Iinketho zonyango lweHidradenitis Suppurativa

Umxholo

• Unyango lwezihloko
• Imiphumela
• Amayeza okubulala iintsholongwane
• Imixholo yeentsholongwane
• Imiphumela
• Amayeza okubulala iintsholongwane
• Imiphumela
• Amayeza entlungu
• Imiphumela
• ICorticosteroids
• Imiphumela
• Unyango lweHormone
• Imiphumela
• Ii-retinoids
• Imiphumela
• Ibhayoloji
• Imiphumela
• Ukukhanya, ii-lasers kunye neminye imithombo yamandla
• Imiphumela
• Unyango lotyando
• Imiphumela
• Unonophelo lwenxeba
• Unyango lwendalo
• Ukuthatha

I-Hidradenitis suppurativa (HS) yimeko yesikhumba engapheliyo yokuvuvukala echaphazela abantu baseMelika. Abantu abane-HS banamava okuqhekeka kwamabala anamaqhakuva okanye abilayo kwiindawo zemizimba yabo apho ulusu luchukumisa ulusu.

Iindawo ezichaphazelekayo zinokubandakanya:

• amakhwapha
• iimpundu
• amabele
• umqala
• amathanga aphezulu

Izilonda ezibuhlungu ze-HS zinokugcwalisa nolwelo olunuka kamnandi nolunokuvuza ngaphandle kwesilumkiso.

Okwangoku alukho unyango lwe-HS. Nangona kunjalo, kukho iintlobo ngeentlobo zonyango kunye notyando lokukunceda ulawule iimpawu zakho, ngokwezikhokelo zamva nje zeklinikhi ezivela eUnited States naseCanada Hidradenitis Suppurativa Foundations.

Ukuba uhlala ne-HS, kuyanceda ukuba wazi zonke iindlela zokhetho ezikhoyo ukuze ufumane olona lufanelekileyo kuwe.

Funda ukuze ufunde malunga neendidi ezahlukeneyo zonyango lwe-HS kunye nendlela ezisebenza ngayo.

Unyango lwezihloko

Unyango lwezihloko yinto oyisebenzisa ngqo kulusu lwakho. Unyango lwezihloko lunokuza ngeendlela ezahlukeneyo, kubandakanya i-lotions, i-ointments kunye neekhrim.

Kuxhomekeka kwimveliso, unyango lwezihloko lunokusebenza ukucoca indawo echaphazelekayo, ukunciphisa ukucaphuka, okanye ukunceda ukuphilisa izilonda. Unyango lwezihloko ze-HS ziimveliso ezinje ngee-antiseptic agents okanye unyango ngamabala. Eminye imizekelo yile:

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

Olu nyango lwasentla lunokusetyenziselwa i-HS ethambileyo ukuya kumodareyitha. Ngelixa benganyangi ngokusebenzayo into ebangela imeko, banokunceda ukunciphisa ezinye zeempawu zayo.

Amayeza okubulala iintsholongwane angasetyenziselwa ukunyanga i-HS. I-clindamycin yezihloko (Cleocin T, Clinda-Derm) ithathwa njengeyona.

Imiphumela

Ukunyanga kwezihloko kunokubangela ukucaphuka kolusu. Oku kunokubandakanya iimpawu ezinje ngokubomvu, ukurhawuzelela, okanye ukuvutha komsindo.

Amayeza okubulala iintsholongwane

Ukunyanga i-HS kunokusetyenziselwa ukunyanga ii-anti-antibiotics.

Imixholo yeentsholongwane

Izihloko ze-antibiotics, ezifana ne-clindamycin (i-Cleocin T, i-Clinda-Derm), iqhelekileyo i-HS. Banokunyanga usulelo, banciphise ukudumba, kwaye bathintele izilonda ezintsha ekubeni zenziwe.

Basenokunciphisa amavumba anokuthi maxa wambi ahambisane nosulelo.

Inkqubo eqhelekileyo yonyango ngamayeza okubulala iintsholongwane anokubandakanya ukufaka into yokuthambisa kwizilonda zakho ze-HS kabini ngemini. Ixesha lonyango luyehluka kuye ngomntu.

Imiphumela

Iziphumo ebezingalindelekanga ze-anti-antibiotics zingabandakanya ukutshisa okuncinci kunye nomngcipheko wokuchasana ne-antibiotic.

