I-Dermatofibroma: I-Nodule Yesikhumba Eqinile Ebonisa I-Dimple Xa Uyiqhawula

I-dermatofibroma — eyaziwa njengempendulo ye-fibrous histiocytoma okanye i-histiocytoma cutis — yikhula yesikhumba evamile, engalunganga eyakhiwe ngombane we-fibroblasts, i-collagen, kunye ne-histiocytes eyakha i-nodule eqinile, ejolise kwi-dermis. Le mikhono ibalwa phakathi kweemeko ezivamile ezijolise kwisikhumba kwi-practice ye-dermatology, ibala malunga neepesenti ezintathu zeemeko zesikhumba ezithunyelwa kwi-analyzes ye-pathological. I-dermatofibromas ivame ukuvela njengeenodules eziqinile, ezijolise kwi-ovale ezilingana neemilimitha ezintlanu ukuya kwezilishumi ububanzi, nangona zikhona ngamanye amaxesha ezifikelela kwiisentimitha ezimbini okanye ngaphezulu.

Ziziva njengebhathini encinci, eqinile efakwe kwisikhumba — eqinile ngakumbi kunemithambo ejolise kuyo. Isikhumba esiphezulu sinokuthi sibe mnyama, pinki, mnyama-brown, okanye sibe ne-hyperpigmentation, kwaye ubuso bayo buphakathi kokuba bube bushelelezi, nangona bungenza bube ne-scaly okanye shiny. I-dermatofibromas ivame ukuvela kwiindawo eziphantsi, ngakumbi kwiindawo ze-shins kunye ne-thighs, nangona zikhona kwiindawo ezahlukeneyo zomzimba.

Zivame kakhulu kubafazi kunezikhumbuzo, kwaye zininzi kakhulu kwi-20 ukuya kwi-50 yeminyaka yobudala. Le mikhono ivame ukuba yodwa — ukuba nezinye ezininzi kuyinto eqhelekileyo, kodwa i-dermatofibromas ezininzi ngaxeshanye zingahambelana ngamanye amaxesha nokunciphisa amandla omzimba. Uma ziqhubele phambili, i-dermatofibromas ivame ukuba zihlala zihlala, zingakhuli kakhulu okanye zixazulule ngokwazo.

Imbangela ethile ye-dermatofibromas ayikaveli ngokupheleleyo, kodwa kukholelwa ngokubanzi ukuba ibonisa ukuphindaphinda kwefibrous ephendulayo — ngokwenene, ukwanda kwe tissue efana nesikhumba esonakeleyo — okubangelwa kukulimala okuncinci kwesikhumba. Abaninzi babaguli banokukhumbula umgqibelo, umphunga, umgqomo, ukusika okuncinci, okanye i-folliculitis kwindawo apho i-dermatofibroma yaphakama emva koko, ukuxhasa umbono we-etiology ephendulayo. Umbono uthi umonakalo omncinci okanye umgqibelo ubangela impendulo ye-inflammatory endaweni, kwaye ngexesha lokuphola, i-fibroblasts nezinye iicell zikhula ngokweqile, zivelisa i-nodule eqinileyo ye-tissue ye-fibrous ehlala ixesha elide emva kokuba umgibeli wokuqala uphume.

Nangona kunjalo, i-dermatofibromas ezininzi zivele ngaphandle kokulimala okukhankanyiweyo, zikhumbuza ukuba ezinye izinto zisebenza. Iimpembelelo zehormone zingaba nomphumo — ukwanda okuphezulu kwababesifazane kunye nokuphuma okanye ukwandisa okukhawulezayo ngexesha lokukhulelwa kusekela le mbono. I-system ye-immune ibonakala ikhokela, njengoko abantu abane-immunosuppression ngenxa yokutheleleka kwe-HIV, ukutshintsha kwezitho, okanye imithi ye-immunosuppressive banokukhula ngakumbi kwi-dermatofibromas ezininzi.

Ukuphosa kwejini kungenzeka ukuba kukhona, njengoko abanye abantu bephuma ne-dermatofibromas ezininzi ngelixa abanye bengenayo nakanye nangona bephumelele kwiingxaki ezincinci zesikhumba. Kwizinga le-cellular, i-dermatofibromas iqulethe umxube we-fibroblasts, myofibroblasts, histiocytes, kunye neecell ze-inflammatory ezihlelwe kwi-pattern ye-storiform (whorled) ngaphakathi kwe-dermis. I-lesion ihlala ikhulisa kwi-fat ye-subcutaneous kwaye ibamba i-collagen bundles ezikufutshane, idala ubunzima obuchasene nezi nodules.

