Blue Nevus: Kungani Ezinye I-Moles Zibukeka Ziluhlaza Kwaye Nini Ukuze Ube Nengxaki

I-blue nevus yi-lesion ye-melanocytic engenabungozi — uhlobo lwe-mole — ebukeka iluhlaza, iluhlaza-mnyama, okanye iluhlaza-mnyama kunokuba ibe mnyama okanye ibrown, i-colour ejoliseleyo kwiimole ezininzi. I-colour eluhlaza ayibangeli i-chemistry ye-pigment eyahlukeneyo kodwa ibangelwa ngumphumela wemvelo wokukhanya ophakathi kwe-melanin efumaneka ejulile kwi-dermis. Ngelixa i-melanocytes kwiimole ezijoliseleyo zihlala kufutshane nomphakathi we-skin kwi-epidermis kunye ne-superficial dermis, i-melanocytes kwi-blue nevus zihlala ejulile kwi-mid-to-lower dermis.

Le ndawo ejulile ikhiqiza umphumela ophawulekayo oluhlaza ngokusebenzisa umphumela obizwa ngokuba yi-Tyndall effect — umthetho ofanayo ophawulela ukuba isibhakabhaka sibukeka siluhlaza kunye neenhliziyo zibukeka ziluhlaza-ntsimbi ngaphakathi kwesikhumba. Xa ukukhanya kungena kwisikhumba, i-wavelengths ezide (ebomvu, emthubi) zifaka ngaphezulu kwaye zifakwe kwi-melanin ejulile, ngelixa i-wavelengths ezimfutshane (ziluhlaza) zihlala zihlala zibuya kumphakathi, zidalela umphumela oluhlaza. I-blue nevi zihlala zifumaneka, zifumaneka malunga ne-1% ukuya kwi-2% yabantu.

Zingavela naphi na emzimbeni kodwa zihlala zifumaneka kakhulu kwiingalo eziphezulu, iinyawo, i-scalp, ubuso, kunye neengqungquthela. Zivame ukuvela ebuntwaneni okanye ebudlaleni kwaye zihlala zizinzile ukuphila kwabo bonke. Uninzi lwezinto zihlala zizinzile, zincinci (ngaphantsi kwe-centimeter enye), kwaye azinabungozi. Ngelixa i-colour engajoliseleyo iluhlaza ingakhathaza, uninzi lwe-blue nevi zihlala zingenabungozi kwaye zifuna kuphela ukuqwalaselwa okujoliseleyo.

Iintlobo ezahlukeneyo ze-blue nevi zikhona, nganye inezinto ezahlukeneyo zempilo kunye nezobuchwephesha. I-blue nevus ejoliseleyo (uhlobo lwe-Jadassohn-Tieche) yintoni efumanekayo kakhulu, ibonisa njengephezulu elincinci (ngokuqhelekileyo ngaphantsi kwe-centimeter enye), elinokubukeka luhlaza ukuya kumthubi. Ikhulu le-melanocytes ezide, ezidibene kwi-dermis kunye ne-pigment ye-melanin eninzi.

I-blue nevi ejoliseleyo zihlala zifumaneka kwiingalo eziphezulu, iinyawo, i-scalp, kunye nobuso. Ziqinile kwi-dermis, ziqinile kumphakathi, kwaye zineemida ezicacileyo, ezichanekileyo. Nje ukuba ziqalise, zihlala zizinzile kwi-bungakanani kunye ne-colour kwiiminyaka.

I-cellular blue nevus yintlobo enkulu, ivame ukuba ne-centimeter enye ukuya kwezintathu, ethanda ukuvela kwiingqungquthela, kwi-sacroccoccygeal region, kunye ne-scalp. Ibukeka njenge-nodule okanye i-plaque eluhlaza ukuya kumthubi kwaye ibonisa iisland ze-melanocytes ezinzima ze-epithelioid kunye ne-spindle-shaped, ngaphezu kwe-melanocytes ezidibene. I-cellular blue nevus ibalulekile ngokomthetho kuba inemngcipheko ophakanyisiweyo (nangona iphantsi kakhulu) yokuguqulwa komphakathi umahluko kwi-blue nevus ejoliseleyo, kwaye ingaba nzima ukuyahlula kwi-melanoma ngokobuchwephesha.

