Izinketho Zokwelapha zeHidradenitis Suppurativa

-Delile

• Ukwelashwa kwezihloko
• Okuqhamuka uma udla imishanguzo
• Imithi elwa namagciwane
• Ama-antibiotics aphezulu
• Okuqhamuka uma udla imishanguzo
• Ama-antibiotic omlomo
• Okuqhamuka uma udla imishanguzo
• Imithi yezinhlungu
• Okuqhamuka uma udla imishanguzo
• Ama-Corticosteroids
• Okuqhamuka uma udla imishanguzo
• Ukwelashwa kweHormone
• Okuqhamuka uma udla imishanguzo
• Ama-retinoids
• Okuqhamuka uma udla imishanguzo
• I-Biologics
• Okuqhamuka uma udla imishanguzo
• Ukukhanya, ama-lasers, neminye imithombo yamandla
• Okuqhamuka uma udla imishanguzo
• Izindlela zokuhlinza
• Okuqhamuka uma udla imishanguzo
• Ukunakekelwa kwesilonda
• Ukwelashwa kwemvelo
• Ukuthatha

I-Hidradenitis suppurativa (HS) yisifo esingapheli sokuvuvukala kwesikhumba esithinta abantu baseMelika. Abantu abane-HS bahlangabezana nokuqubuka kwezilonda ezingamaqhuqhuva noma zamathumba ezindaweni zomzimba wabo lapho isikhumba sithinta khona isikhumba.

Izindawo ezithintekile zingabandakanya:

• amakhwapha
• izinqa
• amabele
• ukububula
• amathanga aphezulu

Izilonda ezibuhlungu ze-HS nazo zingagcwalisa uketshezi olunephunga elibi olungaphuma ngaphandle kwesixwayiso.

Okwamanje alikho ikhambi le-HS. Kodwa-ke, kunezinhlobonhlobo zezinketho zokwelashwa nezokuhlinzeka ukukusiza ukuphatha izimpawu zakho, ngokuya ngemikhombandlela yakamuva yomtholampilo evela e-United States naseCanada Hidradenitis Suppurativa Foundations.

Uma uhlala ne-HS, kuyasiza ukwazi zonke izindlela zokwelashwa ezitholakalayo ukuze uthole okungcono kakhulu kuwe.

Funda ukuze ufunde ngezinhlobo ezahlukahlukene zokwelashwa kwe-HS nokuthi zisebenza kanjani.

Ukwelashwa kwezihloko

Ukwelashwa ngezihloko yinto oyisebenzisa ngqo esikhunjeni sakho. Ukwelashwa ngezihloko kungafika ngezindlela ezahlukahlukene, kufaka phakathi ama-lotion, amafutha okugcoba, nama-okhilimu.

Ngokuya ngomkhiqizo, ukwelashwa ngezihloko ezingasebenza kungasebenza ukuhlanza indawo ethintekile, ukunciphisa ukucasuka, noma ukusiza ekwelapheni izilonda. Ukwelashwa ngezihloko kwe-HS ngokuvamile kuyimikhiqizo efana nama-antiseptic agents noma izindlela zokwelapha izinduna. Ezinye izibonelo yilezi:

• i-chlorhexidine
• zinc pyrithione
• ukhilimu we-resorcinol, 15%

Izindlela zokwelapha ezingenhla zingasetshenziselwa i-HS emnene ukuya kokuphakathi. Yize bengayiphathi ngenkuthalo imbangela yalesi simo, bangasiza ekunciphiseni ezinye zezimpawu zayo.

Ama-antibiotic angasetshenziswa futhi ngezihloko ekwelapheni i-HS. I-topical clindamycin (Cleocin T, Clinda-Derm) ithathwa njengeyiyona.

Okuqhamuka uma udla imishanguzo

Ukwelashwa kwezihloko kungadala ukucasuka kwesikhumba. Lokhu kungafaka izimpawu ezinjengokubomvu, ukulunywa, noma umuzwa ovuthayo.

