Ngokuqhelekileyo umdlavuza wezondlo obulalayo uhlala ungafumani kakuhle
I-melanoma ye-subungual ebizwa ngokuba ngumhlaza wesilumkiso sesilumko, luhlobo lwesifo esibangelisayo esivela kwiisisu zombhede wesikhonkwane. I-melanoma luhlobo lomhlaza olwenzeka kwiiseli ezibizwa ngokuthi i-melanocytes. I-melanocytes iiseli ezivelisa i-melanin, i-pigment enika isikhumba, iinwele, kunye nombala wabo umbala.
Nangona i-subungual melanomas ixhaphake kakhulu kwisiqu okanye inzwane enkulu, iyakwenzeka nakweyiphi na iminwe okanye iminwe.
Zihlala zichithwa ngokungabonakali njengentsholongwane yefungal ngenxa yeenguqu zabo eziguqayo kumbala kunye nokugqithwa kwepiki.
I-melanoma ye-subungual yinto engavamile kwaye ihlala ikhona kubantu abanobumnyama. E-Asia, kucatshangelwa ukuba amaninzi engama-20 e-melanomas yi-subungual melanomas. Zenzeka ngokuqhelekileyo kubantu abaphakathi kweminyaka engama-40 no-70.
Iimpawu
I-subungual melanomas ngokuqhelekileyo ibonakala njengemifudlana emnyama eyenza ixesha elide (i-perpendicular to the cuticle). Phantse isiqingatha sale mijelo ibomvu, i-blue, okanye ibumnyama, ngelixa esinye isiqingatha asiyi-pigmented.
Njengoko umhlaza uyaqhubeka, imilambo eninzi ingavela, kaninzi imbala eyahlukileyo. Njengoko ixesha liqhubeka, isabelo esiseduze kwi-cuticle sinokubanzi.
Uphawu lukaHutchinson luyinto eqhelekileyo ekufumaneni ngayo ininzi ye-melanomas subungual. Oku kubhekisela ekubonakala kwe-streak ephuma ukusuka phezulu kwesikhonkwane yonke indlela eya kwibheyili (apho ikhonkwane iqalisa khona) kunye ne-cuticle uqobo.
Oku kukwahlula kwezinye iimeko ezinxulumene nesosi ngokwemimiselo yayo, ukuchithwa kwexesha elide kunye nokubandakanyeka kwe-cuticle.
Njengoko i-melanoma iqhubeka ikhula, inokubangela ukuphuma kwegazi, ukubunjwa kwe-nodule, okanye ukukhubazeka kwesikhonkwane ngokwayo.
Ukuxilongwa
Ukuxilongwa kwexesha kuya kwenziwa ngokuhlola ngokucophelela kwesikhonkwane kunye nesilonda.
I-Dermatologists izakusebenzisa isixhobo esibizwa ngokuba yi-dermascope esinika iimbono eziphakamileyo zesilumko kunye nezicubu ezijikelezayo.
Ekugqibeleni, ukuhlolwa okubonakalayo kunemida, ngakumbi kuba kubonakala njalo. Ngenxa yoko, ihlala iphosakele kwezinye iimeko eziqhelekileyo, ezifana:
- I-hematoma ye-subungual , i-bruising under the nail engenakho ukufana kwe-melanoma ye-subungual
- Izifo ezifayilini (onychomycosis) ezisoloko ziba nemicu emnyama, engekho emide-longitudine ehamba kunye ne-yellow or white streaks
- Ii-Moles (nevi) ezingenakwenzeka ukuba zivele kwiintlobo
- Iifosti ze-melanin phantsi kwepiki ezinokuthi zenzeke ngenxa yokukhulelwa (kunye ne-chemotherapy okanye unyango lwe-radiation)
Ukuxilongwa okuqinisekileyo kunokwenziwa kuphela nge-biopsy (ukususwa kunye nokuhlolwa kweethambo ezichaphazelekayo).
Ukuba i-melanoma ikhunjulwa, i-biopsy i-excelal biopsy iya kwenziwa ukuba isuswe i-lesion yonke kunye nezinye izicubu ezijikelezayo. I-punch engaphantsi-intsha okanye i-biopsy engacacanga ingasetyenziselwa ukuba i-diagnostic ebonakalayo ingagqibekanga.
Isalathiso seMelanoma
Ngokuxhomekeke kubukhulu kunye nobunzulu be-melanoma ye-subungual, kuya kufuneka ukuba kuhlolwe uvavanyo olongezelelweyo ukucacisa isigaba sesifo. Njengomnye umhlaza womhlaza, isigaba sinokuhluka kwi- carcinoma in situ (ngaphambi komhlaza) yonke indlela eya kwisigaba se-4 sesifo se-metastatic (apho umhlaza usasazeke kwezinye izitho).
Ukuchonga ukuba i-melanoma idibeneyo, kukho iimvavanyo ezahlukahlukeneyo i-oncologist ingajika kuqulethe i-biopsy ye-lymph nodes (iindidi eziseduze ne-tumor) kunye neendlela zokucinga ezifana ne-computerized tomography (CT scan) okanye i-postitron emission tomography (i-PET scan) .