I-combined blue nevus ibhekisela kwi-blue nevus ehlangene nezinye iintlobo ze-melanocytic nevus (njenge-nevus ethathwe okanye i-Spitz nevus) ngaphakathi kwalesi sifo, idala i-lesion eneziqhamo ezimnyama neziluhlaza. I-epithelioid blue nevus yintlobo ehlotshiswe ne-Carney complex, i-syndrome ye-genetic engavamile ebandakanya i-myomas ye-cardiac, ukungasebenzi kakuhle kwe-endocrine, kunye neengxaki ze-pigmentation yesikhumba. Le ntlobo ibonisa i-melanocytes ezinzima ezipigmentiweyo kwaye ifuna ukuhlolwa kwe-syndrome ebandakanyekayo.

Ukuqonda ukuba kutheni i-nevi emnyama ibonakala imnyama kudinga uphando olufutshane lwezibalo zokukhanya ezisebenzisana nesikhumba. Umphumo weTyndall — ogama lakhe luthathwe kumphuhlisi wezibalo uJohn Tyndall ophila ngexesha le-19 — uchaza ukusabalala kokukhanya ngama-particles aphakanyiswe kumjikelo. Xa ukukhanya okukhanyayo (okubandakanya zonke iiwavelength ezibonakalayo) kungena kwisikhumba, kuhlangana nezakhiwo ezahlukeneyo ezisabalalisa ukukhanya.

Iiwavelength ezimfutshane (ukukhanya okumbhiyozela kunye nokuviolet, malunga ne-400 ukuya kwi-490 nanometers) kusabalala ngempumelelo ngakumbi kuneewavelength ezide (ukukhanya okukhanyayo kunye nokomnyama, malunga ne-590 ukuya kwi-700 nanometers). Kwi-mole emnyama ejolise kumhlaba, i-pigment ye-melanin ibekwe kwi-epidermis kunye ne-dermis ephezulu, kufutshane kakhulu nomphakamo ukuze zonke iiwavelength zokukhanya zisebenzisane nayo kwaye zifakwe ngokufanayo, zivelisa ukubonakala kwemnyama. Kwi-nevus emnyama, i-melanin ibekwe phantsi — kwi-dermis ephakathi ukuya phezulu.

Kule depth, iiwavelength ezide zokukhanya zifaka ngokwaneleyo ukuze zifakwe yi-melanin, zisusa ngempumelelo i-red kunye ne-yellow components kumphakamo wokukhanya. Ngaxeshanye, iiwavelength ezimfutshane ezimnyama zisabalala ngaphezulu kwe-collagen ye-dermal ngaphambi kokuba zifike kwi-melanin ephezulu, zibuyela kumjolisi. Umphumo ophakathi kukuba amehlo ethu abona iiwavelength ezimnyama eziphuma kwisikhumba phezu kwe-nevus emnyama. Lo mthetho ufanayo uchaza iimeko ezininzi ezimnyama emhlabeni nasempilweni: ukubonakala kwemibala emnyama yeenxalenye (i-hemoglobin engasasebenzi ibonakala imnyama, hayi emnyama), imibala emnyama yeempahla ezithile ezineemfuno ezinzulu, amehlo amnyama (awana pigment emnyama), kunye nokubukeka kwemibala emnyama-nemnyama yeempahla ze-tattoo ezihamba phantsi kwi-dermis ngokuhamba kwexesha.