Amayeza okubulala iintsholongwane

Amayeza okubulala iintsholongwane angamiselwa isifo esincinci. Nangona kunjalo, zihlala zisetyenziselwa ukumodareyitha ukuya kumatyala e-HS okanye xa unyango lwengxoxo lungakhange lusebenze.

Njengamayeza okubulala iintsholongwane, la machiza ayanceda ukunyanga usulelo kunye nokulawula ukudumba.

Ii-antibiotics zomlomo ezisetyenziselwa ukunyanga izifo ezibangelwa yi-HS zibandakanya:

• tetracycline antibiotics
• clindamycin
• Imetronidazole (Flagyl)
• moxifloxacin (Avelox)
• irifampin (Rimactane)
• dapsone

Zihlala zithathwa ngomlomo iintsuku ezi-7 ukuya kwezi-10. Amanye amatyala anokufuna ixesha elide lonyango. Kuxhomekeka kubukhali bemeko yakho, unokufumana i-antibiotics enye okanye i-antibiotics ezininzi.

Imiphumela

Iziphumo ebezingalindelekanga zomlomo zibandakanya urhudo, IClostridium difficile usulelo lwebacteria, kunye nomhlwa-mthubi ukuya kumbala omdaka kumchamo.

Amayeza entlungu

Iintlungu ezinxulumene ne-HS zinokuvela kwimithombo eyahlukeneyo, kubandakanya izilonda, amathumba kunye nokonakala. Oku kwenza ukuba ulawulo lweentlungu lubaluleke kakhulu kunyango lwe-HS.

Intlungu ehambelana ne-HS inokwahluka ngokwendalo. Umzekelo, kunokuba yinto ebukhali okanye engapheliyo kunye nokuvuvukala okanye ukunganyanzelisi.

Amayeza obuhlungu anokusetyenziswa abandakanya:

• i-lidocaine (iZtlido)
• iziyobisi ezingasebenziyo ezichasayo (ii-NSAID)
• i-acetaminophen (iTylenol)
• iiopioids
• ii-anticonvulsants

Amachiza entlungu anjenge-lidocaine ngamanye amaxesha anokusetyenziselwa ukunyanga iintlungu ze-HS. Ezi zinokusetyenziswa ngqo kwindawo echaphazelekayo.

Unyango lweentlungu zomlomo ngokubanzi lukhethwa ukulawula iintlungu ezinxulunyaniswa ne-HS. Amayeza okuqala entlungu abandakanya i-acetaminophen kunye nee-NSAID, ezinje nge-ibuprofen (Advil, Aleve) kunye ne-naproxen (Naprosyn).

Ukuba amayeza okuqala entlungu awasebenzi, ikhosi ye-opioid yexesha elifutshane inokumiselwa. I-opioid tramadol (i-ConZip, i-Ultram) inokusetyenziswa njengenye indlela ye-opioid zesiko ezinje ngecodeine kunye ne-morphine.

Ukongeza, ezinye ii-anticonvulsants, ezinje nge-gabapentin (Neurontin) kunye ne-pregabalin (Lyrica), inokusebenza ekuthomalaliseni iintlungu ze-neuropathic.

Imiphumela

Iziphumo ezahlukeneyo ezichaphazelekayo zinxulunyaniswa namayeza ahlukeneyo entlungu. Imizekelo inokubandakanya ukuphazamiseka kwesisu, isicaphucaphu kunye nokugabha, kunye nokuqhina. Ukusetyenziswa kweeopioids kukwanomngcipheko wokuba likhoboka leziyobisi.

ICorticosteroids

I-Corticosteroids inokusetyenziselwa ukunciphisa ukudumba, ukunciphisa ukudumba, kunye nokulawula iintlungu. Banokuqhutywa ngenaliti okanye ngomlomo.

I-corticosteroids ejoyiweyo, ekwabizwa ngokuba yi-intralesional corticosteroids, inokusetyenziswa kwiimeko ezinobulali. Inaliti yenziwa ngqo kwindawo echaphazelekayo kwaye inokunceda ukunciphisa iintlungu kunye nokudumba.

I-corticosteroids yomlomo isetyenziselwa ukumodareyitha ngakumbi iimeko ezinzima. Xa uthathwa ngomlomo, ii-corticosteroids zinokuchaphazela umzimba uphela. Oku kunokukunceda ukucoca izilonda ezikhoyo ze-HS kunye nokuthintela ezintsha ekubeni zenziwe.

Ikhosi yexesha elifutshane ye-corticosteroids yomlomo ingasetyenziselwa ukulawula ukuvela kweempawu.

