Iiwati eziQhelekileyo: Ukukhula kweNtliziyo eZinzileyo Eziqhubeka Zibuya

Iiwati eziqhelekileyo (verruca vulgaris) ziinkcukacha ezingenabungozi ezibangelwa kukhuhlana ne-human papillomavirus (HPV). Kukho iintlobo ezingaphezu kwe-200 ze-HPV ezichongiweyo, kwaye iintlobo ezahlukeneyo zineemfuno ezahlukeneyo kwiindawo zomzimba kwaye zivelisa iintlobo ezahlukeneyo zeewati. Iiwati eziqhelekileyo ezandleni zihlala zibangelwa ziintlobo ze-HPV 2, 4, 27, kunye ne-29.

Iiwati ze-planta kwiinyawo zihlala zibangelwa ziintlobo ze-HPV 1, 2, 4, kunye ne-63. Iiwati ezijolise phantsi zifuna iintlobo ze-HPV 3, 10, 28, kunye ne-49. Kubalulekile, iintlobo ze-HPV ezibangela iiwati eziqhelekileyo azifani neentlobo ezibangela iiwati zezitho zomzimba okanye umhlaza wombungu — le yinto eyaziwayo engalunganga ebangela uxinzelelo olungadingekile.

I-HPV idluliselwa ngokuxhumana ngqo kwesikhumba okanye ngokuxhumana okungaqondakali kwiindawo ezingcolileyo. I-virus ingena kwiindawo ezincinci zesikhumba — uk cuts, i-hangnails, i-cuticles eziphukileyo, okanye iindawo zesikhumba ezonakeleyo ezivela ekubambeni iinzipho okanye ekukrazuleni i-hangnails. Iindawo ezimanzi zikhuthaza ukudluliselwa, yiyo le nto iindawo zokuhlambela ezisebenzisanayo, iindawo zokubhukuda, kunye neendawo zokugcina iimpahla zihlala zihlala zikhona kwiindawo zokufumana iiwati ze-planta.

Emva kokukhuhla, ixesha lokuphila lingahluka ukusuka kwiinyanga ezi-1 ukuya kwiinyanga ezi-20, okuthetha ukuba ungase ube uthathe i-virus ixesha elide ngaphambi kokuba i-wart ibonakale. I-virus ithintela i-keratinocytes (iicell zesikhumba) kwaye ithatha umgca wabo wokukhula, ibangela ukuphindaphinda ngokukhawuleza okukhupha ukukhula okuphakanyisiweyo, okuneempawu ezahlukeneyo. Iingane kunye nabantu abatsha bahlala bephazamiseka kakhulu, kunye nokuphakama kokuphazamiseka kubantwana abaninzi, mhlawumbi ngenxa yokungabi namandla emzimbeni kunye nokuxhumana rhoqo kwesikhumba. Abantu abaneempawu zokungabikho kwamandla bahlala bephazamiseka kwaye bahlala bephuhlisa iiwati ezininzi, ezinzima ukuphatha.

Iiwoti ezivamile (verruca vulgaris) zibonakala njengezikhukhula eziphakanyisiweyo, ezinzima, ngokubanzi kwiimvama, iifinger, kunye nasemanzini. Zihlala zisuka kwi-1mm ukuya ngaphezulu kwe-1cm kwaye zineempawu ezithile ezifana ne-cauliflower. Ukujonga ngokusondeleyo kuvame ukuveza iindawo ezincinci ezimnyama ngaphakathi kwewoti — ezi ziithrombosid capillaries (iindawo zegazi ezincinci), hayi 'imbewu' njengoko ulwazi lwabantu lukhumbuza.

Iiwoti ezivamile ziqinile ukujolisa kwaye zinemibala yesikhumba ukuya kwi-grayish-brown. Iiwoti zeperiungual zikhula malunga nasezantsi nasezantsi kwemizimba yeenkwenkwezi, zidalela imiceli mngeni ethile yokunyanga kwaye zikhokelela ekuphambukeni kwemizimba yeenkwenkwezi ukuba zikhule ziye kwi-matrix yeenkwenkwezi. Zivamile kwiingcambu zeenkwenkwezi kunye nabantu abathanda ukuncamathela.