Ingxaki ephambili ye-clinical kunye ne-nevi emnyama kukuba zingadideka ne-nodular melanoma okanye i-melanoma efana ne-nevus emnyama, zombini zikwazi ukuvela njengezikhumbuzo ezimnyama okanye ezimnyama-nemnyama. Iimpawu ezahlukeneyo ze-nevus emnyama ejolise kumhlaba ziquka ubungakanani obuncinci (phantsi kwe-centimeter enye), umbala omnyama-nemnyama ophakathi, imida ecacileyo, ubuso obushelelezi, kunye nokuzinza ixesha elide ngaphandle kokutshintsha. I-melanoma, ngokuchasene, ibonisa ukungalingani, imida engalunganga okanye engacacanga, umbala onobungakanani (ukudibanisa kwemibala emnyama, emnyama, emnyama, ebomvu, okanye emhlophe), ubungakanani obukhulu, kunye nokuphucuka ngokuhamba kwexesha.

Iimpawu eziphambili ze-clinical ezixhasa i-nevus emnyama ejolise kumhlaba kukuzinza — i-lesion emnyama ehlala iminyaka ngaphandle kokutshintsha ubungakanani, umfanekiso, okanye umbala ibonakala ngempumelelo njengebenign.!! Ngaphandle koko, i-lesion emnyama okanye emnyama-nemnyama entsha, ekhula, itshintsha umfanekiso okanye umbala, ibonisa iimpawu (ubuhlungu, ukungakhululeki, okanye ukuvuza), okanye ibanzi kune-centimeter enye kufuneka ihlolwe ukuze kubekho umngcipheko we-nevus emnyama okanye i-melanoma. I-nevus emnyama engalunganga iyinto engafumanekiyo kodwa eyaziwayo — i-melanoma enobungozi eyavela ngaphakathi okanye efana ne-nevus emnyama.

Iveliswa ngokuqhelekileyo kwi-variant ye-nevus emnyama, ngakumbi kwi-lesions ezinkulu kwi-scalp. Iimpawu ezikhumbuza ukungafanelekanga ziquka ukukhula ngokukhawuleza, ubungakanani obudlula i-centimeter ezimbini, i-ulceration, i-lesions ze-satellite, kunye nemida engalunganga. I-Dermoscopy (uhlolo nge-magnifier ye-polarized light) ingasiza ekuhlukaniseni i-nevi emnyama ejolise kumhlaba kwi-melanoma.

I-nevi emnyama ngokubanzi ibonisa umfanekiso omnyama-nemnyama ongafaniyo ngaphandle kweemigca engalunganga, i-structures zokuhla, okanye umfanekiso ophakathi kokudibanisa okungafaniyo okuchasene ne-melanoma. Xa uhlolo lwe-clinical kunye ne-dermoscopic lungakwazi ukuxhasa ngokukhawuleza umgomo omhle, i-biopsy iyafuneka.!!

I-nevi emnyama zihlala zihlola ngokomthetho ngokusekelwe kumfanekiso wazo ophawulekayo — i-papule encinci, ecacileyo, emnyama-nemnyama okanye emnyama-nemnyama ehlala ikhululekile ngokuhamba kwexesha. I-Dermoscopy ikhulisa ukuchaneka kokuhlola ngokukhupha umfanekiso omnyama-nemnyama okanye omnyama-nemnyama ophakathi kokuphucuka kwe-nevi emnyama, ehluke kwiimifanekiso ezahlukeneyo ezibonwa kwi-melanoma. Kwiingcali, uhlolo lwe-clinical kunye ne-dermoscopic lanele ukuphatha i-nevi emnyama ezijolise kumhlaba ngaphandle kwe-biopsy.

