Iziyobisi ze-biologic ezitsha zinika ithemba kubantu abagulayo
Nangona kungekho nonyango ye-plaque psoriasis engapheliyo, kukho iintlobo ezahlukeneyo zonyango ezinokukunceda ukususa izikali nokukhusela iiseli zesikhumba ukuba zingakhuli ngokukhawuleza. Izinketho ziquka amafutha okugcoba, ukunyanga okulula, kunye neziyobisi ezisemthethweni ezithathwe ngomlomo okanye ngomjovo. Ukunyamekela kwesikhumba kunye nokukhetha kwendlela yokuphila kunokukunceda ufumane ukulawulwa kweengxaki eziqhubeka zichaphazela abaninzi abantu abangama-7,5 baseMelika, ngokwe-American Academy of Dermatology.
Imigaqo
I-corticosteroids yezihloko, ezaziwa ngokuba yi-steroids, zibhekwa njengezona ndlela zisebenzayo zokuphatha i-psoriasis enobumba. Nangona kunjalo, njengengxaki engapheliyo ye- autoimmune disorder , i-plaque psoriasis inokufuna okungakumbi. Kwezinye iimeko, iimpendulo ezizenzekelayo ziza kufuneka zicetyiswe ukuba zithintele umzimba ukuba ungabangela ingozi ngakumbi. Kule nto, oogqirha bavame ukuphendukela kwiziyobisi ezijolise ekuphenduleni omzimba, nokuba kusetyenzisweni (ngokubanzi) okanye inxalenye.
Corticosteroids
I-corticosteroids yezihloko eziqhelekileyo zisetyenziselwa ukuphathwa ngonyango kubantu abanomnxeba we-psoriasis, kwaye bangasetyenziselwa kunye nezinye iziyobisi kubantu abaneemodareyitha kwiimeko ezinzima.
Ukuba ubeka i-steroid ye-topic, i-dermatologist yakho iya kuqwalasela indawo kunye nobukhulu beeplathi zakho. Kwabo ebusweni okanye kwizitho zangasese, amandla angaphantsi, ukulungiswa kwama-1.0% anokumiselwa, ngelixa i-steroid ephakathi nendawo ephezulu ingasetyenziselwa kwezinye iindawo zomzimba.
I-steroids yezihloko zifumaneka ngogqirha kunye nangaphezulu kwi-counter in various lotions, i-creams, i-ointments, i-shampoos, i-foam kunye ne-sprays. Ngexesha elifanelekileyo, ukusebenzisa ixesha elide okanye ukusetyenziswa ngokugqithiseleyo kunokukhokelela kwi-atrophy yesikhumba (ukunqunyulwa kwesikhumba), imeko engaqhelekanga.
Izidakamizwa ezingezizo
Iziyobisi ezingezizo ze-biologic zizo ezo zenziwe ngobungcali kwibhulebhu.
Kukho ezintathu ezingezizo-biologics eziqhelekileyo ezisetyenziselwa ukuphatha i-psoriasis ye-plaque:
- I-Methotrexate iyisisigxina sokuxhatshazwa ngumzimba esiye sasijikeleze iminyaka engaphezu kwama-50 kwaye isebenza ngokunciphisa impendulo yomzimba ngokubanzi. Ngokuqhelekileyo isetyenziswe kwinkqubo yokuqala yokunyanga kwendlela yokumodareyitha ye-plaque psoriasis. Ngokunciphisa umzimba wonke, i-methotrexate ingabangela iziphumo zecala ukususela kwisibindi sesibindi ukuya kutshintsho lomongo. Iimvavanyo zegazi ezifunekayo zifunekayo ukwenzela ukuphepha iingxaki zonyango.
- I-Cyclosporine iyisisulu sokukhusela umzimba esifana ne-methotrexate. Isetyenziswe xa i-psoriasis inkulu okanye ingazange iphendule ubuncinane esinye isistim. Ngoxa i-cyclosporine isebenza ngokukhawuleza kwi-immune system, ifuna ukubeka esweni rhoqo kwimiphumo emibi, kuquka ukunyuka kwengcinezelo yegazi, ubuthi besibindi, kunye nokukhubazeka kweengtso.