Iiwoti zePlantar zikhula kwiindawo zokuphumla, apho uxinzelelo oluvela ekuhambahambeni lukhupha zibe ngaphakathi, kudala i-lesions ezijolise okanye ezincinci ezijolise ngumbhalo wesikhumba ophakanyisiweyo (callus). Iiwoti zePlantar zingabuhlungu kakhulu, zenza ukuhamba kube nzima, ngakumbi xa zikhula kwiindawo zoxinzelelo ezifana ne-heel okanye ibhola yeenyawo. Iiwoti zeMosaic ziqokelelwa kwezi woti zePlantar ezikwiqela ezikhethekileyo eziphikisana nokunyanga.

Iiwoti ezijolise (verruca plana) zincinci (1-5mm), zikhanyayo, ziqhelekileyo, kwaye zikhanyayo. Zivame ukuvela kwiindawo ezinkulu — iindidi ukuya kwiikhwenkwezi — ebusweni, emlonyeni, ezandleni, okanye emilenzeni. Nangona zincinci, umkhwa wazo wokuphuma kwiikholoni zenza ukuba zibe yingozi ngokobuhle.

Kwabantu, zivamile ukuvela kwiindawo zeenkwenkwezi, apho ukuncamathela kusasaza umgubo. Iiwoti zeFiliform zihlala ziqhelekileyo, zifana nezikhumbuzo ezijolise kwiindawo ezijolise ebusweni, emlonyeni, emlonyeni, nasezithweni. Ziyahluka ngokubukeka kodwa zingaphoswa njengezikhumbuzo zesikhumba. Ukuhlukanisa iiwoti kwezinye iindawo zokukhula kwesikhumba (i-seborrheic keratoses, i-squamous cell carcinoma, i-molluscum contagiosum) kubalulekile kuba iindlela zokunyanga zihluka kakhulu.

Ukwelashwa kweewoti okukhutshelwe kwiintengiso kugxile kwi-asidi ye-salicylic, etholakala njengeemveliso, iijeli, iipadi, kunye neephepha kwi-concentration ukusuka kwi-17% ukuya kwi-40%. I-asidi ye-salicylic isebenza ngokuhamba kancinci ikhulula i-keratin protein eyenza iiwoti kunye nesikhumba esibuhlungu esiqinileyo, iphinde ibangele impendulo ye-immune ethile. Ukuze ufumane iziphumo ezilungileyo, gquma iiwoti emanzini afudumeleyo imizuzu eyi-5-10, emva koko ufile phantsi isikhumba esiqinileyo esifile ngombhoxo ophumayo okanye i-pumice stone (ungayabelani nezi zixhobo), sebenzisa i-asidi ye-salicylic ngokuchanekileyo kwi-surface ye-wart, kwaye uyiqwalasele ngombhoxo.

Phinda yonke imihla kwiiveki eziyi-8-12. Ukwamkela kubalulekile — ukwelashwa kweewoti ngumjikelo, hayi umjikelo, kwaye abantu abaninzi bayayeka ukwelashwa masinyane.!! Iimpumelelo ze-asidi ye-salicylic zilinganiselwa kwi-50-70% ngokusebenzisa okuqhubekayo, okuphakathi.

Iikiti ze-cryotherapy ezithengiswa kwiintengiso (imveliso ezifreeze-away) zisebenzisa i-dimethyl ether kunye ne-propane mixtures ukuze zifreeze iiwoti. Nangona zikhankanywe njengezilingana ne-cryotherapy yobuchwephesha, zifikelela kwiimeko ze- -57 degrees Celsius kuphela xa kuthelekiswa ne-nitrogen ye-liquid ye- -196 degrees, zenza ukuba zingasebenzi kakuhle. Zingasetyenziswa njengomphakathi kwi-asidi ye-salicylic kodwa zihlala zingaphumeleli njengokwelashwa okuzimeleyo kweewoti ezimiselweyo.

