Mankhwala atsopano a biologic amapereka chiyembekezo kwa odwala matenda aakulu
Ngakhale kuti palibe mankhwala a plaque psoriasis osatha, pali mankhwala osiyanasiyana omwe angathandize kuchotsa mamba ndi kuteteza maselo a khungu kukula mosavuta. Zosankha zimaphatikizapo mafuta onunkhira, mankhwala opatsirana, ndi mankhwala osokoneza bongo omwe amatengedwa pamlomo kapena mwa jekeseni. Kusamalira khungu kotheratu komanso zosankha za moyo wanu kungakuthandizenso kuthetsa matenda omwe akukhudzabe anthu ambiri a ku America okwana 7.5 miliyoni, malinga ndi American Academy of Dermatology.
Malemba
Matenda a corticosteroids, omwe amadziwikanso kuti steroids, amaonedwa kuti ndiwo njira zothandiza kwambiri pochizira psoriasis yofatsa. Komabe, ngati matenda aakulu osadziwika , plaque psoriasis angafune zambiri. Nthaŵi zina, yankho lokhazikitsidwa mwadzidzidzi liyenera kukhala lotetezedwa kuti thupi lisapweteke. Pofika pamapeto pake, madokotala amayamba kugwiritsa ntchito mankhwala omwe amathandiza kuti chitetezo cha mthupi chitetezedwe, kaya chimagwiritsidwe ntchito (monga lonse) kapena mbali.
Masewero a Corticosteroids
Mankhwala otchedwa corticosteroids amagwiritsidwa ntchito ngati mankhwala opatsirana kwa anthu omwe ali ndi psoriasis yofatsa, ndipo amatha kugwiritsidwa ntchito limodzi ndi mankhwala ena mwa anthu omwe ali ndi vuto lalikulu.
Ngati ndikufotokozera a topical steroid, dermatologist yanu idzaona malo omwe muli malo anu komanso mwamphamvu. Kwa iwo omwe ali pamaso kapena kumaliseche, mphamvu yowonjezera, 1.0% yokonzekera ikhoza kulamulidwa, pamene sing'anga-high-potency steroid ingagwiritsidwe ntchito kumbali zina za thupi.
Mankhwala a steroid amapezeka ndi mankhwala komanso mankhwala osiyana siyana, mavitamini, mafuta onunkhira, shamposi, mavuvu, ndi sprays. Ngakhale kugwiritsidwa ntchito, kugwiritsa ntchito nthawi yaitali kapena kugwiritsira ntchito mopitirira muyeso kungapangitse khungu atrophy (kupatulira khungu), vuto lomwe nthawi zambiri silingatheke.
Mankhwala Osagwiritsa Ntchito Mankhwala
Mankhwala osakhala a biologic ndiwo omwe apangidwa mu labu.
Pali zitatu zomwe sizili biologics zomwe zimagwiritsidwa ntchito popanga psoriasis yala:
- Methotrexate ndi mankhwala osokoneza thupi omwe akhalapo kwa zaka zopitirira 50 ndipo amagwira ntchito pochepetsa mphamvu ya chitetezo cha mthupi. Amagwiritsidwa ntchito pa mankhwala oyambirira a psoriasis. Poletsa chitetezo cha m'thupi mwathunthu, methotrexate ingayambitse zotsatira zoyipa kuchokera ku chiwindi cha poizoni mpaka kuponderezedwa kwa mafupa. Kuyezetsa magazi nthawi ndi nthawi kumafunika kuti mupewe matenda ovuta.
- Cyclosporine ndi mankhwala osokoneza thupi omwe amachititsa kuti thupi likhale lopanda mphamvu. Amagwiritsidwa ntchito pamene psoriasis ndi yaikulu kapena sanayankhepo kwa mankhwala osakaniza amodzi. Pamene cyclosporine imagwira ntchito mwamsanga pa chitetezo cha mthupi, imakhalanso kuyang'anira zotsatira zoyipa, kuphatikizapo kuthamanga kwa magazi, chiwindi cha chiwindi, ndi kufooka kwa impso.
