Okuqukethwe
Ukwelashwa kwe-PUVA
Kuyini ukwelashwa kwe-PUVA?
Incazelo yokwelashwa kwe-PUVA
Ukwelashwa kwe-PUVA kuhlanganisa ukuvezwa komthombo wokufakelwa wemisebe ye-UVA nokwelashwa okususelwa ku-psoralen, umkhiqizo wokukhuthaza i-UV. Ngakho-ke isifinyezo esithi PUVA: P kubhekiswa kuPsoralen naku-UVA kwimisebe ye-ultraviolet A.
Isimiso
Ukuvezwa ku-UVA kuzodala uketshezi lwezinto ezibizwa ngama-cytokines, azoba nezenzo ezimbili:
- isenzo okuthiwa i-antimitotic, esizokwehlisa ukwanda kwamaseli e-epidermal;
- isenzo se-immunological, esizokwehlisa ukuvuvukala.
Izinkomba ze-PUVA-therapy
Inkomba eyinhloko yokwelashwa kwe-PUVA ukwelashwa kwe-psoriasis vulgaris (amaconsi, izindondo noma amabala) aqatha ezindaweni ezinkulu zesikhumba.
Njengesikhumbuzo, i-psoriasis isifo esivuthayo sesikhumba ngenxa yokuvuselelwa okusheshayo kwamaseli e-epidermis, ama-keratinocyte. Njengoba isikhumba singenaso isikhathi sokuzisusa, i-epidermis iyajiya, izikali ziyanqwabelana bese ziyavela, zishiya isikhumba sibomvu futhi sivuvukele. Ngokunciphisa ukuvuvukala futhi unciphise ukwanda kwamaseli e-epidermal, i-PUVAtherapy isiza ukunciphisa amapuleti e-psoriasis futhi ikhiphe indawo yokuqhuma.
Ezinye izinkomba zikhona:
- i-atopic dermatitis lapho ukuqubuka kubaluleke kakhulu futhi kumelana nokunakekelwa kwendawo;
- i-lymphomas yokuqala ye-cutaneous;
- ama-photodermatoses, njenge-summer lucitis ngokwesibonelo, lapho ukwelashwa kokuvikela izithombe nokuvikelwa yilanga kunganele;
- i-polycythemia pruritus;
- isikhumba se-lichen planus;
- ezinye izimo ze-alopecia areata ezinzima.
Ukwelashwa kwe-PUVA ekusebenzeni
Uchwepheshe
Amaseshini e-PUVA-therapy anqunywa udokotela wesikhumba futhi enzeka ehhovisi noma esibhedlela esifakwe ikhabethe le-irradiation. Zimbozwe yi-Social Security ngemuva kokwamukelwa kwesicelo sesivumelwano sangaphambilini.
Inkambo yeseshini
Kubalulekile ukuthi ungafaki lutho esikhunjeni ngaphambi kweseshini. Emahoreni amabili ngaphambili, isiguli sithatha i-psoralen ngomlomo, noma ngaphezulu ngokungajwayelekile, ngokufaka ingxenye yomzimba noma umzimba wonke kusixazululo esinamandla se-psoralen (balneoPUVA). I-Psoralen ingumenzeli we-photosensitizing okwenza ukuthi kwandiswe ukusebenza kahle kokwelashwa kwe-UV.
I-UVA ingalawulwa kuwo wonke umzimba noma endaweni (izandla nezinyawo). Iseshini ithatha imizuzu emi-2 kuye kweyi-15. Isiguli sinqunu, ngaphandle kwezitho zangasese, futhi kufanele sigqoke izibuko ezimnyama ezikhanyayo ukuze sizivikele emisebeni ye-UVA.
Ngemuva kweseshini, kubalulekile ukuthi ugqoke izibuko zelanga futhi uvikele ukukhanya kwelanga okungenani amahora ayisithupha.
Ukuvama kwamaseshini, ubude bawo kanye nokwelashwa kunqunywa yi-dermatologist. Isigqi samaseshini ngokuvamile amaseshini ambalwa ngeviki (ngokuvamile amaseshini ama-3 ahlukaniswe ngamahora angama-48), alethe imithamo ekhuphuka kancane kancane ye-UV. Cishe izikhathi ezingama-30 ziyadingeka ukuthola umphumela oyifunayo.
Kungenzeka ukuhlanganisa ukwelashwa kwe-PUVA nokunye ukwelashwa: i-corticosteroids, i-calcipotriol, i-retinoids (re-PUVA).
Izimo
Ukwelashwa kwe-PUVA kuyaphikiswa:
- ngesikhathi sokukhulelwa kanye ne-lactation;
- uma kwenzeka kusetshenziswa imishanguzo yokuthwebula izithombe;
- ukwehluleka kwesibindi nezinso;
- izimo zesikhumba ezibangelwe noma zenziwa zimbi ngokukhanya kwe-ultraviolet;
- umdlavuza wesikhumba;
- umonakalo ekamelweni langaphambili leso;
- ukutheleleka okunamandla.
Imiphumela emibi kanye nezingozi
Ingcuphe enkulu, uma kwenzeka izikhathi eziningi zokwelashwa kwe-PUVA, ileyo yokuba nomdlavuza wesikhumba. Le ngozi ilinganiselwa ukuthi izokhuphuka lapho inani leseshini, lihlangene, lidlula ama-200-250. Futhi ngaphambi kokumisela amaseshini, udokotela wesikhumba wenza ukuhlolwa okuphelele kwesikhumba ukuthola esigulini ubungozi bomdlavuza wesikhumba (umlando womuntu siqu womdlavuza wesikhumba, ukuvezwa kwangaphambilini kuma-X-ray, ubukhona bezilonda zesikhumba zangaphambi komdlavuza, njll.). Ngasikhathi sinye, kunconywa ukuqapha unyaka nonyaka kwesikhumba kubantu abathole izikhathi ezingaphezu kuka-150 ze-phototherapy sessions, ukuze kutholakale izilonda ezingapholi noma umdlavuza wokuqala kusenesikhathi.
Imiphumela emibi ibhekwa njalo:
- isicanucanu ngenxa yokuthatha iPhoralen;
- ukoma kwesikhumba okudinga ukusetshenziswa kwe-emollient;
- ukwanda kwezinwele ezizofiphala lapho amaseshini eyeka.