Imithi elwa namagciwane

Imithi elwa namagciwane ngezihloko nangomlomo ingasetshenziswa ukwelapha i-HS.

Ama-antibiotics aphezulu

Ama-antibiotic aphezulu, njenge-clindamycin (Cleocin T, Clinda-Derm), ajwayele ukunikezwa i-HS emnene. Bangakwazi ukwelapha izifo, banciphise ukuvuvukala, futhi bavimbele izilonda ezintsha ekubunjweni.

Zinganciphisa nephunga elingahamba nesifo kwesinye isikhathi.

Inkambo ejwayelekile yokwelashwa ngama-antibiotic e-topical ingafaka ukufaka i-lotion kuzilonda zakho ze-HS kabili ngosuku. Isikhathi sokwelashwa okunjalo siyehluka kuye ngomuntu.

Okuqhamuka uma udla imishanguzo

Imiphumela engemihle yama-topical antibiotics ingafaka ukuzwa okushisayo okuncane nobungozi bokumelana nama-antibiotic.

Ama-antibiotic omlomo

Ama-antibiotic omlomo angabelwa izifo ezincane. Kodwa-ke, zivamise ukusetshenziswa emacaleni ama-HS amaphakathi kuya kwanzima noma lapho ukwelashwa ngezihloko ezingaphumelelanga kungasebenzi khona.

Njengama-antibiotics, le mithi isiza ekwelapheni ukutheleleka futhi iphathe ukuvuvukala.

Ama-antibiotic omlomo asetshenziselwa ukwelapha izifo ezibangelwa i-HS afaka:

• ama-antibiotic e-tetracycline
• clindamycin
• i-metronidazole (Flagyl)
• moxifloxacin (Avelox)
• i-rifampin (Rimactane)
• dapsone

Zivame ukuthathwa ngomlomo izinsuku ezi-7 kuya kwezingu-10. Amanye amacala angadinga izinkathi ezinde zokwelashwa. Ngokuya ngobukhulu besimo sakho, ungathola i-antibiotic eyodwa noma ama-antibiotic amaningi.

Okuqhamuka uma udla imishanguzo

Imiphumela emibi yama-antibiotic omlomo ingabandakanya isifo sohudo, IClostridium difficile ukutheleleka kwamagciwane, nokugqwala okuphuzi kuya kokusundu kombala onsundu.

Imithi yezinhlungu

Ubuhlungu obuhlobene ne-HS bungaqhamuka emithonjeni ehlukahlukene, kufaka phakathi izilonda, amathumba kanye nesibazi. Lokhu kwenza ukuphathwa kobuhlungu kube yinto ebalulekile yokwelashwa kwe-HS.

Ubuhlungu obuhambisana ne-HS bungahluka ngokwemvelo. Isibonelo, kungaba okunamandla noma okungapheli kanye nokuvuvukala noma okungafisi.

Imithi yobuhlungu engasetshenziswa ifaka:

• i-lidocaine (iZtlido)
• izidakamizwa ezingezona ukuvuvukala (ama-NSAID)
• i-acetaminophen (iTylenol)
• ama-opioid
• ama-anticonvulsants

Imithi yokwelapha yezinhlayiya njenge-lidocaine kwesinye isikhathi ingasetshenziswa ukwelapha ubuhlungu obunzima be-HS. Lezi zingasetshenziswa ngqo endaweni ethintekile.

Imithi yobuhlungu bomlomo ivame ukuncanyelwa ukuphatha izinhlungu ezihambisana ne-HS. Imithi yezinhlungu zomugqa wokuqala ifaka i-acetaminophen nama-NSAID, njenge-ibuprofen (Advil, Aleve) ne-naproxen (Naprosyn).