- Otezla (apremilast) inavomerezedwa mu 2014 kuti athandize psoriasis ndi psoriatic nyamakazi , mtundu wa nyamakazi ya nyamakazi yofanana kwambiri ndi psoriasis. Otezla amagwira ntchito mwa kutseka puloteni, yomwe imatchedwa phosphodiesterase 4, yomwe imachititsa kutupa kwa maselo. Ngakhale kuti Otezla amalekerera bwino, zingayambitse kutsekula m'mimba, kupweteka kwa mutu, kapena kupweteka mutu. Kawirikawiri, anthu amatha kulemera kapena zizindikiro za kuvutika maganizo.
Mankhwala Osokoneza Bongo
Mankhwala osokoneza bongo ndiwo opangidwa kuchokera ku mapuloteni a anthu kapena a nyama. Chiwerengero chowonjezereka cha biologics chavomerezedwa kuti chithandizo cha psoriasis yapamwamba kwambiri. Mosiyana ndi methotrexate, biologics imalimbikitsa chigawo china cha chitetezo cha mthupi osati mphamvu ya chitetezo cha mthupi.
Zamoyo zimaperekedwa ndi jekeseni kapena intravenously (kudzera mu mitsempha). Kawirikawiri amaperekedwa kwa anthu omwe ali ndi psoriasis ovuta kwambiri omwe sanachitepo mankhwala ena.
Maofesi omwe amavomerezedwa tsopano akuwongolera gawo limodzi mwa magawo atatu a chitetezo cha mthupi:
- Cimzia (certolizumab), Huma (adalimumab) , Enbrel (etanercept) , Remicade (infliximab) , ndi Simponi (golimumab) chivomezi cha tumor necrosis (TNF) .
- Stelara (ustekinumab) , Costyx (secukinumab) , Siliq (brodalumab), Taltz (ixekizumab), ndi Tremfya (guselkumab) amateteza mitundu yosiyanasiyana ya interleukin, mapuloteni opangidwa ndi maselo oyera a magazi omwe amachititsa kuti chitetezo cha mthupi chitetezeke.
- Orencia (abatacept) imateteza mtundu wina wa t-cell , womwe umatetezedwa ndi chitetezo cha thupi.
Monga mankhwala osokoneza bongo angapangitse chiopsezo chotenga kachilomboka, kudulidwa kulikonse, kupweteka, kapena chizindikiro cha matenda ayenera kuchiritsidwa ndi dokotala. Zotsatira zoyipa zimaphatikizapo kupweteka kwa tsamba, kupweteka kwa kupuma, ndi zizindikiro za chimfine. Nthawi zambiri, khansa zina ndi zizindikiro za neurologic (monga kugunda ndi multiple sclerosis) zingapangidwe.
Mankhwala othandiza
Palinso mankhwala ambiri omwe amagwiritsidwa ntchito pochirikiza psoriasis:
- Calcipotriol (calcipotriene) ndi mavitamini D3 analog omwe anayamba kufalitsidwa m'zaka za m'ma 1990 pofuna kuchiza pshalaasis. Amakhulupirira kuti amachititsa kuti zizindikiro ziziyenda bwino mwa kuchepetsa kuchulukitsidwa kwa keratinocytes pakhungu. Mavitamini ena a vitamini D3 amaphatikizapo calcitriol ndi tacalcitol.
- Tazorac (tazarotene) ndi mankhwala opangira mavitamini A omwe amatha kuchepetsa maselo a khungu ndi kuchepetsa kutupa. Ikugulitsidwanso pansi pa mayina a brand Avage ndi Fabior. Zotsatira zoyipa zimaphatikizapo kukwiya kwa khungu komanso kutentha kwa dzuwa.
- Soriatane (acitretin) ndi retinoid ya pamlomo yomwe nthawi zina imathandizidwa ndi mankhwala a kuwala kwa UV. Zotsatirapo zimaphatikizapo kutupa pamlomo, tsitsi lotha, komanso kuyanika kwa maso, mphuno, ndi pakamwa.