I-duct tape occlusion therapy ifundwe ngemiphumo emixube — umbono kukuba ukuvalwa kweewoti kudala ukucaphukisa isikhumba kwaye kukhuthaza impendulo ye-immune. Ukuba uzama, sebenzisa i-duct tape phezu kwewoti imihla emithandathu, uyikhiphe, gquma kwaye ufile iiwoti, emva koko uyishiye ivulekile ubusuku bonke ngaphambi kokuyifaka kwakhona emihla emithandathu. Ubungqina bokusebenza buxhomekeke, kodwa kuphephile.

Iindlela ezingozi zokwelapha ekhaya okufuneka zigwenywe: ukusika okanye ukugquma iiwoti ngezixhobo ezibukhali kubeka umngcipheko wokufumana umphunga, ukuluma, kunye nokususa okungaphelelanga okukhupha umgubo; ukutshisa iiwoti ngama-match okanye iisigubhu kubangela ukutshisa kunye nokuluma; ukusetyenziswa kwe-oyile ye-essence engavunyelwanga okanye i-bleach kungabangela ukutshisa kwemichiza. Ungazami ukwelapha iiwoti ebusweni, kwiindawo zeenkwenkwezi, okanye kwiindawo ezinkulu ngaphandle kokukhokelela kochwepheshe.

Xa ukwelashwa kwekhaya kungaphumeleli — kwaye kuvame ukuba njalo, ngakumbi kwi-warts zePlantar, iiwoti zeperiungual, kunye neewoti ezininzi — ukwelashwa kobuchwepheshe kunika iindlela ezinamandla ngakumbi. I-cryotherapy nge-nitrogen ye-liquid iyindlela evamile yokwelapha iiwoti. I-nitrogen ye-liquid kwi -196 degrees Celsius ifakwe ngqo kwi-wart nge-spray okanye i-cotton-tipped applicator, ibangela ukufa kweeseli ngokwakha i-crystal yeqhwa kunye nokuphazamiseka kwe-vessel.

I-blister ivame ukuvela phakathi kweeyure ezingama-24. Ukwelashwa kubuhlungu (umjikelo wokufriza uqobo kunye ne-blister elandelayo), kwaye iiseshoni ezininzi kwiiveki ezi-2-3 zihlala zidingeka ukuze zikhulule, kunye neepesenti ezijolise kwi-50-75% emva kwee sesi. I-Cantharidin iyinto edala i-blister ethathwe kwi-beetle ye-blister, ifakwe kwi-ofisi kwaye ihlambululwe ekhaya kwiiyure ezizayo.

Ibangela i-blister engabuhlungu ephakamisa iiwoti. Ikhulu kakhulu kwiingane kuba ukufakwa akubuhlungu — i-blistering iyenzeka kamva. I-electrodesiccation kunye ne-curettage kubandakanya ukunciphisa indawo nge-anesthesia yendawo, emva koko ukugquma iiwoti nge-curette kunye nokucima isiseko.

Le ndlela iyasebenza kwi-warts ezithile kodwa ibangela umonakalo ofuna ukuphola kwiiveki ezi-2-4 kwaye ingashiya umgubo. I-intralesional immunotherapy ibandakanya ukungena kwe-antigens (i-Candida antigen ivame ukusetshenziswa) ngqo kwi-wart, ibangela impendulo ye-immune ethintela umgubo. Ubuhle balolu hlobo kukuba kuvame ukukhulula iiwoti ezikude, ezingazange zinyangwe ngaxeshanye njengoko impendulo ye-immune ye-systemic ijolise kwiiseli ezine-HPV ezithintekayo emzimbeni.

Ikhulu kakhulu kwiingcambu ezineewoti ezininzi. I-bleomycin injection (i-intralesional chemotherapy) ibekwe kwi-warts ezinzima, eziphikisanayo nezinyanga kwaye ibulala iiwoti ngokusebenzisa umphumo we-cytotoxic. Kubuhlungu kwaye kunemiphumo yokulimala kwemizimba yeenkwenkwezi xa isetyenziswa kwi-warts zeperiungual.