Uma imithi yezinhlungu zomugqa wokuqala ingasebenzi, inkambo yesikhathi esifushane yama-opioid ingahle inqunywe. I-opioid tramadol (i-ConZip, i-Ultram) ingasetshenziswa njengenye indlela yama-opioid wendabuko njenge-codeine ne-morphine.

Ukwengeza, amanye ama-anticonvulsants, afana ne-gabapentin (Neurontin) ne-pregabalin (i-Lyrica), angasebenza ekuqedeni ubuhlungu be-neuropathic.

Okuqhamuka uma udla imishanguzo

Imiphumela emibi ehlukahlukene ihlotshaniswa nemithi ehlukahlukene yezinhlungu. Izibonelo zingabandakanya ukucasuka kwesisu, isicanucanu nokuhlanza, nokuqunjelwa. Ukusetshenziswa kwama-opioid nakho kunengozi yokulutha.

Ama-Corticosteroids

I-Corticosteroids nayo ingasetshenziselwa ukunciphisa ukuvuvukala, ukunciphisa ukuvuvukala, nokuphatha ubuhlungu. Zinganikezwa ngomjovo noma ngomlomo.

Ama-corticosteroids afakiwe, abizwa nangokuthi i-corticosteroids yangaphakathi, angasetshenziswa ezimweni ezimnene. Umjovo wenziwa ngqo endaweni ethintekile futhi ungasiza ekudambiseni ubuhlungu nokuvuvukala.

Ama-corticosteroids omlomo asetshenziselwa amacala alinganiselayo kuya kakhulu. Uma ithathwa ngomlomo, ama-corticosteroids angathinta umzimba wonke. Lokhu kungasiza ekususeni izilonda ze-HS ezikhona futhi kuvimbele ezintsha ekwakhekeni.

Isifundo sesikhashana esifushane se-corticosteroids yomlomo singasetshenziswa ukuphatha ukuqhuma kwezimpawu.

Ama-corticosteroids omlomo wesikhathi eside nawo angasetshenziswa ezimweni ezinzima ze-HS ezingaphenduli ekwelashweni okujwayelekile. Kodwa-ke, kulezi zimo, kuzodingeka ukuthi kubekwe isilinganiso esiphansi kunazo zonke.

Okuqhamuka uma udla imishanguzo

Ama-corticosteroids afakiwe angaholela ebuhlungwini eduze kwendawo yokujova, ukuqhuma ebusweni, nokuqwasha.

Eminye imiphumela emibi engaba khona ye-corticosteroids yomlomo ingumfutho wegazi ophakeme, ukuzuza kwesisindo nokushintsha kwemizwelo. Ukusetshenziswa kwesikhathi eside kungaholela ekunciphiseni isikhumba, ushukela ophakeme wegazi kanye ne-osteoporosis.

Ukwelashwa kweHormone

I-HS kucatshangwa ukuthi ithonywe ama-hormone abizwa ngama-androgens. Izinguquko zehomoni, njengesikhathi sokuya esikhathini nokukhulelwa, zingazenza zibe zimbi izimpawu ze-HS.

Ngenxa yomphumela wamahomoni ku-HS, udokotela wakho angancoma ukwelashwa ngamahomoni njengendlela yokwelashwa engaba khona. Ukwelashwa kweHormone kungasiza ekwehliseni ubuhlungu futhi kunciphise inani lokukhipha uketshezi oluvela ezilondeni ze-HS ngesikhathi sokuqhuma.

Ukwelashwa kweHormone ye-HS kungabandakanya ukuthatha lezi zinhlobo zemithi ezilandelayo:

• izinto zokuvimbela inzalo zomlomo eziqukethe i-estrogen
• i-spironolactone (Aldactone)
• i-finasteride (iPropecia, iProscar)
• i-metformin (Glumetza)

Ukwelashwa kweHormone ye-HS kungaphuzwa ngomlomo. Ingasetshenziswa njengokwelapha kuphela (i-monotherapy) ye-HS emnene ukuya kokuphakathi. Ezimweni ezinzima, ingasetshenziswa ngokuhlanganiswa nezinye izindlela zokwelapha.