- I-Otezla (apremilast) yavunywa ngo-2014 ukunyanga i-psoriasis kunye ne- psoriatic arthritis , uhlobo lwe-rheumatoid arthritis oluhlobene kakhulu ne-psoriasis. U-Otezla usebenza ngokuthintela i-enzyme, eyaziwa njenge-phosphodiesterase 4, elawula ukuvuvukala kweselula. Ngoxa i-Otezla ixhaswe kakuhle, inokubangela ihudo, isicupunu, okanye intloko xa kuqala. Ngokuqhelekanga, abantu banokulahleka kwesisindo okanye iimpawu zokudakumba.
Biologic Drugs
Iziyobisi ze-biologic zizo zivela kwiiprotheni zomntu okanye zezilwanyana. Inani elinyukayo lezinto eziphilayo liye lavunyelwa ukuba unyango lwe-psqueasis eliphambili. Ngokungafani ne-methotrexate, i-biologics ijolise iqela elithile lempendulo ye-immune kunokuba isistim somzimba sisonke.
I-biologics ihanjiswa okanye nge-injection okanye nge-intravenously (nge-vein). Zivame ukumiselwa abantu abane-modoriasis ezinzima ezingaphendulanga kwezinye iyeza.
Ama-arhente okwamkelwa ngoku ajolise kwizinto ezintathu zempendulo yomzimba:
- I-Cimzia (certolizumab), i- Humira (adalimumab) , i- Enbrel (etanercept) , i- Remicade (infliximab) , kunye ne-Simponi (golimumab) ye-block tumor necrosis factor (TNF) , iprotheni yokubonakalisa ibandakanyeka kwi-systemic inflammation.
- I-Stelara (ustekinumab) , i- Cosentyx (secukinumab) , i-Siliq (brodalumab), i-Taltz (ixekizumab), kunye ne-Tremfya (guselkumab) ivimba iintlobo ezahlukeneyo ze-interleukin, iprotheni eveliswa ngamaseli egazi amhlophe alawula ukumelana nomzimba.
- I-Orencia (abatacept) ibimbela uhlobo lwegazi elimhlophe elibizwa ngokuba yi- T-cell , leyo isistim somzimba esisebenzisayo ukuvuselela impendulo yokuvuvukala.
Njengoko iziyobisi ze-biologic zinokunyusa umngcipheko wokusuleleka, naluphi na ukusika, ubunzima, okanye uphawu losulelo kufuneka lugqirwe ngugqirha. Iziphumo eziqhelekileyo zeziphumo ziquka intlungu yesifo senkunkuma, izifo zokuphefumula, kunye neempawu ezifana nezifo. Kwiimeko ezinqabileyo, ezinye iintsholongwane kunye neempawu ze-neurologic (ezifana nokuxhwala kunye ne-multiple sclerosis) zingakhula.
Imithi exhasa
Kukho nenani lemithi yesigqirha esetyenziswa ngokubanzi ukuxhasa unyango oluphambili lwe-psoriasis:
- I-Calcipotriol (i-calcipotriene) yi-vitamin D3 analog eyenziwe kuqala kwiminyaka ye-1990 ukuphatha i-plaque psoriasis engapheliyo. Kukholelwa ukuba kuphuculwe iimpawu ngokucutha ukwanda kwama- keratinocytes ekhumbeni. Ezinye ii-analogs ze-vitamin D3 ziquka i-calcitriol kunye ne-tacalcitol.
- I-Tazorac (i-tazarotene) yi- retinoid ephezulu ye-vitamin A ekwazi ukuphucula imveliso yeseli kunye nokunciphisa ukuvuvukala. Kuye kuthengiswa phantsi kwegama le-brand Avage noFabior. Imiphumo emibi ibandakanya ukucaphukiswa kwesikhumba nokuzwela kwelanga.
- I-Soriatane (acitretin) yi-retinoid yomlomo edlalwa ngamanye amaxesha kunye neyeza lokukhanya kwe-UV. Imiphumo emibi iquka ukuvutha komlomo, ukulahleka kweenwele, kunye nokomiswa kwamehlo, impumlo, nomlomo.
I-Tazorac kunye ne-Soriatane zihlelwe njengoluhlu lwe-X lokukhulelwa kwaye alukwazi ukusetyenziswa ngexesha lokukhulelwa ngenxa yengozi yeziphene zokuzalwa.