I-corticosteroids yomlomo yexesha elide inokusetyenziswa nakwiimeko ezinzima ze-HS ezingaphenduliyo kunyango oluqhelekileyo. Nangona kunjalo, kwezi meko, kufuneka kumiselwe idosi esezantsi kakhulu.

Imiphumela

I-corticosteroids ejoyiweyo inokukhokelela kwintlungu kufutshane nendawo yenaliti, ukugungxula ebusweni, kunye nokuqaqanjelwa sisisu.

Ezinye zeempembelelo ezinokubakho ze-corticosteroids yomlomo luxinzelelo lwegazi oluphezulu, ukuzuza ubunzima, kunye nokutshintsha kwemood. Ukusetyenziswa kwexesha elide kunokukhokelela ekunciphiseni ulusu, iswekile ephezulu yegazi, kunye ne-osteoporosis.

Unyango lweHormone

I-HS icingelwa ukuba iphenjelelwe ziihomoni ezibizwa ngokuba zii-androgens. Utshintsho lwehomoni, olufana nexesha lokuya esikhathini nokukhulelwa, lunokuzenza mandundu iimpawu zeHS.

Ngenxa yesiphumo sehomoni kwi-HS, ugqirha wakho unokucebisa unyango lwehomoni njengonyango olunokubakho. Unyango lwehormone lunokunceda ukunciphisa iintlungu kunye nokunciphisa inani lokuhambisa amanzi kwizilonda ze-HS ngexesha lokutsha.

Unyango lweHormone lwe-HS lunokubandakanya ukuthatha ezi ndidi zilandelayo zamayeza:

• izinto zokucwangcisa ngomlomo eziqukethe i-estrogen
• i-spironolactone (Aldactone)
• ifinasteride (iPropecia, iProscar)
• metformin (iGlumetza)

Unyango lweHormone lwe-HS lunokuthathwa ngomlomo. Ingasetyenziselwa njengonyango kuphela (i-monotherapy) ye-HS ethambileyo ukuya kumodareyitha. Kwiimeko ezinzima, inokusetyenziswa ngokudibeneyo nolunye unyango.

Ukusetyenziswa kwezicwangcisi zomlomo ezineprogesin kuphela kuthintelwa. Kungenxa yokuba kukho ubungqina bokuba i-HS inokuba mandundu xa usebenzisa olu hlobo lonyango.

Imiphumela

Iziphumo ebezingalindelekanga zonyango lwehomoni kubafazi zinokubandakanya amahlwili egazi ukuba athathwe ngexesha lokukhulelwa. Amadoda anokuba namava okunciphisa i-libido kunye neengxaki zokuphuma.

Kwiimeko ezinqabileyo, amadoda nabasetyhini banokukhulisa izilonda zamabele njengempembelelo yecala.

Ii-retinoids

I-Retinoids ngamayeza avela kwivithamini A. Asebenza ngokunciphisa ukukhula kweeseli zolusu kwaye anokunciphisa ukudumba. I-Retinoids inokusetyenziselwa ukunyanga iimeko ezahlukeneyo zolusu, kubandakanya amabala kunye ne-psoriasis.

Ii-retinoids zomlomo zinokuba luncedo kwabanye abantu abane-HS. Ukuba umiselwe i-retinoid yomlomo kwi-HS yakho, iya kuba yenye yezi:

• Isotretinoin (Amnesteem, Claravis)
• iacitretin (iSoriatane)

Ii-retinoids zomlomo zicetyiswa kuphela njengonyango lwesibini okanye lwesithathu lonyango lwe-HS. Banokumiselwa ukuba amabala aqatha avela kunye nezilonda ze-HS.

Imiphumela

Ii-retinoids zomlomo akufuneki zithathwe ngexesha lokukhulelwa, njengoko zinokukhokelela kwiziphene ezinzima zokuzalwa. Ezinye iziphumo ebezingalindelekanga ezinokubakho zibandakanya ulusu olomileyo, imilebe eqhekekileyo, kunye nokulahleka kweenwele okwexeshana.

Ibhayoloji

Kwiimeko ezinzima ze-HS ezingaphenduliyo kwi-antibiotics okanye unyango lwe-hormone, iziyobisi ze-biologic zinokukhetha. I-Biologics inceda umzimba wakho ukuba ulwe ne-HS ngokujolisa kumalungu omzimba wakho akhuthaza ukudumba.

