Kwamanye amaCandelo, iiNyango zeMibandela emiBini zingadlulela
Abantu abanezifo zesibindi (UBD) ngamanye amaxesha bahlakulela ezinye izifo okanye iimeko ezibizwa ngokuba yimibonakalo yangaphezulu yamathumbu (okanye ngamanye ama-EIM) . Izimo zesikhumba ziqhelekileyo kubantu abane-IBD, kwaye enye ihlala iqhubeka rhoqo kubini kubantu bonke kunye nabantu abane-IBD yi- psoriasis . Abantu abaninzi banokucinga nge-psoriasis njengento yokukhawuleza, kodwa ngokwenene imeko yenkqubo kwaye inokwabelana ngendlela efanayo yokuvuvukala njengesifo sikaCrohn.
Ngenxa yokuba le mibini mibi ingabangelwa yinkinga ekusebenzeni kwe-immune system, bahlala bephathwa ngamanye amayeza afanayo. Kubantu abane-IBD nabo bane-psoriasis, zombini iimeko zingabangela ukuba zikhethwe xa unyulwa unyango.
Kukho iintlobo ezahlukeneyo zonyango olusebenzayo kwi psoriasis sele sele ikhona kwaye ezinye ziphuhliswa ngoku. Abantu abane-psoriasis kunye ne-IBD baya kufuna ukunyamekela kwi-dermatologist enamava kunye ne-IBD kwaye iza kusebenza ngokusondeleyo ne- gastroenterologist .
Yintoni i-Psoriasis?
I-Psoriasis iyisifo sesistim ekhangela ukugquma kwesikhumba. Ukugqithwa kungabonakala kuyo nayiphi na inxalenye yomzimba, kodwa kaninzi kuboniswa kwiindawo, iidolo, kunye ne-scalp kodwa kunokufunyanwa kwimilenze, ipiki kunye ne-trunk. Uhlobo oluqhelekileyo lwe-psoriasis lubizwa ngokuthi i-plaque psoriasis kunye neeplates zingabangela ubunzima okanye ukutsha.
I-Psoriasis ihamba ngexesha lokutshatyalaliswa kunye nokuxolelwa. Kwiimeko ezininzi, i-psoriasis iyaphathwa ngama-creams.
I-Psoriasis efana neyiphi na abantu abane-IBD?
I-IBD ithathwa njengesimo sokukhusela umzimba. Akuqhelekanga kubantu abanesifo esisigxina-mzimba ukuhlakulela omnye. I-IBD kunye ne-psoriasis zombini izimo ezinesizathu esingaziwa (esibizwa ngokuba yi-idiopathic disease) kwaye zibangele ukuvuvukala.
Kwiminyaka yakutshanje abaphandi bafumanisa ngakumbi malunga nokuxhamla phakathi kwe-IBD kunye nezifo ze-psoriatic. I-Psoriasis ebantwini ngokubanzi iyaqhuba malunga nama-2 eepesenti ukuya kuma-3 ekhulwini kodwa abantu abane-IBD bahlala bephakamileyo. Izifundo zibonisa ukuba abantu abanesifo sikaCrohn kunye nesifo sezilonda zesilonda sinokuphuhlisa i-psoriasis kwisantya malunga nama-13 ekhulwini.
Indlela eVuthileyo yokuvutha
Njengoko abaphandi bafumanisa ngakumbi ngeendlela ezivuthayo ze-IBD kunye ne-psoriasis, ezinye zihamba phakathi kwezi zimbini izifo ziyafunyanwa. Isifo sikaCrohn kunye ne-psoriasis zombini ziqwalaselwa njengeT1 izimo ezidibeneyo. I-Th1 yiseli yesistim ephakamisa impendulo evuthayo xa umzimba uhlaselwa yintengiso yangaphandle, njenge-parasite, ibhaktheriya okanye intsholongwane. I-ulcerative colitis ithathwa njenge-Th2-like conditioned condition. Iifayile zeT2 ziyasebenza xa kukho ibhaktheriya, impendulo ye-allergen, okanye i-toxin ekhoyo. Njengoko indima yale T cells iqondwa kangcono ngokubhekiselele kuphuhliso lwe-IBD kunye ne-psoriasis, kunokukhokelela ekudalweni kwamanyathelo angaphezulu kwezi zifo.
Ngaba Ukuba ne-Psoriasis Yandisa Ingozi Yokuphuhlisa IBD?
Kukho izifundo ezimbalwa kuphela ezijonga ingozi ye-IBD kubantu abaye bafumanisa ukuba bane-psoriasis.