Nangona kunjalo, i-biopsy iyacetyiswa kwi-lesion emnyama ethintela ubungakanani, umbala, okanye umfanekiso; nayiphi na i-lesion emnyama engaphezulu kwe-centimeter enye; i-nevi emnyama eziphakanyiswe, ngakumbi ezinkulu kwi-scalp okanye kwi-sacrum; i-lesions emnyama ezineemida ezingalunganga, ukungalingani, okanye umbala onobungakanani; i-lesions emnyama ezintsha ezivela kubantu abadala abangaphezu kweminyaka engama-40; kunye nayiphi na i-lesion emnyama ebangela ukungaqiniseki kokuhlola. I-Excisional biopsy — ukususa i-lesion yonke kunye nemida emincinci — ikhethwa phezu kwe-biopsy engaphelelanga, njengoko ivumela ukuhlola okupheleleyo kwe-histopathologic kunye nokuchonga okugqithisileyo. Ukuhlola kwe-pathological kwe-nevus emnyama kubonisa i-melanocytes ye-dendritic ezinzulu ezine-melanin pigment, kunye nomfanekiso ophawulekayo uhlelwe ngokwe-subtype.

Ukuba i-nevus emnyama iqinisekiswe njengebenign, ukulandelela okujolise kumhlaba kuyafuneka. Ukuhlola isikhumba rhoqo kufuneka kubandakanye ukuhlola i-nevi emnyama ezaziwayo ukuze kubekho nawaphi na utshintsho. Abaguli kufuneka bafundiswe ngamaqhosha afuna ukubuya — ukukhula, utshintsho lombala, utshintsho olukhumbulekayo, okanye ukungalingani kwemida. Kwi-nevi emnyama eziphakanyiswe, abanye abaguli be-dermatology bacebisa ukususa ngokupheleleyo ukuze kupheliswe umngcipheko omncinci wokuguqulwa okungafanelekanga, ngakumbi kwi-lesions ezinkulu.

I-lesion emnyama okanye emnyama-nemnyama kwisikhumba ibonakala ingxaki — umbala ongajolise kumgangatho ubonisa ukuba kukho into engafaniyo ne-mole ejolise kumhlaba. I-Skinscanner ibonelela ngovavanyo olukhawulezayo lwe-AI xa uthatha umfanekiso we-lesion emnyama, ihlola umgangatho wayo, imida, ukulingana, ubungakanani, kunye neempawu zendawo ukuze kuqinisekiswe ukuba ihambelana nomfanekiso omhle we-nevus emnyama okanye ibonisa iimpawu ezidinga ukuhlolwa ngochwepheshe. I-AI ifundiswe ukuqonda umfanekiso ophawulekayo omnyama-nemnyama we-nevi emnyama ejolise kumhlaba kunye nokuchonga iimpawu ezikhathazayo ezifana nokungalingani kombala, imida engalunganga, kunye nokungalingani okungafanelekanga okungase kubonise i-melanoma.

Le mveliso yokuqala ibaluleke kakhulu kuba i-lesions emnyama zivelisa ukungakhululeki okungafanelekanga — umbala wazo ongajolise kumgangatho wenza ukuba zibonakale zikhathazekile kunemibala emnyama nangona zikhona ezinjalo. I-Skinscanner inceda ukuhlinzeka ngengcaciso efanelekileyo malunga ne-lesions emnyama, ichaza umphumo weTyndall kunye nobume obuhle be-nevi emnyama ezikhululekile ngexesha elide ngelixa ibonisa ngokufanelekileyo i-lesions eziphambeneyo kumfanekiso ophosakeleyo. Kubantu abaziwayo nge-nevi emnyama, i-app ivumela ukulandelela utshintsho ngokuhamba kwexesha ngokusebenzisa umfanekiso ophindaphindiweyo, idala irekhodi elibonakalayo elenza kube lula ukufumanisa nawaphi na utshintsho kubungakanani, umbala, okanye iimpawu zemida.

I-Skinscanner ayifuni ukuhlola i-dermoscopic ngochwepheshe — nayiphi na i-lesion emnyama enezimpawu ezingafanelekanga okanye utshintsho olukhathazayo kufuneka ihlolwe ngochwepheshe kunye nomngcipheko we-biopsy. Kodwa kwiimeko ezivamile zokufumanisa i-lesion emnyama kwaye ucinga ukuba ingaba ibi, i-Skinscanner ibonelela ngengcebiso efikelela kalula, ngokukhawuleza.