Tazorac ndi Soriatane onse amadziwika kuti ali ndi kachilombo koyambitsa X mankhwala ndipo sangagwiritsidwe ntchito panthawi ya mimba chifukwa cha zoopsa za kubala.
Mankhwala
Kuwala kwa dzuwa kungakhale kothandiza kuthetsa psoriasis, koma kutuluka kwa nthawi yayitali kungayambitse kutentha kwa dzuwa ndi kuwonjezereka kwa zizindikiro. Pachifukwa ichi, mankhwala a kuwala kwa UV, omwe amadziwikanso kuti phototherapy , akhala njira yabwino kwa iwo omwe amalephera kuyankha mankhwala okha.
Mazira a Ultraviolet B (UVB), makamaka, amatha kulowa mkati mwa khungu ndipo amachepetsa kuchulukitsa kwa maselo a khungu popanda kuvulaza. Mankhwala angakhoze kuchitidwa ku ofesi ya dokotala kapena ndi nyumba yoyumba. Mulimonsemo, njirayi iyenera kutsogoleredwa ndi dermatologist yomwe imapezeka pachithunzi. Ngakhale khungu lanu lingayambe kuwonjezeka kuti likhale labwino, kusinthasintha nthawi zambiri kumawathandiza zotsatira zabwino.
Njira ina yothandizira kuwala, yotchedwa psoralen + UVA (PUVA), imagwiritsa ntchito ma radiation a UVA ndi mankhwala othandizira kuwala monga psoralen, omwe amalankhula pamlomo kapena pamutu. PUVA ndi yothandiza kwambiri psoriasis yokhala ndi mapepala osasunthika kusiyana ndi maulendo oopsa.
Mankhwala Oposa Amphamvu
Kuphatikiza pa malemba osagwiritsidwa ntchito osakaniza a corticosteroids, palinso zinthu zina zamtundu wambiri (OTC) zomwe zimapezeka kuti zithetse psoriasis.
Monga ena angagwiritse ntchito bwino kuposa ena (ndipo ena angakhale ovuta kwambiri kwa inu), nkofunika kulankhula ndi dermatologist musanagwiritse ntchito iliyonse.
Zina mwazofunika kwambiri:
- Mafuta a malasha akhala akugwiritsidwa ntchito pochiza psoriasis kwa zaka zoposa 100, ndipo palinso ena omwe amalumbirabe. Katemera wa malasha amapezeka popanda mankhwala ndipo angapezekedwe m'makonzedwe osiyanasiyana, kuphatikizapo shampoo, mafuta onunkhira, lotions, creams, ndi foams. Ngakhale zotsitsimula, zina mwazinthu zingakhale zosokoneza komanso ngakhale pang'ono.
- Salicylic acid ndi mankhwala othandiza kuchepetsa ndi kuchotsa mamba. Amakhala ndi mitundu yosiyanasiyana yowonjezera mafuta, mavitamini, ndi mafuta onunkhira. Pewani kugwiritsira ntchito mankhwala opangidwa ndi salicylic, ndipo musagwiritse ntchito pa magawo 20 peresenti ya thupi, chifukwa izi zingayambitse kupaka mankhwala ndi poizoni. Musagwiritse ntchito pa ana.
Zothetsera Pakhomo ndi Moyo Wamoyo
Ngakhale pali mankhwala ochulukirapo omwe alipo komanso mankhwala OTC omwe amapezeka kuti athetse psoriasis, pali mankhwala ochizira komanso zochepetsera khungu zomwe zingathandizenso.
Zothetsera Pakhomo
Cholinga chachikulu cha mankhwala ochiritsira kunyumba ndiko kuchepetsa kutentha, kutentha, ndi kusokonezeka kwa malowa pamene kuchotsa mosavuta maselo a khungu popanda magazi.