I-pulsed dye laser ijolise kwiindawo zegazi ezinika iiwoti, ibangela ukutshatyalaliswa kokukhetha. Kwi-warts ezinzima, i-topical immunotherapy nge-squaric acid dibutylester (SADBE) okanye i-diphencyprone (DPCP) ibangela impendulo ye-allergic yokuthintela umgubo.

Umjikelo wokuphinda kweewoti emva kokwelashwa uphucukile — iimeko zihlala zihluka ukusuka kwi-20% ukuya kwi-70% ngokuxhomekeka kwiindlela zokwelapha kunye nepopulashoni yomgibeli. Ukuqonda kutheni kubonisa umgca wokuthintela. Iiwoti zibuya kuba ukwelashwa kuqeda iiwoti ezibonakalayo kodwa akukhumbuli ukuba kuhlale kungekho zonke iiseli ezine-HPV ezithintekayo, ngakumbi kwiindawo ezikwi-periphery ye-wart okanye kwisikhumba esikufutshane.

Umgubo unokuhlala kwi-state ye-latent kwiiseli ze-epithelial ezijolise, uphinda uvuselelwe xa iimeko zikhuthaza. Abantu abane-immunocompromised bahlala bephosa umjikelo kuba iimeko zabo ze-immune azikwazi ukunceda impendulo efunekayo yokukhulula umgubo. Ukwelashwa kweewoti kwiingcambu eziphilayo kuphumeza impendulo ye-immune eqhuba iiseli ezine-HPV — ukwelashwa kusebenza ngokunciphisa umgubo we-viral kunye nokukhuthaza umgca we-immune, kodwa ukunceda kokugqibela kudinga impendulo ye-immune efanelekileyo.!!

Le yindlela i-65% yeewoti kwiingcambu eziphilayo ziya kuhlulwa ngokwazisa kwiinyanga ezimbini ngaphandle kokwelashwa — umgubo ekugqibeleni uqhuba impendulo efanelekileyo. Ukuthintela ukusasazeka kunye nokuphinda kubandakanya iindlela ezininzi: gwenya ukuncamathela okanye ukugquma iiwoti, njengoko oku kusasaza umgubo kwiindawo ezintsha (autoinoculation); gquma iiwoti ngombhoxo ngexesha lokwelashwa ukuze ugweme ukunciphisa umgubo kwabanye nakwiindawo ezintsha zomzimba; ungabelani ngezinto zomntu ezifana neetawuli, iirazor, iinhloko zeenkwenkwezi, okanye iifayili; gqoke i-flip-flops okanye iishoe zamanzi kwiindawo zokuhlambela, kwiindawo ze-pool, kunye neelokhwe; gcina isikhumba sikhululekile kwaye sikhululekile kuba isikhumba esiqinileyo sithanda ukungena kwi-HPV; gwenya ukuncamathela kwiingcambu zeenkwenkwezi kunye nokugquma iihangnails njengoko ezi zenza ukuba kube neendawo zokungena zomgubo ezandleni; phosa iiwoti ngokukhawuleza kunokuba ulinde, njengoko iiwoti ezincinci ziphendula ngcono kwiindlela zokwelapha kwaye zikhupha umgubo omncinci. Kwiingane ikakhulu, ukuxoxa iiwoti kwangoko kuthintela umgca wokuphosa kunye nomphumo wepsychological onokukhula njengoko iiwoti ziba zicacile.

Nangona iiwoti ezininzi zingabungozi kwaye zikhawuleza, iimeko ezininzi zifuna ukuhlolwa kochwepheshe. Hamba kudokotela ukuba awuqinisekanga ukuba ukukhula kuyinto yeewoti — ngakumbi kubantu abadala abangaphezulu kweminyaka engama-50, apho ukukhula okukhukhulayo kungabangelwa yi-actinic keratoses okanye i-squamous cell carcinoma kunokuba iiwoti. Nanyani i-lesion ehlula kalula, ekhula ngokukhawuleza, itshintsha umbala, okanye ibangela imida engalunganga ifuna ukuhlolwa kochwepheshe ukuze kuqinisekiswe ukuba ayinayo imalungelo.