Bakhombise iziphumo eziphikisanayo: Abanye baye babonisa ingozi ephezulu ye-IBD kulabo abane-psoriasis nabanye baye babonisa okuchaseneyo. Ukongezelela, iindlela ezazisetyenziselwa kwezi zifundo zazingekho ngaphandle kwazo, ezenza izigqibo zibe nzima ukuma. Okwangoku, awaziwa ukuba yintoni umngcipheko, kodwa kubonakala ngathi yinto ejongene nabantu abane psoriasis abanomngcipheko okhulayo wokuphuhlisa isifo sikaCrohn. Okufanayo akunako ukunyaniseka kwi-ulcerative colitis: Kukho ubungqina obuncinane bokuthi abantu abane-psoriasis basenokuba besengozini yokwanda kwe-ulcerative colitis.
Iingcebiso zonyango kunye noLwaphulo lwe-Psoriasis
Kukho unyango oluninzi lwe-psoriasis, kubandakanywa unyango olumandla, unyango lwamayeza, kunye neyeza. Kwiimeko ezininzi, unyango olungaphezulu kweyodwa lunokusetyenziswa ngexesha elifanayo ukulwa neempawu ze-psoriasis. Ngokuqhelekileyo, iindlela zokwelapha zeengqungquthela zingasetyenziswa kuqala, ngaphambi kokuba ziqhubele phambili ekukhanyeni unyango okanye imishishini ye-systemic.
- Zonyango. Kukho iintlobo ezahlukeneyo zeekram kunye namafutha angasetyenziselwa i-psoriasis, zombini kwi-counter kunye nemithi. Ezinye zezinto ezibandakanyekayo ziquka i- corticosteroids , i- vitamin D , i-retinoids, i- anthralin , i- calcinurin inhibitors (i-Protopic ne-Elidel) , i-salicylic acid kunye ne- tar yamakha . Kwezinye iimeko i-moisturizers ingasetyenziselwa ukulwa nokuma.
- Uphulo lo kukhanya. UkuKhanya okuqukethe i-ultraviolet A kunye ne-ultraviolet B ingasetyenziselwa ukuphatha i-psoriasis. Oku kudla ngokusetyenziswa kunye namanye amachiza. Ukukhanya kwelanga ukusuka ngaphandle kungasetyenziswa, ixesha elifutshane. Iimitha ezinobungozi zingaphathwa kwakhona nge-phototherapy ngepaneli yokukhanya, ibhokisi, okanye idokodo. Kwiimeko ezinzima, unyango olwenza ulusu lube lukhuni ngakumbi ekukhanyeni kwe-ultraviolet lungasetyenziselwa ngexesha elifanayo njengonyango olulula ukuze luphumelele. Olunye uhlobo lwe laser kananjalo lusetyenziswa ngenxa yokuba lukwazi ukujolisa kwiindawo ezithile emzimbeni ngeqondo elomeleleyo lokukhanya kwe-ultraviolet B.
Amachiza asetyenziswa ukunyanga i-Psoriasis
Ngenxa yokuba i-psoriasis isifo se-systemic, amayeza anikezwa ngomlomo okanye ngejojo ​​angasetyenziswa. Kwezinye iimeko, amayeza avunywe ukunyanga i-psoriasis anikezelwa ukunyanga enye okanye iindidi ze-IBD, kuquka i-methotrexate, i-cyclosporine, kunye nezinye zezinto eziphilayo:
- I-Cosentyx (secukinumab) : I- Cosentyx yi-anti-monoglonal antibody evunyelwe ukunyanga i-psoriasis, i-psoriatic arthritis, kunye ne-arthritis echaphazelekayo ne-IBD ebizwa ngokuba yi-spondylitis e-ankylosing, nangona ayivunyelwe ukuphatha nayiphi na uhlobo lwe-IBD. I-Cosentyx inikezelwa ekhaya nge-injection kunye neepen okanye i-syringe ekhethiweyo. Iziphumo eziqhelekileyo ziquka iimpawu ezibandayo, isifo sohudo kunye nezifo eziphezulu zokuphefumula.
- I-Cyclosporine : I- Cyclosporine iyisistim e-immunosuppressant esisetyenziselwa ukuphatha iimeko ezinzima ze psoriasis kwaye ngamanye amaxesha zisetyenziswa kwisifo sikaCrohn. Ezinye zeziphumo eziqhelekileyo ezichaphazelekayo zibandakanya intloko yesifo, ukukhushulwa kwegazi, ukunyuswa kwegazi kunye nokukhathala. Akuxhaswanga ngokusetyenziswa kwexesha elide kwimeko ye psoriasis, kwaye ngokuqhelekileyo iyanqanyulwa phantsi konyaka.
- I-Enbrel (etanercept) : I- Enbrel yimiyeza ye-biologic evunyelwe ukuphatha i-psoriasis kunye ne-spondylitis e-ankylosing. I-blocker ye-TNF, kodwa ayisetyenziswanga ukuphatha nayiphi na indlela ye-IBD. I-Enbrel ijojowe ekhaya kwaye igalelo eliqhelekileyo elisecaleni linokuphendula kwisayithi yokujova, njengobomvu okanye intlungu.