Izinto zobungozi
Ngethuba esingazi ukuba yintoni eyenza i-subungual melanoma, siyazi ezininzi izinto ezinobungozi ezinxulumene nophuhliso lwayo.
Into enye engabonakali iyinto-kwaye iyayahlula kuyo yonke iindidi ze-melanoma - ukukhanya kwelanga. I-ultraviolet (UV) ukukhanya kwelanga ukusuka elangeni okanye eminye imithombo ayinakunceda ekuphuhlisweni kwayo okanye ayikhulise isantya esenza ngayo.
Imiba yengozi edlala indima iquka:
- Ingozi yangaphambili kwiminwe okanye kwizwane (ukufumana okuqhelekileyo)
- Imbali yomntu okanye yentsapho ye-melanoma
- Ezininzi iilesi
- Ukuxhatshazwa kwe-immune, kuquka nabamkeli begciwane kunye nabantu abane-HIV ephambili
- I-Genetics, njengalezo ezinesimo esizuze ifa xeroderma pigmentosa (ubukhulu obunzulu kwimitha ye-UV)
Unyango
Unyango lwe-subungual melanomas lushintshile kakhulu kwiminyaka yamuva. Kwixesha elidlulileyo, ukuchithwa kwezwane zonke okanye umunwe kwakucatshangwa unyango olukhethiweyo.
Namhlanje, amaninzi e-subungual melanomas athatyathwa ngokungakumbi ngokukhutshwa kwendawo yokuphela kwesisu. Xa ukuchithwa kubonisiwe, kudla ngokubandakanya kuphela umdibaniso wokuqala osondeleyo kwintonga. Ngezikhonkwane, ukuchithwa kwinqaku yesibini kuqhelekileyo.
Ukuhlaziywa kuka-2014 kunyango lwezonyango lucebise ukuba indlela eninzi yokulondoloza ingasebenza kunye nokuchithwa okupheleleyo; Ngaphezu koko, ukugqithiswa okupheleleyo akubonwanga ukuphucula ubomi.
Ukulungiselela i-subungual melanoma kwangaphambili, ezinye iintlobo zonyango zingafuneka, kubandakanywa:
- I-Chemotherapy, enikezwa ngokusesikweni ngendlala okanye ngqo kwi-tumor
- Ulwaphulo lwe-radiation, elisetyenziswe ngokuyinhloko njengonyango olunyamezelayo ukunciphisa intlungu
- I-Immunotherapy , uhlobo olutsha lomhlaza wonyango olujolise ekuvuseleleni amasosha omzimba ukulwa namaseli anomhlaza
- Iipilisi ezijoliswe kuzo, iziyobisi ezinokukwazi ukujolisa kwiinguqu ze-BRAF ezenzeka kwi-50 ekhulwini ze-tumoroma
Ukuphendula kwonyango kuyahlukahluka ngokusekelwe kwinqanaba lomhlaza. Iziphumo zabantu abane-melanoma ye-subungual zihlala zihlwempuze kunezinye iintlobo ze-melanoma, ngokuqhelekileyo ngenxa yokulibaziseka ekufuneni ukuxilongwa nokunyango.
Oku kuphela kugxininisa imfuno yesenzo xa ufumana nayiphi na inguqu kwiisilonda okanye isikhumba esibonakala singavamile okanye sihluleka ukuphucula. Ukungenelela kwangaphambili yindlela eqinisekileyo yokufumana impumelelo yonyango.
ILizwi
Ukuba uye wafumanisa ukuba unesifo se-melanoma ye-subungual, kubalulekile ukufumana ingcali ejongene nesifo. I-subungual melanomas ayiqhelekanga, kwaye ukungabikho kwamava kunokubangela ukhathalelo olungenasidingo kunyango.
Ngoxa kubalulekile ukuba iqela elijongene nokukhathalela, kubalulekile ukuba uhlale ubaluleke kakhulu kwiqela. Funda ngokusemandleni akho ngomdlavuza wakho. Cela uncedo uze wamukele uncedo. Ukubandakanyeka kuluntu oluxhasayo kuluntu olungabelana nabo ngamava kunye nokuqonda.
Yenze into yokuba ube ngummeli wakho kumnonophelo wakho womhlaza. Ngokwenene yenza ukubahluko.
> Imithombo
- > Cochran, A .; Buchanan, P .; Bueno, R .; okqhubekayo. "I-Melanoma ye-Subungual: Ukuhlaziywa kweMpilo yangoku." Uphulo lwePlastiki kunye noKhuseleko . 2014; 134 (2): 259-73.
- > Nguyen, J .; Bakri, K .; Nguyen, E .; okqhubekayo. "Ulawulo loPhando lweMelanoma ye-Subungual: I-Mayo Clinic I-Casino 124." Iingxelo zePlastic Surgery . 2013; 71 (4): 346-54.
- > Ohn, J .; Choe, Y; Park, J .; okqhubekayo. "Iimpawu ze-Dermoscopic ze-Fungal Melanoychia: Uvavanyo olulinganisa kunye nezinye izizathu zeMelanonychia." Umbhalo we-American Academy of Dermatology . Oktobha 25, 2016 (Epub ngaphambi kokuprintwa).