Ukusetshenziswa kwezindlela zokuvimbela inzalo zomlomo eziqukethe kuphela i-progestin kuvame ukugwenywa. Lokhu kungenxa yokuthi kunobunye ubufakazi bendatshana bokuthi i-HS ingase ibe yimbi kakhulu uma isebenzisa lolu hlobo lomuthi.

Okuqhamuka uma udla imishanguzo

Imiphumela emibi yokwelashwa kwehomoni kwabesifazane ingafaka amahlule egazi uma ethathwe ngesikhathi sokukhulelwa. Abesilisa bangathola ukwehla kwe-libido nezinkinga zokukhipha umjovo.

Ezimweni ezingavamile, abesilisa nabesifazane bangathuthukisa izicubu zesifuba njengomphumela wecala.

Ama-retinoids

Ama-Retinoids yimithi etholakala ku-vitamin A. Asebenza ngokunciphisa ukukhula kwamaseli esikhumba futhi anganciphisa ukuvuvukala. Ama-Retinoids angasetshenziselwa ukwelapha izimo zesikhumba ezinhlobonhlobo, kufaka phakathi induna ne-psoriasis.

Ama-retinoids omlomo angasiza abanye abantu abane-HS. Uma ngabe unqunywe i-retinoid yomlomo ye-HS yakho, kungenzeka kube enye yalezi:

• isotretinoin (Amnesteem, Claravis)
• i-acitretin (Soriatane)

Ama-retinoids omlomo ngokuvamile anconywa kuphela njengokwelashwa kolayini wesibili noma wesithathu kwe-HS. Zingabuye zinqunywe uma kwenzeka izinduna ezinzima kanye nezilonda ze-HS.

Okuqhamuka uma udla imishanguzo

Ama-retinoids omlomo akufanele athathwe ngesikhathi sokukhulelwa, ngoba angaholela ekukhubazekeni okukhulu kokuzalwa. Eminye imiphumela emibi engaba khona ibandakanya isikhumba esomile, izindebe eziqhekekile, kanye nokulahleka kwezinwele okwesikhashana.

I-Biologics

Ezimweni ezinzima kakhulu ze-HS ezingaphenduli kuma-antibiotic noma ekwelapheni ama-hormone, izidakamizwa ze-biologic zingaba inketho. I-Biologics isiza umzimba wakho ukuba ulwe ne-HS ngokukhomba ezingxenyeni zesistimu yakho yomzimba ezikhuthaza ukuvuvukala.

I-Biologics ilawulwa ngomjovo noma ngomjovo we-intravenous (IV). Zivame ukuthathwa njalo ngesonto futhi zingaphathwa ekhaya noma esibhedlela noma emtholampilo ngudokotela wezokwelapha.

Ukwelashwa okuwukuphela kwe-HS okuvunyelwe yi-Food and Drug Administration (FDA), futhi okunobufakazi obuqine kakhulu bokusetshenziswa, yi-adalimumab (Humira). Le biologic ivunyelwe ukwelapha i-HS elinganiselayo kuya kwelinzima.

Ezinye i-biologics, njenge-infliximab (Remicade) ne-anakinra (Kineret), nazo zingasebenza ekwelapheni i-HS.

Okuqhamuka uma udla imishanguzo

Imiphumela emibi ingafaka:

• ubuhlungu obuseduze nendawo yomjovo
• imfiva
• ukuphefumula kanzima
• umfutho wegazi ophansi
• ingozi eyengeziwe yokutheleleka

Uma uthola izifo, udokotela wakho cishe uzoyeka ukusebenzisa i-biologics futhi ahlole ezinye izindlela zokwelashwa.

Imiphumela emibi ejwayelekile kodwa emibi ingafaka izimpawu zomzimba ezisebenza ngokuzimela nokuhluleka kwenhliziyo. I-Biologics nayo ingadala ingozi eyengeziwe ye-lymphoma. Khuluma nodokotela wakho ngezinzuzo nezingozi zalokhu kwelashwa.