I-Biologics ilawulwa ngenaliti okanye ukufakwa ngaphakathi (IV). Zihlala zithathwa ngeveki kwaye zinokulawulwa ekhaya okanye esibhedlele okanye eklinikhi ngugqirha.

Olona nyango kuphela lwe-HS oluvunyiweyo luLawulo lwezoKutya kunye noLawulo lweziyobisi (i-FDA), kwaye olunobungqina obunamandla bokusebenzisa, yi-adalimumab (Humira). Le biologic ivunyiwe ukuba inyange iHS ngokuphakathi.

Ezinye i-biologics, ezifana ne-infliximab (Remicade) kunye ne-anakinra (iKineret), inokusebenza kakuhle ekuphatheni i-HS.

Imiphumela

Iziphumo ezinokubandakanya:

• iintlungu kufutshane nendawo yenaliti
• ifiva
• ubunzima bokuphefumla
• uxinzelelo lwegazi oluphantsi
• ukwanda kwengozi yosulelo

Ukuba ufumana usulelo, ugqirha wakho uya kuyeka ukusebenzisa i-biologics kwaye ajonge ezinye iindlela zonyango.

Zininzi kodwa iziphumo ebezingalindelekanga ezibi zinokubandakanya iimpawu zemithambo-luvo kunye nokusilela kwentliziyo. I-Biologics nayo inokubangela ukwanda kwengozi ye-lymphoma. Thetha nogqirha wakho malunga nezibonelelo kunye nobungozi bonyango.

Ukukhanya, ii-lasers kunye neminye imithombo yamandla

Imithombo emininzi yamandla inokuqwalaselwa ukunceda ukunyanga i-HS. Ezi zihlala zisetyenziselwa ukumodareyitha ukuya kwi-HS kodwa zingasetyenziselwa iimeko ezinobulali.

Olunye lwezi ndlela lubandakanya ukusebenzisa i-laser ukunyanga izilonda ezisebenzayo. Amandla avela kwi-laser anokutshabalalisa iifollic zeenwele, ukunceda ukucoca izilonda ze-HS. Olu hlobo lonyango lunokubandakanya iiseshoni zonyango ezine ukuya kwezine.

Unyango lwe-Photodynamic lusebenzisa iziyobisi ezibizwa ngokuba ziifotosensitizers kunye nomthombo okhanyayo wokubulala iiseli ezingaqhelekanga. Amachiza e-photosensitizing drug asetyenziswa ngokwemixholo okanye afakwe kwizilonda. Iiseli ze-HS ziyalifunxa eli chiza. Xa umthombo wokukhanya uvuliwe, iyeza liphendula kunye neeseli kwaye zibangele ukuba bafe.

Unyango ngemitha lukwasetyenziselwa ukunyanga i-HS kwaye lunokukhokelela ekuphuculeni kwabanye abantu. Nangona kunjalo, kuba kubandakanya ukuveza umzimba wakho kwimitha, ugqirha wakho uya kuncoma ezinye iindlela zonyango kuqala.

Imiphumela

Kungenzeka ukuba uzive ungonwabanga ngexesha lezi nkqubo. Ezinye iziphumo ezinokubakho emva kwexesha zinokubandakanya ukungonwabi okwethutyana, ukuba bomvu, okanye ukudumba kwindawo enyangiweyo.

Unyango lotyando

Iindlela ezahlukeneyo zotyando ziyafumaneka kunyango lwe-HS, ukusukela ekucocweni okuncinci ukususwa ngokupheleleyo kwesikhumba esichaphazeleka zizilonda.

Nokuba ukulungele na utyando lwe-HS kuxhomekeke kubukhali be-HS yakho kunye nendlela ophendula ngayo kwezinye iindlela zonyango.

Abantu abane-HS ebukhali engaphendulanga kwezinye iintlobo zonyango bangabagqatswa abafanelekileyo kotyando. Iimpawu ze-HS ezinzima zingabandakanya:

• izilonda ezandayo okanye amathumba
• izilonda
• amatonela amaninzi okudibanisa phantsi kolusu

Ezinye zeendlela zotyando ezinokusetyenziswa zibandakanya:

• Ukuphelisa: Ugqirha ususa izicwili ezingaphezulu kwetonela okanye amathumba, avumela indawo ebonakalayo ukuba inyange. Le ndlela isetyenziselwa izilonda eziphindaphindayo okanye iitonela.
• Ukuxhamla: Ugqirha ususa isilonda kunye nolunye ulusu olusempilweni. Oku kunokufezekiswa nge-scalpel, laser, okanye isixhobo sombane. Isetyenziselwa izilonda ezibanzi, eziphindaphindayo.
• Ukuzikhupha kunye nokuhambisa amanzi: Ugqirha ukhupha isilonda esinye okanye ezibini emva koko azisuse. Oku kucetyiswa kuphela ukubonelela ngoncedo lwexeshana elifutshane kwizilonda ezingenamithambo.

