Ukwelashwa kwe-Psoriasis

-Delile

• Ukwelashwa ngezihloko kwe-psoriasis
• Ama-analogues ka-Vitamin D
• Okhilimu bamalahle noma ointments
• Ama-shampoo we-Dandruff
• I-salicylic acid ne-lactic acid
• Ukwelashwa okuhlelekile kwe-psoriasis
• IMethotrexate
• ICyclosporine
• Ama-PDE4 inhibitor
• Ama-retinoids
• I-Hydroxyurea
• Izidakamizwa ze-Immunomodulator (biologics)
• Thioguanine
• Ukusetshenziswa kwezidakamizwa ezingekho kwelebula
  
• I-Phototherapy (ukwelashwa okulula)
• Ukukhanya kwelanga
• Ukwelashwa kwe-UVB
• Ukwelashwa kweGoeckerman
• I-Excimer laser
• I-Photochemotherapy, noma i-psoralen kanye ne-ultraviolet A (PUVA)
• I-laser yedayi eqhutshwayo

Ukubuka konke

Ukwelapha i-psoriasis kudinga izindlela ezahlukahlukene ezahlukahlukene. Lokhu kungafaka phakathi izinguquko zokuphila, umsoco, i-phototherapy, nemithi. Ukwelashwa kuya ngobukhulu bezimpawu zakho, iminyaka yakho, impilo yakho yonke, nezinye izinto.

Alikho ikhambi le-psoriasis, ngakho-ke odokotela bavame ukuzama izindlela eziningi ngaphambi kokuthola ukwelashwa okulungile kuwe.

Izinketho zokwelashwa kwe-psoriasis zincike kulezi zinto ezilandelayo:

• ubunzima be-psoriasis yakho
• ukuthi umzimba wakho uthinteke kangakanani
• uhlobo lwakho lwe-psoriasis
• isikhumba sakho siphendula kahle kanjani ekwelashweni kokuqala

Izindlela zokwelashwa eziningi ezijwayelekile zenzelwe ukwelapha izimpawu zesifo. Bazama ukuthambisa isikhumba esirhawuzayo nesivuzayo futhi banciphise ukuqhuma. Ukusetshenziswa njalo kwama-moisturizer we-over-the-counter (OTC) ngemuva kokugeza kanye nokugeza kungasiza ukugcina umswakama esikhunjeni ukuvimbela ukuqhuma. Kepha ngeke iphathe ukuvuvukala okuyisisekelo.

Odokotela besikhumba bancoma nokuthi abantu abane-psoriasis basebenzise insipho engenawo amakha nengenawo udayi, okokuhlanza kanye nezithambisi ukugcina ukucasuka kwesikhumba kube kuncane.

Lapha, sizochaza ukwelashwa okuvamile kwe-psoriasis, kusuka ekwelashweni kolayini wokuqala njengokhilimu abasebenza ngezihloko kuya esigabeni esisha semithi ebizwa nge-biologics.

Ukwelashwa ngezihloko kwe-psoriasis

Ukwelashwa okusetshenziswe ngqo esikhunjeni kubizwa ngokuthi yimithi yokwelapha. Kubandakanya:

• okhilimu
• amafutha
• ama-lotion
• ama-gel

Imvamisa kungumugqa wokuqala wokwelashwa kwabantu abane-psoriasis emnene kuya kokulingene. Kwezinye izimo, zisetshenziswa ngokuhlanganiswa nolunye uhlobo lwezokwelapha.

Okhilimu namafutha okugcoba i-Corticosteroid yizona ukwelashwa okuvame kakhulu kwe-psoriasis. Lezi zokwelashwa ezinomthamo ophansi zisebenza ukulawula ukukhiqizwa okwedlulele kwamaseli esikhumba futhi zinciphise isikhumba. Kodwa-ke, amanye ama-corticosteroids afaka phakathi ama-steroids anamandla angenza izimpawu zakho zibe zimbi kakhulu. Udokotela wakho uzokwazi amandla afanele okunciphisa izimpawu zakho, kunokuba azikhulise.