Mwa zina mwazomwe mungachite bwino:
- Kusamba kwa mankhwala opangidwa ndi mchere wa Epsom, mafuta a mchere, mkaka, kapena maolivi kungathetsere khungu pang'onopang'ono kukweza mamba kuchokera kunja kwa khungu (epidermis). Gwiritsani madzi okha ofunda; Madzi otentha amatha kuchotsa mafuta ndi kuzisiya khungu kusiyana ndi kale lonse.
- Mafuta osapaka mafuta onunkhira, monga mafuta odzola mafuta, aloe vera gel, kapena mafuta odzola, angathandize kuthana ndi maselo pakumeta khungu. Mitengo yodulayiyi iyenera kugwiritsidwa ntchito itatha kusamba kuti iwononge kutaya kwa chinyezi.
- Monga taonera, kuwala kwa dzuŵa kumachepetsa kuwonjezereka kwa maselo a khungu koma kumafunika kuchepera kwa mphindi khumi zokha patsiku. Mukhoza kupititsa patsogolo nthawi yowonjezerapo koma nthawi zonse muzichita masewera olimbitsa thupi a SPF 30.
Njira yokwanira yoperekera mankhwala a psoriasis nthawi zonse iyenera kukhala yochita masewera olimbitsa thupi, kuchepetsa kupanikizika, chakudya chochepa cha mafuta omega-3 fatty acids, komanso kupeŵa mowa ndi ndudu.
Chisamaliro chakhungu
Kusamala bwino khungu n'kofunika kuti muzitha kuika zizindikiro za psoriasis. Pakati pa izi ndiko kupeŵa sopo zamadzimadzi, zowonongeka, ndi zakumwa zozizira. Izi zikhoza kuyambitsa khungu lanu lodziwika bwino ndipo zingayambitsenso.
Zowonjezereka zothandizira khungu ndi:
- Sambani khungu lanu kamodzi tsiku ndi tsiku kuti mupewe kuyanika.
- Sankhani sopo wofatsa kapena kuyeretsa kwa psoriasis.
- Gwiritsani ntchito nsalu yofewa kapena manja anu kuti mutenge. Musagwiritse ntchito loofah kapena chirichonse chomwe chingathe kukanda kapena kukwiyitsa khungu lanu.
- Sambani ndi madzi ofunda. Madzi otentha amachititsa mitsempha yowonongeka kale kuti iwonjezeke kwambiri ndipo ingathe kuchotsa mafuta ambiri a thupi.
- Musapitirire-sopo khungu lanu. Mukamachita zambiri, khungu lanu lidzakhala lofewa. Sopo sopo okha m'thupi lanu omwe amafunikira izo.
- M'miyezi yozizira, sungani mavitamini ochepetsetsa kuti mukhale ndi zonona zobiriwira kuti muthe kuchepa kwa chinyezi.
- Pewani zonunkhira ndi zitsamba zomwe ziri ndi mowa.
- Pamene mukuyenera kupewa zodzoladzola ngati muli ndi psoriasis ya nkhope, mungayese kugwiritsa ntchito malo oteteza khungu ngati Dermablend kapena Covermark, omwe ena amagwiritsa ntchito kubisala ndi zilonda.
- Imwani madzi ambiri-magalasi asanu ndi atatu pa tsiku. Kuchita motero kumatulutsa khungu ngati momwe chimakhalira thupi lanu lonse.
> Zotsatira:
> Bungwe la American Academy of Dermatology (AAD), et al. "Malangizo othandizira kusamalira ma psoriasis ndi psoriatic nyamakazi: gawo 6. Malangizo othandizira kuchiza psoriasis ndi psoratic nyamakazi: zowonetsera zochitika ndi zochitika zokhudzana ndi umboni." J Am Acad Dermatol . 2011 Jul; 65 (1): 137-74. DOI: 10.1016 / j.jaad.2010.11.055.
> National Psoriasis Foundation. "Wodzichepetsa kwa Psoriasis ndi Psoriatic Arthritis: Mankhwala Osokoneza Bongo." Portland, Oregon.