Iipilisi
Ukukhanya kwelanga kunokusebenza ekunciphiseni i-psqueasis yepenasis, kodwa ukutyhila ixesha elide kunokukhokelela ekushiseni ilanga kunye nokugqithisa kweempawu. Kule ndlela, unyango lwe-UV, olubizwa ngokuba yi- phototherapy , lube yindlela ekhuselekileyo kulabo abangakwazi ukuphendula kumachiza kuphela.
Umbane we-Ultraviolet B (UVB), ngokukodwa, uyakwazi ukungena kwesikhumba kwaye unciphise ukukhutshwa kwamanzi eeseli ngaphandle kweengozi. Unyango lunokwenziwa kwiofisi yegqirha okanye ngeyunithi yekhaya. Kukho nawuphi na umzekelo, inkqubo kufuneka ilandelwe yidermatologist ebonwe kwiphototherapy. Nangona isikhumba sakho singaqala ukuba sibi ngakumbi ngaphambi kokuba sibe ngcono, ukuvumelana ngokuqhelekileyo kuqinisekisa ukuba iziphumo ezilungileyo.
Olunye uhlobo lokunyanga okukhanya, olubizwa ngokuba yi-psoralen + UVA (PUVA), ludibanisa i-radiation ye-UVA kunye nesilwanyana esicacisayo esibizwa ngokuba yi-psoralen, esithathwe ngomlomo okanye ngesigxina. I-PUVA iphumelela ngakumbi kwi-psoriasis yeplates egxininiseleyo kunokuba iifutha ezinzima.
I-Over-Counter Counter
Ukongeza kwiinguqu ezingagunyazisiyo ze-corticosteroids eziphezulu, zikhona ezinye zeemveliso ezingaphezulu kwe-counter (i-OTC) ezikhoyo ukuphatha i-plaque psoriasis.
Njengoko abanye banokusebenza bhetele kunabanye (kwaye abanye bangabakho buhlungu kakhulu), kubalulekile ukuba uthethe nodokotela wakho we-dermatologist ngaphambi kokusebenzisa nayiphi na.
Phakathi kwezinye zeendlela ezikhethiweyo:
- I-tar yamalahle sele isetyenziselwe ukuphatha i-psoriasis iminyaka engaphezu kwe-100, kwaye kukho abanye ababesifungayo. I-tar yamacala iyatholakala ngaphandle komyalelo kwaye inokufumaneka kwiindidi ezahlukeneyo, kuquka i-shampoos, i-ointment, i-lotions, i-creams kunye ne-foam. Ngelixa ulududuza, ezinye zeemveliso zingangcola kwaye zincinci.
- I-acid ye-salicylic i-agent ye-peeling engakunceda ukuthobisa nokususa izikali zokukhahlela. Iqulethwe kwiindawo ezahlukeneyo zokunyusa ama-creams, lotions, kunye namafutha okugcoba. Gwema ukudibanisa iimveliso ze-salicylic, kwaye ungayisebenzisi ngaphezu kweepesenti ezingama-20 zomzimba, njengoko oku kungakhokelela ekugqithiseni ngokugqithiseleyo kunye nobutyhefu. Musa ukuwusebenzisa kubantwana.
IziPhulo zaseKhaya kunye nokuPhila
Nangona kukho ukunyuka okuthe rhoqo kwimiqathango yesigqirha kunye ne-OTC iimveliso ezikhoyo ukuphatha i-psoriasis ye-plaque, kukho iindlela zokwelapha ekhaya kunye nezenzo zokunakekelwa kwesikhumba ezinokukunceda.
Zonyango
Injongo ephambili yezilwanyana zasekhaya kukunciphisa ukutshabalalisa, ukuvutha, kunye nokungahambi kakuhle kweeplates ngelixa ususa ngobumnene iiseli zekhumba ngaphandle kwegazi.
Phakathi kwezinye zeendlela ezifanelekileyo:
- Amanzi okuhlamba ayenziwe ngetyuwa ye-Epsom, ioli ye-mineral, ubisi, okanye ioli yeoli iyanciphisa isikhumba ngelixa ephakamisa ngokukhawuleza izikali ukusuka kwinqanaba elingaphandle lesikhumba (epidermis). Sebenzisa kuphela amanzi aphunga; Amanzi atshisayo anokukhawuleza ahluthe amafutha omzimba aze ashiye isikhumba esidlulayo kunanini ngaphambili.