Ama-retinoids ezihloko ayindlela ehlukile yokwelashwa okuvela e-vitamin A. Asebenza ukujwayela ukukhula komsebenzi kumaseli esikhumba. Lokhu kubambezela inqubo yokuvuvukala. Yize kungenjalo njengokusebenza okusheshayo njengamafutha we-corticosteroid, ama-retinoids ama-topical anemiphumela emibi embalwa. Abesifazane abakhulelwe noma abangahle bakhulelwe akufanele basebenzise lezi ngenxa yengozi yokukhubazeka kokuzalwa.

Ama-analogues ka-Vitamin D

Lezi izinhlobo zokwenziwa zikavithamini D ezehlisa ukukhula kwamaseli esikhumba. Udokotela wakho angabanikeza yena yedwa noma nezinye izindlela zokwelapha i-psoriasis emnene naphakathi. Kubandakanya:

• i-calcipotriene (i-Dovonex)
• i-calcitriol (Rocaltrol)

Okhilimu bamalahle noma ointments

I-tar yamalahle iyindlela yokwelashwa endala ye-psoriasis. Yenziwe ngemikhiqizo eyenziwe ngophethiloli. Imikhiqizo yetiyela lamalahle inciphisa ukukala, ukulunywa nokuvuvukala. Ukugxila okuphezulu kuyatholakala ngemithi kadokotela.

Lawa makhilimu anezinye izinto ezimbi, noma kunjalo. Itiyela lamalahle liyaxaka, futhi lingangcolisa izingubo nezingubo zokulala. Kungaba nephunga elinamandla futhi elingathandeki.

Ama-shampoo we-Dandruff

Imishanguzo yokwelashwa ekhishwe ngamandla nemithi kadokotela iyatholakala kudokotela wakho ukwelapha i-psoriasis ekhanda lakho.

I-salicylic acid ne-lactic acid

Womabili lawa ma-asidi akhuthaza ukucekelwa phansi kwamaseli esikhumba afile, anciphisa ukukala. Zingasetshenziswa futhi ngokuhlangana nezinye izindlela zokwelapha. Atholakala kuma-OTC namafomula kadokotela.

Ukwelashwa okuhlelekile kwe-psoriasis

Imithi kadokotela ingasiza ekulweni nokusabalala kwe-psoriasis ngokubhekana nokuvuvukala.

Odokotela imvamisa bakhetha ukusebenzisa indlela yokwelashwa ephansi kakhulu edingekayo ukumisa izimpawu. Baqala ngokwelashwa ngezihloko ezimweni eziningi. Njengoba isikhumba siqina futhi singasaphenduli ekwelashweni okukodwa, ukwelashwa okuqinile kungasetshenziswa.

Udokotela wakho angakunikeza izidakamizwa zomlomo noma zomjovo uma i-psoriasis yakho inzima kakhulu noma ingaphenduli ekukhethweni kwezihloko. Eminingi yale mithi inemiphumela engemihle, ngakho-ke odokotela banciphisa ukusetshenziswa kwabo ezimweni ezinzima kuphela noma eziphikelelayo.

IMethotrexate

I-Methotrexate inciphisa ukukhiqizwa kwamaseli esikhumba futhi icindezela ukuphendula komzimba. Odokotela bavame ukunquma lokhu kubantu abane-psoriasis elinganiselayo. Ngenye yezindlela zokwelashwa eziphumelela kakhulu kubantu abane-erythrodermic psoriasis noma i-pustular psoriasis. Muva nje, odokotela sebeqalile ukuyinikeza njengokwelapha kwe-psoriatic arthritis futhi.

Imiphumela emibi ifaka phakathi:

• ukulahlekelwa isifiso sokudla
• ukukhathala
• isisu esibuhlungu

ICyclosporine

ICyclosporine yisidakamizwa esisebenza kahle kakhulu esenzelwe ukucindezela amasosha omzimba. Odokotela bavame ukunquma lo muthi kuphela kubantu abanezifo ezinzima ze-psoriasis ngoba buthaka amasosha omzimba.

Odokotela abaningi baphinde banikeze lesi sidakamizwa ubude obufushane besikhathi ngenxa yengozi yomfutho wegazi ophakeme. Uma uthatha lo muthi, uzodinga ukuhlolwa kwegazi okuvamile nokuhlolwa kwengcindezi yegazi ukuqapha izinkinga ezingaba khona.