Ukuba ucinga ukuba ungangumgqatswa ofanelekileyo woqhaqho, thetha nogqirha wakho malunga nokuba loluphi ukhetho olulungele wena.

Imiphumela

Ezinye zeziphumo ebezingalindelekanga ezinokubakho zotyando lwe-HS zibandakanya ukonakala okanye usulelo kwindawo yotyando. Ukongeza, utyando luphatha indawo ethile kuphela, ngenxa yoko izilonda zinokuvela kwiindawo ezintsha.

Unonophelo lwenxeba

Unonophelo lwenxeba emva kotyando lwe-HS lukwabaluleke kakhulu. Ugqirha wakho uya kukhetha isinxibo esifanelekileyo esekwe kwindawo kunye nobungakanani botyando. Banokucebisa nangokusebenzisa into yokuhlamba i-antiseptic ngexesha lokuphilisa.

Xa ukhathalela inxeba emva kotyando lwe-HS, kubalulekile ukulandela ezona ndlela zibalaseleyo zokukhathalela inxeba, kubandakanya:

• soloko uhlamba izandla zakho ngaphambi kokuchukumisa indawo
• ukunqanda iimpahla ezinokuthi zihlikihle enxebeni
• ukulandela imiyalelo kagqirha wakho malunga nokucoca inxeba lakho rhoqo kwaye kaninzi kangakanani okanye ukutshintsha indlela elinxiba ngayo
• Ukujonga ngononophelo imiqondiso yosulelo olunokubakho

Unyango lwendalo

Kukho iindlela ezimbalwa zonyango kunye neendlela zokuguqula indlela yokuphila enokuthi incede kwi-HS yakho.

Ukutshaya iisigarethi kunye nokuba ngaphezulu komndilili wobunzima kuye kwaba kukuqaqamba kwesifo se-HS. Ukuziqhelanisa nokulungiswa kwendlela yokuphila njengokuyeka ukutshaya kunye nokugcina ubunzima obulinganiselweyo kunokunceda ukulawula kakuhle iimpawu zakho.

Ukongeza, kukho eminye imisebenzi enokuthi icaphukise isikhumba sakho. Unokukufumanisa kuluncedo ukunqanda ukwenza ezi zinto zilandelayo kwindawo ekufutshane okanye ejikeleze indawo echaphazelekayo:

• unxibe iimpahla ezixineneyo okanye ezithintelayo
• Ukucoca ngezixhobo ezirhabaxa ezinje ngeebrashi okanye amalaphu okuhlamba
• usebenzisa iibhandeji zokubambelela
• ukusebenzisa iimveliso ezinokuqulatha izinto ezingafunekiyo, njengezicoci okanye iziqholo
• utsheva

Kukho into ebonisa ukuba isongezelelo sokutya, ngakumbi nge-zinc, sinokunceda abantu abane-HS emnene ukuya phakathi. Ngenxa yoku, ugqirha wakho unokuncomela izongezo zomlomo zinc. Musa ukuyibaxa, nangona kunjalo - i-zinc eninzi inokubangela isisu esibuhlungu.

Ukuphepha ukutya okuqulathe ubisi okanye igwele lomenzi kunganceda abanye abantu abane-HS. Nangona kunjalo, uphando oluthe kratya luyafuneka ukuxhasa oku.

Ukuthatha

Zininzi iindlela zonyango ezinokubakho zeHS, nganye inezibonelelo zayo kunye neziphumo ebezingalindelekanga ezinokubakho. Loluphi unyango (okanye unyango) olunokucetyiswa kuwe oluya kuxhomekeka kubukhali bemeko yakho.

Kubalulekile ukuxoxa ngokucokisekileyo ngonyango lwakho kunye nogqirha wakho. Qiniseka ukuba ubazisa ukuba ngaba ufumana naziphi na iziphumo ebezingalindelekanga ngexesha lonyango kwaye nokuba uvulekile ukuzama naluphi na unyango olutsha. Ukusebenza kunye kunokukunceda ulawule i-HS yakho.