- Humira (adalimumab) : I- Humira iyilwayeza ejoyiweyo esetyenziswa ekuphatheni isifo sika-Crohn kunye ne-ulcerative colitis kunye ne-psoriasis. Izigulana zikwazi ukuzinika uHuma ekhaya ngenxa yokuba ziza kwi-penicular pen pen. Eli nyanga li-antioclonal antibody kwaye lihlelwa njenge-TNF-inhibitor. Umphumo oqhelekileyo ochaphazelekayo intlungu okanye ukucasula kwisayithi yokuxilongwa, ephathwe ekhaya ngeqhwa okanye i-antihistamines.
- I-Methotrexate : La mayeza anganikwa ngomlomo okanye ngejojo, kwaye isetyenziselwa ukuphatha i-psoriasis kunye nesifo sikaCrohn kunye nesipulylitis engavumelaniyo. Ezinye zeempembelelo zibandakanya izibilini, intloko nokulala. Abasetyhini abafumana i-methotrexate mabaphephe ukukhulelwa kuba le nkunkuma ingabangela ukungabikho komntwana. I-Methotrexate idlalwa kunye namanye amayeza e-IBD kunye / okanye kwi-psoriasis.
- I-Otezla (apremilast) : I- Otezla yonyango lomlomo kwaye iyona yokuqala evunyelwe ukusetyenziswa ekuphatheni i-psoriatic arthritis kubantu abadala kwaye ivunyiwe ukuba isebenziswe kwi-plaque psoriasis. Iimiphumo eziqhelekileyo ezibikwe ngokuqhelekileyo ngexesha lokuvavanywa klinikhi kwakuyi-nausea, intloko yesifo, kunye ne-diarrhea, kodwa ezi zidla ngokuphucula emva kweeveki ezimbalwa zonyango.
- U-Stelara (ustekinumab) : UStela wavunywa kuqala ukuba aphathe i-psoriasis kwaye ngoku ivunyiwe kwakhona ukuphatha isifo sika-Crohn. I-Stelara yipilisi ye-biologic eyi-interleukin (IL) -12 kunye ne-IL-23. U-Stelara uqale wanikwa ngu-IV kodwa emva kokuba umthamo wokuqala unikezwa ekhaya nge-injection. Iziphumo eziqhelekileyo ezibandakanyeka zibandakanya ukuziva utyhafile, ukusabela kwisayithi yokuxilongwa, intloko yesifo, kunye neempawu ezibandayo.
ILizwi
Ubu bungqina bume bokuba i-psoriasis ne-IBD zithandana ngokuphindaphindiweyo kunokuba zicingwe kumashumi eminyaka edlulileyo. Akukacaci ukuba i-psoriasis yenza ukuba kubekho umntu oza kuphuhlisa uhlobo lwe-IBD. Kwezinye iimeko amayeza asetyenziswa ukuphathwa kwe-IBD asetyenziswa ukuphatha i-psoriasis. Uninzi lweziganeko ze-psoriasis zithathwa njengento enomlinganiselo ukuya kumodareyitha kwaye zingaphathwa ngonyango olulula okanye unyango lwamayeza. Kwiimeko ezinzima ze psoriasis, apho iipesenti ezi-5 ukuya kwi-10 ekhulwini okanye ngaphezulu komzimba zichaphazelekayo, imithi yomlomo okanye i-biologics ingasetyenziswa kwakhona. Njengokuba ne-IBD, kubalulekile ukuqhubeka unyango lwe-psoriasis ukwenzela ukukhusela ukuhlaselwa. Kukho unyango olutsha lwe-psoriasis okwangoku olufundiswayo, kwaye ikamva ukwenzela unyango lwe-psoriasis liqaqambile.
> Imithombo:
> Gisondi P, Del Giglio M, Cozzi A, Girolomoni G. "I-Psoriasis, isibindi, kunye nesondlo sesisu." Dermatol Ther . Ngo-2010 uMar-Apr; 23: 155-159.
> Li WQ, Han JL, Chan AT, Qureshi AA. "I-Psoriasis, isifo se-psoriatic kunye nomngcipheko ophezulu weganeko likaCrohn kwi-Women's US." Iziganeko zezifo ze-rheumatic . 2013; 72: 1200-1205.
> DJ Najarian, uGottlieb AB. "Unxibelelwano phakathi kwe-psoriasis nesifo sikaCrohn." J Am Acad Dermatol . 2003 Juni; 48 (6): 805-821; Imibuzo 822-824.
> Strober W, Fuss IJ. "Iiprotokines ze-Pro-Inflammatory kwi-Pathogenesis ye-IBD." Gastroenterology . 2011; 140: 1756-1767.