole ukufakelwa izinso, noma abaku-dialysis. Ithinta imithambo yegazi esikhunjeni noma ungqimba lwamafutha. Izinga le-calcium ne-phosphate emzimbeni alijwayelekile.

Izimpawu ze-calcinosis cutis

Ukubukeka nendawo ye-calcinosis cutis kuncike embangela. Izilonda zivame ukuba nzima, zibe ngamaqhuqhuvana amhlophe aphuzi esikhunjeni. Ziqala kancane futhi ziyahlukahluka ngosayizi.

Izilonda kungenzeka zingabi nazimpawu, noma zingaba nzima, zibe buhlungu, noma ziveze into emhlophe. Ezimweni ezingavamile, i-lesion ingasongela impilo.

Nazi izindawo lapho izilonda zivela khona ku-subtypes ngayinye ye-calcinosis cutis:

• Ukubalwa kweDystrophic. Iziqubu zenzeka endaweni yokulimala kwezicubu. Izindawo ezijwayelekile ziyizingalo zangaphambili, izindololwane, iminwe, namadolo. Nge-lupus, izilonda zenzeka ezandleni nasezinyaweni, ezinqeni, nangaphansi kwezilonda ze-lupus.
• Ukubalwa kwe-Metastatic. Ama-bumps atholakala ngokulingana ngokuzungeza amalunga: amadolo, izindololwane, noma amahlombe. Zingahle zakhiwe zizungeze izitho zangaphakathi, njengamaphaphu, izinso, imithambo yegazi, noma isisu. Izilonda ezizungeze amalunga zinganciphisa ukuhamba njengoba isikhumba siqina.
• Ukubalwa kwe-Idiopathic. Lokhu kuvame ukuthinta indawo eyodwa kuphela yomzimba. Kungenzeka ezinhlangothini ezinkulu, i-scrotum, ikhanda, amabele, ipipi, isitho sangasese, noma izandla nezinyawo. Ezinganeni kungaba ebusweni. Izilonda zingase zibe nokukhishwa okumhlophe.
• Ukubalwa kwe-Iatrogenic. Isilonda sivela endaweni yenqubo yezokwelapha noma yokwelapha ehlaba isikhumba.
• I-Calciphylaxis. Izilonda zesikhumba zivame ukuba semilenzeni noma esiqwini, ikakhulukazi ezindaweni ezinamafutha ezifana namabele, izinqe, nesisu. Izilonda zibukeka zinamabala futhi zibuhlungu. Zingaba izilonda ezingapholi, noma zingaba nesilonda esibolile. Izilonda zingahambisana nezinye izimpawu, njengokukhathala nobuthakathaka.

Izimbangela ze-calcinosis cutis

I-calcinosis cutis ayivamile kepha inezimbangela ezahlukahlukene, kuya nge-subtype:

Ukubalwa kweDystrophic

Ngokuvamile, ukulimala kwezicubu kuholela emaprotheni e-phosphate akhishwe amaseli afayo abese ebala, akhe usawoti we-calcium. Ukulimala kwezicubu kungavela ku:

• izifo
• izimila
• induna
• izifo zezicubu ezixhuma njenge-lupus, systemic sclerosis, noma i-dermatomyositis

Ukubalwa kwe-Metastatic

Lapho i-calcium phosphate yomzimba iphakeme ngokungajwayelekile, ikhiqiza usawoti we-calcium akha amaqhuqhuva esikhunjeni. Izimbangela zamazinga angajwayelekile we-calcium ne-phosphate yilezi:

• ukwehluleka kwezinso okungapheli (imbangela evame kakhulu)
• uvithamini D omningi kakhulu
• i-hyperparathyroidism (indlala ekhulisiwe ye-parathyroid ikhiqiza i-hormone yegilo)
• i-sarcoidosis (amaqembu amaseli wokuvuvukala akha amaphaphu, ama-lymph node, isikhumba, nezinye izingxenye zomzimba)
• ubisi lwe-alkali syndrome (i-calcium eningi kakhulu evela ekudleni noma kuma-antacids)
• izifo zamathambo, njengesifo sePaget

Ukubalwa kwe-Idiopathic

Ngokungafani nezinhlobo ezimbili zokuqala ze-calcinosis cutis, ukubalwa kwe-idiopathic kwenzeka kungabikho ukulimala kwezicubu okuyisisekelo futhi kungekho namazinga angajwayelekile we-calcium noma i-phosphorus. Idiopathic isho ukuthi “akukho sizathu esaziwayo.” Kunezinhlobo ezintathu:

• amaqhuqhuva omndeni, avame ukuvela kwintsha enempilo noma ezinganeni ezincane
• ama-subepidermal nodules, avela ngezansi kwesikhumba
• amaqhubu esikhunjeni

Ukubalwa kwe-Iatrogenic

Imbangela yokubalwa kwe-iatrogenic inqubo yezokwelapha eholela ngengozi ekufakeni usawoti we-calcium njengomphumela wecala. Indlela yalokhu ayaziwa. Ezinye zezinqubo ezithintekayo yilezi:

• ukuphathwa kwezixazululo eziqukethe i-calcium ne-phosphate
• ukuxhumana isikhathi eside nokugcwala kwe-calcium chloride electrode ngesikhathi se-electroencephalograph noma i-electromyograph
• i-calcium gluconate efakwa emthanjeni, i-calcium chloride, ne-para-aminosalicylic acid ekwelashweni kofuba
• isithende sinamathela ezinganeni ezisanda kuzalwa

I-Calciphylaxis

Isizathu se-calciphylaxis sihlala singaqinisekile. Kuyinto engavamile kakhulu, yize ezinye zezici ezihambisanayo zivamile:

• ukwehluleka kwezinso okungamahlalakhona
• ukukhuluphala ngokweqile
• isifo sikashukela
• hyperparathyroidism

Ngokuhlanganiswa ne-scleroderma

I-calcinosis cutis ivame ukwenzeka kanye ne-systemic sclerosis (scleroderma). Kutholakala ikakhulukazi esimweni esilinganiselwe salesi sifo, esaziwa njenge-limited cutaneous systemic sclerosis (CREST).

Kulinganiselwa ukuthi labo abane-CREST syndrome bazokwakha i-calcinosis cutis ngemuva kwalokho.

Izilonda zivame ukuvela ezungeze iminwe nezindololwane futhi zingavuleka zivule impahla emhlophe eminyene.

Ukuxilongwa kwe-calcinosis cutis

Ukunquma uhlobo lwe-calcinosis cutis onalo kubalulekile ekunqumeni ukwelashwa okufanele. Udokotela wakho uzokuhlola futhi athathe umlando wakho wezokwelapha futhi akubuze imibuzo mayelana nezimpawu zakho.

Udokotela kungenzeka a-oda izivivinyo eziningi zaselebhu ukuthola imbangela eyisisekelo se-calcinosis cutis yakho:

• ukuhlolwa kwegazi ukubona ukuthi amazinga akho e-calcium ne-phosphate aphakeme ngokungajwayelekile, ukufuna izimpawu zelupus kanye nezimila ezingenzeka, nokunqanda amazinga angajwayelekile we-parathyroid ne-vitamin D
• ukuhlolwa komzimba ukukhipha izinkinga zezinso
• I-X-ray, i-CT scan, noma i-bone scans (scintigraphy) ukubheka ubukhulu besibalo
• i-biopsy yezilonda
• okunye ukuhlolwa okukhethekile ukuhlola i-dermatomyositis (isifo sokuvuvukala) kanye nobisi-alkali syndrome

Ubuchwepheshe obusha obusetshenziswayo ukusiza ukuxilongwa yisibuko esibucayi se-vibrational. Le ndlela yokuxilonga isebenzisa i-Fourier transform infrared (FT-IR) noma i-Raman analysis spectroscopic. Ikhomba ngokushesha ukwakheka kwamakhemikhali kwezilonda ze-calcinosis cutis. Kungabikezela futhi ukuqhubeka kwesifo.

Ukwelashwa kwe-calcinosis cutis

Ukwelashwa kwe-calcinosis cutis kuya ngesifo esiyimbangela noma imbangela.

Izidakamizwa

Izidakamizwa ezahlukahlukene zingazama ukwelapha izilonda, kepha impumelelo yazo ibe ngamabala.

Ngezilonda ezincane, izidakamizwa ezibandakanya:

• warfarin
• umabhebhana
• i-immunoglobulin emithanjeni (IVIG)

Ngezilonda ezinkulu, izidakamizwa ezibandakanya:

• umabhebhana
• ama-bisphosphonates
• kubi
• i-aluminium hydroxide

Ucwaningo lwango-2003 lwabika ukuthi umthamo ophansi wemithi elwa namagciwane i-minocycline wawusebenza ekwehliseni ubuhlungu nobukhulu bezilonda kubantu abane-CREST syndrome. I-topical sodium thiosulfate nayo ingasiza.

Ukuhlinzwa

Uma izilonda zakho zibuhlungu, utheleleke kaningi, noma kuphazamise ukusebenza kwakho, udokotela wakho angancoma ukuhlinzwa. Kodwa izilonda zingabuya emuva kokuhlinzwa. Kunconywa ukuthi ukuhlinzwa kuqale ngengxenye encane yesilonda.

Ezinye izindlela zokwelapha

Ukwelashwa okusha okuhlongozwayo yi-hematopoietic stem cell transplantation (HSCT), ethatha indawo yamaseli womuntu okukhiqiza igazi. Lokhu kusetshenziselwe ukwelapha ezinye izifo ezizimele.

Ukwelashwa kwe-Laser ne-wave wave lithotripsy (i-ultrasound therapy esetshenziselwa ukuqeda amatshe ezinso) nakho kuyindlela yokwelapha.

Umbono we-calcinosis cutis

Umbono we-calcinosis cutis uncike kwisifo noma imbangela yaso, nobukhulu bezilonda zakho. Izindlela zokwelapha zamanje zingasiza, futhi kwenziwa izindlela ezintsha zokwelapha. Khuluma nodokotela wakho ngokuthi ungazikhulula kanjani izimpawu zakho futhi welaphe umsuka wenkinga.