Ukukhanya, ama-lasers, neminye imithombo yamandla

Imithombo yamandla eminingana ingacatshangelwa ukuthi isize ukwelapha i-HS. Lezi zivame ukusetshenziselwa i-HS elinganiselayo kuya kwezinzima kepha zingasetshenziselwa amacala amancane.

Enye yalezi zindlela ifaka phakathi ukusebenzisa i-laser ukwelapha izilonda ezisebenzayo. Amandla avela ku-laser angabhubhisa izinwele zezinwele, okusiza ukusula izilonda ze-HS. Lolu hlobo lwezokwelapha lungahle lubandakanye izikhathi ezintathu noma ezine zokwelashwa kwelaser.

I-Photodynamic therapy isebenzisa izidakamizwa ezibizwa nge-photosensitizers kanye nomthombo okhanyayo ukubulala amaseli angajwayelekile. Izidakamizwa ze-photosensitizing zisetshenziswa phezulu noma zijojowe ezilondeni. Amaseli we-HS abe esemunca lo muthi. Lapho umthombo wokukhanya uvuliwe, umuthi uphendula namaseli futhi uwabulale.

Ukwelashwa ngemisebe nakho kusetshenziselwe ukwelapha i-HS futhi kungaholela ekwenzeni ngcono kwabanye abantu. Kodwa-ke, njengoba kuhilela ukuveza umzimba wakho emisebeni, cishe udokotela wakho angancoma ezinye izindlela zokwelashwa kuqala.

Okuqhamuka uma udla imishanguzo

Kungenzeka ukuthi uzizwe ungakhululekile phakathi kwalezi zinqubo. Eminye imiphumela emibi ongaba nayo ngemuva kwalokho ingafaka ukungakhululeki kwesikhashana, ukubomvu, noma ukuvuvukala endaweni ephethwe.

Izindlela zokuhlinza

Kunezinhlobonhlobo zezinketho zokuhlinza ezitholakalayo zokwelashwa kwe-HS, kusuka ekuziqhekeni okuncane kuze kube ukususwa ngokuphelele kwesikhumba esithinteke izilonda.

Ukuthi ufanelekile yini ukuhlinzekwa nge-HS kuya ngobukhulu be-HS yakho nokuthi uphendula kahle kanjani kwezinye izindlela zokwelashwa.

Abantu abane-HS enamandla engaphendulanga kwezinye izinhlobo zokwelashwa bangabafanelekile ukuhlinzwa. Izimpawu ze-HS ezinzima zingabandakanya:

• izilonda noma amathumba asakazekile
• izibazi
• imigudu eminingi yokuxhuma ngaphansi kwesikhumba

Amanye amasu wokuhlinza angasetshenziswa afaka:

• Ukuchithwa: Udokotela ohlinzayo ususa izicubu ezingaphezulu kwemigudu noma amathumba, avumele indawo evelele ukuthi yelapheke. Le ndlela ijwayele ukusetshenziselwa izilonda eziphindaphindayo noma imigudu.
• Ukuzikhandla: Udokotela ohlinzayo ususa isilonda kanye nesinye isikhumba esinempilo esizungezile. Lokhu kungafezwa ngethuluzi le-scalpel, laser, noma le-electrosurgical. Isetshenziselwa izilonda ezibanzi, eziphindaphindayo.
• Ukuzikhandla nokudonsa: Udokotela ukhipha isilonda esisodwa noma ezimbili bese ezisusa. Lokhu kunconywa kuphela ukuhlinzeka ukukhululeka kwesikhashana kwezilonda ezingenathumba.

Uma ucabanga ukuthi ungaba ngumuntu olungele ukuhlinzwa, khuluma nodokotela wakho mayelana nokuthi iyiphi inketho engakulungela.