Iiwoti ebusweni kufuneka zinyangwe ngochwepheshe kuba ukwelashwa okunyanga ekhaya kubeka umngcipheko wokuluma kwiindawo ezibucayi. Iiwoti zeenkwenkwezi okanye ze-perianal zifuna ukuhlolwa kochwepheshe kunye nokunyanga, njengoko zingabangelwa iintlobo eziphezulu ze-HPV kwaye zineemfuno ezahlukeneyo zokunyanga. Iiwoti zePlantar ezibangela ubuhlungu obukhulu okanye eziphazamisa ukuhamba zifuna ukunyanga kochwepheshe.

Ukuba ukwelashwa kwekhaya kuhlulekile emva kweeveki eziyi-12 zokusebenza okuqhubekayo, ukungena kochwepheshe kunika iindlela ezisebenzayo ngakumbi. Abaguli be-diabetic kunye nabantu abane-peripheral neuropathy okanye i-peripheral vascular disease akufuneki bazame ukwelapha iiwoti kwiinyawo — ukungabikho kokuziva kunye nokuhamba kuphakamisa umngcipheko wezingozi. Abaguli abane-immunosuppressed (abamkelayo i-organ transplant, abantu abane-HIV, abo baphosa iimveliso zokunciphisa i-immune) kufuneka bafune uncedo kochwepheshe kwiiyoti zonke, njengoko aba baguli benza iiwoti ezinzima, eziphikisanayo, nezinyanga ezineemfuno eziphezulu zokuphosa.

Iiwoti ezininzi ezikhula ngokukhawuleza zikhumbuza ukungabikho kwe-immune kwaye zifuna ukuhlolwa kwezonyango. Iingane ezineewoti ezikwiindawo zeenkwenkwezi ezithintela ukukhula kweenkwenkwezi kufuneka ziye kudokotela wezonyango, njengoko iiwoti zeperiungual zingabangela ukungaphumeleli kwemizimba yeenkwenkwezi ukuba zingaphathwa kakuhle.

Ukwahlula i-warts kwizinye iintshukumo ze skin akulula ngokuqhelekileyo — i-seborrheic keratoses, i-molluscum contagiosum, i-calluses, kunye nezinye iintshukumo ze skin ezithile zingafana ne-warts kumntu ongaziyo. I-Skinscanner ibonelela ngovavanyo olufikelelelekayo lokuqala, lukunceda uqonde ukuba i-growth eqhelekileyo ingaba yi-wart okanye into efuna ingqalelo eyahlukeneyo. I-AI yethu ifundiswe ukuba ibone iimpawu ezichasene neentlobo ezahlukeneyo ze-wart — umphunga onobungakanani obungaphezulu, i-capillaries ezithinteleka ezibonakala njengeedoti ezimnyama, kunye nomphunga we-keratotic ophawula i-warts kwiintshukumo ezahlukeneyo.

Kubantu abaphantsi kokunyanga i-wart, ukurekhoda i-warts zakho ngemiceli mveliso eqhelekileyo kubonelela ngobufakazi obubonakalayo bokuphendula kokunyanga. Kungaba nzima ukujonga ukuba i-plantar wart iyancipha xa uyijonga yonke imihla, kodwa imifanekiso ethathwe ngexesha elahlukileyo ibonisa intsebenzo (okanye ukungabikho kwayo) ngokucacileyo. Le mveliso yokurekhoda ikunceda ukhethe ukuba kufuneka uqhubeke nokunyanga okwamanje okanye ukuba kufuneka uphumelele kwi-care yobungcali.

I-Skinscanner ikwasiza ukulawula i-warts ezintsha ezivela kwiindawo ezingezizo, ngakumbi ngexesha lokunyanga aktivi xa umngcipheko we-autoinoculation uphakamile. Nangona i-warts ngokubanzi zingabantu abangenamsebenzi kwaye zingekho mngcipheko wezonyango, ukuthetha ngazo kuqinisekisa ukuba uphumeza umphumo ofanelekileyo ngendlela efanelekileyo — kwaye kugcina iiveki zokunyanga ezingasebenziyo ukuba i-growth ibonakale ingeyiyo i-wart.