Ama-PDE4 inhibitor

Umuthi owodwa kuphela womlomo, obizwa ngokuthi i-apremilast (Otezla), njengamanje uyatholakala kulesi sigaba esisha semithi ye-psoriasis. Akuqondakali kahle ukuthi i-apremilast isebenza kanjani ukwelapha i-psoriasis. Kucatshangwa ukuthi kusebenza ngokunciphisa impendulo yomzimba wakho ekuvukeleni.

Ama-retinoids

Ama-retinoid enziwa ngemikhiqizo ephuma ku-vitamin A. Baphatha i-psoriasis ngokulinganisela kuya kokuqinile ngokunciphisa ukukhiqizwa kwamaseli esikhumba. Udokotela wakho angase asikisele ukuthi usebenzise lokhu ngokwelashwa okulula.

Njengeminye imithi yesistimu, lokhu kunemiphumela emibi engaba khona emikhulu. Udokotela wakho angalawula ukuhlolwa kwegazi njalo ukuze ahlole i-cholesterol ephezulu, okuyinkinga ejwayelekile kubantu abakulo muthi. Ama-retinoids nawo angadala ukukhubazeka kokuzalwa. Abesifazane abakhulelwe noma abafisa ukukhulelwa akufanele bathathe le mithi.

I-retinoid yomlomo evunyelwe yi-FDA kuphela yokwelashwa kwe-psoriasis yi-acitretin (Soriatane).

I-Hydroxyurea

I-Hydroxyurea ingeyesigaba semithi ebizwa ngama-antimetabolites. Kucatshangwa ukuthi kusebenza ngokuvimbela ukuphindaphindeka kwe-DNA. Ingasetshenziswa nge-phototherapy, kepha ayisebenzi njenge-cyclosporine ne-methotrexate.

Imiphumela engemihle ibandakanya amazinga eseli abomvu aphansi kakhulu (i-anemia) nokwehla kwamaseli amhlophe egazi nama-platelet. Abesifazane abakhulelwe noma abahlela ukukhulelwa akufanele bathathe i-hydroxyurea ngenxa yengozi yokukhubazeka kokuzalwa nokukhulelwa kwesisu.

Izidakamizwa ze-Immunomodulator (biologics)

I-Biologics isigaba esisha semithi ekhomba ekuphenduleni komzimba wakho. Le mithi inikezwa ngomjovo noma ngomjovo we-intravenous (IV). Odokotela bavame ukubanikeza abantu abane-psoriasis elinganiselayo kuya kwelinamandla abangaphendulanga ekwelashweni kwendabuko.

I-biologics evunyelwe ukwelashwa kwe-psoriasis yile:

• i-adalimumab (Humira)
• i-etanercept (Enbrel)
• isitifiketi (Cimzia)
• infliximab (i-Remicade)
• ustekinumab (Stelara)
• secukinumab (Cosentyx)
• ixekizumab (Taltz)
• brodalumab (Siliq)
• i-guselkumab (Tremfya)
• i-tildrakizumab (Ilumya)
• i-risankizumab (Skyrizi)

Ama-biosimilars nawo asanda kutholakala, afana nemithi ye-biologic, kodwa hhayi ikhophi eliqondile. Kulindeleke ukuthi babe nemiphumela efanayo nomuthi ojwayelekile. Kukhona ama-biosimilars njengamanje we-infliximab ne-etanercept.

Thioguanine

I-Thioguanine isetshenziswa ngaphandle kwelebula ukwelapha i-psoriasis. Yize ingasebenzi njenge-methotrexate noma i-cyclosporine, i-thioguanine inemiphumela emibi embalwa. Lokhu kwenza kube yindlela yokwelashwa ekhangayo. Noma kunjalo, kusengadala ukukhubazeka kokuzalwa. Abesifazane abakhulelwe noma abahlela ukukhulelwa kufanele bagweme ukuyithatha.

Ukusetshenziswa kwezidakamizwa ezingekho kwelebula

• Ukusetshenziswa kwezidakamizwa ezingekho kwelebula kusho ukuthi umuthi ovunyelwe yi-FDA ngenhloso eyodwa usetshenziselwa injongo eyehlukile engavunyelwe. Kodwa-ke, udokotela usengasisebenzisa lesi sidakamizwa ngaleyo njongo. Lokhu kungenxa yokuthi i-FDA ilawula ukuhlolwa nokuvunywa kwezidakamizwa, kodwa hhayi ukuthi odokotela bazisebenzisa kanjani izidakamizwa ukwelapha iziguli zabo. Ngakho-ke, udokotela wakho angakunikeza umuthi kodwa bacabanga ukuthi kungcono kakhulu ukunakekelwa kwakho.