Okuqhamuka uma udla imishanguzo

Eminye yemiphumela emibi engaba khona yokuhlinzwa kwe-HS ifaka isibazi noma ukutheleleka endaweni yokuhlinzwa. Ngokwengeziwe, ukuhlinzwa kuphatha kuphela indawo ethile, ngakho-ke izilonda zingavela ezindaweni ezintsha.

Ukunakekelwa kwesilonda

Ukunakekelwa kwesilonda ngemuva kokuhlinzwa kwe-HS nakho kubaluleke kakhulu. Udokotela wakho uzokhetha ukugqoka okufanele ngokuya ngendawo kanye nobukhulu bokuhlinzwa. Bangancoma futhi ukusebenzisa ukugeza okubulala amagciwane ngesikhathi sokuphulukiswa.

Lapho unakekela isilonda ngemuva kokuhlinzwa kwe-HS, kubalulekile ukulandela izindlela ezijwayelekile zokunakekelwa kwesilonda, kufaka phakathi:

• hlamba izandla njalo ngaphambi kokuthinta indawo
• ukugwema izingubo ezingahlikihla enxebeni
• ukulandela imiyalo kadokotela wakho maqondana nokuhlanza isilonda sakho nini futhi kangaki noma ukushintsha ukugqoka kwaso
• ubheke ngokucophelela izimpawu zokutheleleka okungenzeka

Ukwelashwa kwemvelo

Kunezindlela zokwelashwa ezimbalwa zemvelo kanye nokuguqulwa kwendlela yokuphila okungasiza nge-HS yakho.

Ukubhema osikilidi nokuba ngaphezulu kwesisindo esijwayelekile kube yisiqubulo esibi kakhulu sesifo se-HS. Ukuprakthiza ukuguqulwa kwendlela yokuphila njengokuyeka ukubhema nokugcina isisindo esilinganisiwe kungasiza ukuphatha kangcono izimpawu zakho.

Ngokwengeziwe, kukhona eminye imisebenzi engaqhubeka nokucasula isikhumba sakho. Ungakuthola kuwusizo ukugwema ukwenza izinto ezilandelayo endaweni ethintekile noma ezungezile:

• ukugqoka izingubo eziqinile noma ezivimbelayo
• ukuhlanza ngamathuluzi anokhahlo, njengamabhulashi noma izindwangu zokuwasha
• usebenzisa amabhandeshi okunamathela
• sisebenzisa imikhiqizo engaqukatha izinto ezicasulayo, njengama-detergents noma amakha
• ukushefa

Kukhona futhi okunye okubonisa ukuthi ukwesekwa kokudla, ikakhulukazi nge-zinc, kungasiza abantu abane-HS emnene ukuya kokulinganayo. Ngenxa yalokhu, udokotela wakho angancoma izithako zomlomo ze-zinc. Ungayikhiphi ngokweqile, noma kunjalo - i-zinc eningi ingadala isisu esithukuthele.

Ukugwema ukudla okuqukethe ubisi noma imvubelo yobhiya kungasiza abanye abantu abane-HS. Kodwa-ke, kudingeka olunye ucwaningo ukusekela lokhu.

Ukuthatha

Kunezindlela eziningi zokwelapha i-HS, ngayinye enezinzuzo zayo kanye nemiphumela emibi engaba khona. Yikuphi ukwelashwa (noma izindlela zokwelashwa) ongahle unconyelwe kuwe okuzoxhomeka ebucayi besimo sakho.

Kubalulekile ukuxoxa kahle ngezinketho zakho zokwelashwa nodokotela wakho noma udokotela wesikhumba. Qiniseka ukuthi ubazisa uma uhlangabezana nanoma yimiphi imiphumela emibi ngesikhathi sokwelashwa futhi nokuthi uvulelekile yini ukuzama noma yiziphi izindlela zokwelashwa ezintsha. Ukusebenza ngokubambisana kungakusiza ukuphatha i-HS yakho.