- I-moisturizers engenasiphalisi , enjenge-petroleum jelly, i-aloe vera gel, okanye i-oyili yamaminerali, inokukunceda ekutyeni kweeseli ngexesha lokufaka umswakama esikhumbeni. Ezi zityebi ezicebileyo kufuneka zisetyenziswe emva kokuhlamba ukulwa nokulahleka kobutyu.
- Njengoko kubonisiwe, ukukhanya kwelanga kusenokunciphisa ukwanda kwee-klebhu zelinqe kodwa kufuneka kufikelelwe kumzuzu engama-10 yokuhamba ngokuthe ngqo kwimihla. Unokwandisa ixesha lokunyusa kodwa uhlale usenjenjalo xa ugqoke ubuncinane be-SPF 30 yelanga.
Indlela epheleleyo yokwenza unyango lwe-psoriasis kufuneka ihlale iquka ukuzivocavoca, ukunciphisa uxinzelelo, ukutya okunamafutha amaninzi okucebile kwi-omega-3 fatty acids, kunye nokuphepha kokusela utywala kunye ne-cigarettes.
Ukhathalelo lolusu
Ukunyamekela kalukhuni kubalulekile ekulawuleni iimpawu zakho ze-psoriasis. Okuphambili kule nto kukukhusela isepha ezidliwayo, ukuxubha, kunye nokucoca i-alcohol. Ezi ziyakwazi ukuphazamisa isikhumba sakho esibuhlungu kwaye sinokubangela ukuqhuma.
Ezinye iingcebiso zokunakekelwa kwesikhumba ziquka:
- Hlanza kwaye unyuse isikhumba sakho kanye rhoqo imihla ngemihla ukuze ugweme ukuma.
- Khetha isepha esilula okanye i-purifier eyenzelwe i-psoriasis.
- Sebenzisa ilinen elithambileyo okanye izandla zakho ukuze uqokelele. Ungalokothi usebenzise i-loofah okanye nantoni na engakwazi ukutshiza okanye ukucaphukisa isikhumba sakho.
- Geza ngamanzi ashushu. Amanzi afudumele enza ukuba imithanjeni yegazi esele ivele iqhube ngakumbi kwaye iyakunqumla amaninzi omzimba wendalo.
- Ungapheli-sophe isikhumba sakho. Ukwenza oku ngakumbi, isikhumba sakho siza kuba. Yenza isepha kuphela loo malungu omzimba wakho ayifunayo.
- Ngeenyanga zasebusika, tshintsha kwi-lotion ye-lighting kwi-cream ekwinkcenkceshe yokunyusa ukuhlawulela ukulahlekelwa ngumswakama.
- Gwema iiphunga kunye ne-colognes equle utshwala.
- Ngexa ufanele uphephe ukuzenzela ukuba unayo i-psoriasis yobuso, ungazama ukusebenzisa i -concealer ekhuselekileyo yesikhumba efana neDermablend okanye i-Covermark, apho abanye basebenzisa ukufihla ukutshisa kunye nezibazi.
- Phuza amaninzi amanzi-ubuncinane iiglasi ezili-8 ngosuku. Ukwenza oko u-hydrates isikhumba njengoko kwenzayo umzimba wakho wonke.
> Imithombo:
> I-American Academy yeDermatology (AAD) Iqela loLuntu, kunye al. "Izikhokelo zokunyamekela ukuphathwa kwe-psoriasis kunye ne-psoriatic arthritis: icandelo 6. Izikhokelo zokunyamekela unyango lwe-psoriasis kunye ne-psoriatic arthritis: iintetho ezisekelwe kwimeko kunye nezigqibo ezisekelwe kwiziqinisekiso." J Am Acad Dermatol . 2011 Julayi; 65 (1): 137-74. INGXELO: 10.1016 / j.jaad.2010.11.055.
> National Psoriasis Foundation. "I-Moderate kuya kwi-Psoriasis ne-Psoriatic Arthritis: i-Biologic Drugs." EPortland, eOregon.