I-Phototherapy (ukwelashwa okulula)

I-Phototherapy yinqubo lapho isikhumba sivezwa ngokucophelela ekukhanyeni kwemvelo noma okufakelwayo kwe-ultraviolet (UV).

Kubalulekile ukuxoxa nge-phototherapy nodokotela wakho wesikhumba ngaphambi kokuziveza emithamo ephezulu yokukhanya kwe-UV. I-phototherapy yesikhathi eside ihlotshaniswa nokwanda kwezifo zomdlavuza wesikhumba, ikakhulukazi i-melanoma. Ungalokothi uzame ukuzitholela ngokwakho ngombhede wokushuka noma ukugeza ilanga.

Ukukhanya kwelanga

Umthombo wemvelo wokukhanya kwe-UV yilanga. Ikhiqiza imisebe ye-UVA. Ukukhanya kwe-UV kunciphisa ukukhiqizwa kwamaseli we-T futhi ekugcineni kubulale noma yimaphi ama-T cell asebenzayo. Lokhu kubambezela impendulo yokuvuvukala kanye nenzuzo yeseli lesikhumba.

Ukuvezwa okufushane kokukhanya okuncane kwelanga kungathuthukisa i-psoriasis. Kodwa-ke, ukukhanya okukhulu kwelanga noma ukuhlala isikhathi eside elangeni kungazenza zibe zimbi izimpawu. Kungadala nokulimala kwesikhumba futhi kungakhuphula amathuba akho okuba nomdlavuza wesikhumba.

Ukwelashwa kwe-UVB

Ezimweni ezincane ze-psoriasis, kungasetshenziswa ukwelashwa kokukhanya okukhanyayo okukhanyayo nge-UVB.Ngoba amabhokisi okukhanya akhipha i-UVB asetshenziswa kaningi kulolu hlobo lokwelashwa, kungalashwa amabala amancanyana noma izindawo ezincane zesikhumba, esikhundleni sokuveza umzimba wonke.

Imiphumela emibi ifaka ukulunywa, isikhumba esomile nokubomvu ezindaweni eziphethwe.

Ukwelashwa kweGoeckerman

Ukuhlanganisa ukwelashwa kwe-UVB nokwelashwa ngetela lamalahle kwenza ukuthi lezi zindlela zokwelapha ezimbili zisebenze kangcono ukwedlula ukwelashwa okukodwa. Itiyela lamalahle lenza isikhumba samukele ukukhanya kwe-UVB. Lokhu kwelashwa kusetshenziselwa amacala amnene kuya kokuphakathi.

I-Excimer laser

Ukwelashwa kwe-Laser kuyintuthuko ethembisayo ekwelapheni i-psoriasis emnene kuya kokulingene. Ama-Lasers angakhomba imishayo egxilile yokukhanya kwe-UVB kuma-psoriatic patches ngaphandle kokuthinta isikhumba esizungezile. Kepha kungasiza kuphela ekwelapheni amabala amancane ngoba i-laser ayikwazi ukumboza izindawo ezinkulu.

I-Photochemotherapy, noma i-psoralen kanye ne-ultraviolet A (PUVA)

I-Psoralen imithi yokwazisa okukhanyayo engahlanganiswa ne-UVA light therapy njengokwelashwa kwe-psoriasis. Iziguli zithatha umuthi noma zifaka ukhilimu inguqulo esikhumbeni bese zifaka ibhokisi elikhanyayo le-UVA. Le ndlela yokwelashwa inolaka kakhulu futhi ivame ukusetshenziswa kuphela ezigulini ezinamacala amaphakathi kuya kokubi we-psoriasis.

I-laser yedayi eqhutshwayo

Udokotela wakho angancoma udayi we-laser odayiwe uma ezinye izindlela zokwelapha zinempumelelo elinganiselwe. Le nqubo ibulala imithambo yegazi emincane ezindaweni ezizungeze ama-psoriasis plaque, inqamula ukugeleza kwegazi futhi inciphise ukukhula kwamaseli kuleyo ndawo.