Umphawu ophawulekayo klinikali we-dermatofibroma ngu-uphawu lwe-dimple — okubizwa ngokuba nguFitzpatrick sign okanye uphawu lwe-buttonhole. Xa uphosa isikhumba esikufutshane ne-dermatofibroma phakathi kwefama yakho kunye ne-finger, i-lesion ibonisa ukuba i-dimples okanye ibuyela ngaphakathi endaweni yokuphuma ngaphandle njengoko i-lesions eziphakanyisiweyo zihlala zisenza.!! Oku kwenzeka kuba i-dermatofibromas zixhoma kwi-dermis ezikufutshane ngeentambo zazo ze-fibrous, kwaye ukucinezela kwe-lateral kubangela ukuba i-lesion ihlale idibene kwi-tissue ye-subcutaneous.

Uphawu lwe-dimple luhlala luphawuleka kangangokuba lungakwazi ukusungula uxilongo klinikali kwiimeko ezininzi, nangona lungaphelelanga ngokupheleleyo — i-lesions ezinzima ezixhaphakileyo zihlala zivelisa uphawu olufana. Ngaphandle kwe-dimple sign, ezinye iimpawu ziya kunceda ukufumanisa i-dermatofibromas. Ziqinile kakhulu xa zixhaphakile — ziqinile kunezikhumba ezikufutshane kunye nezinye i-lesions ezingenasiphumo.

Isikhumba esikufutshane sikhumbuza ukungcoliseka okumnyama okungandisiyo, okungandisiyo ngexesha lokukhanya kwelanga. Ngexesha le-dermoscopy, i-dermatofibromas ibonisa ipatheni ethile: indawo emhlophe efana nesikhumba esonakeleyo esijolise kumjikelo opholileyo, ngamanye amaxesha kuchazwa ukuba ibonakala njengephawu emhlophe ejolise kumjikelo omnyama. Le patheni ihluke kwi-pigment network ebona kwi-lesions ze-melanocytic kwaye iyaziwa ngabaguli abaqeqeshiweyo. Ukubamba kwe-dermatofibromas ngaphakathi kwe-dermis kukhumbuza enye impawu ehlukileyo — zinyuka ngesikhumba xa uziqhuba phezu kwe-tissue esezantsi kodwa ziqinile ngaphakathi kwesikhumba uqobo, ngokungafani ne-lipomas ezihamba ngokukhululekileyo ngaphantsi kwesikhumba.

Nangona i-dermatofibromas zingezona zinto zikhumbuzo, ezinye iimeko ezikhathazayo zingaphinda zifane nezi zinto kwaye kufuneka zihlukaniswe ngokuqwalasela ngokucophelela. I-Dermatofibrosarcoma protuberans (DFSP) yithemba elingaqhelekanga, elinokukhula ngokukhawuleza, elinokufana ne-dermatofibroma ekuqaleni. I-DFSP ikhulisa kakhulu, ikhula ngokukhawuleza, kwaye ihlala ikwi-trunk kunokuba kwiinyawo.

Ngokungafani ne-dermatofibromas, i-DFSP ikhulisa kakhulu kwi-tissue ye-subcutaneous kunye ne-fascia ezikufutshane, inenani eliphezulu lokuphinda ibonakale emva kokususa, kwaye ingaphinda ibonakale. Nodules nayiphi na ekhula ngaphezu kweemilimitha ezimbini, ikhulisa ngokuqhubekayo, okanye ibanjwe kwiindawo ezijulileyo ifuna i-biopsy ukuze kuqinisekiswe i-DFSP.!! I-melanoma ingavela njengonodules oqinileyo, opholileyo onokuhlanganiswa ne-dermatofibroma epholileyo.

Iimpawu ezikhumbuza i-melanoma ziquka ukungalingani, imida engalunganga, ukungafani kwemibala kuquka imibala emnyama-emnyama okanye ebomvu, kunye notshintsho lwakutshanje kwi-size okanye kwiimpawu. Uphawu lwe-dimple luhlala lungabikho kwi-melanoma. I-basal cell carcinoma, ngakumbi i-morpheaform okanye i-nodular subtypes, ingavela njengonodules oqinileyo, onombala wesikhumba.

Jonga umgangatho opholileyo, i-telangiectasias phezu, kunye nokungabikho kwe-dimple sign. I-Merkel cell carcinoma ingavela njengonodules oqinileyo, okhula ngokukhawuleza, onombala obomvu ukuya kwi-violet, ngokuqhelekileyo kwi-skin ebhiyozayo kwiingcuka ezindala. Nayiphi na i-nodule yesikhumba ekhula ngokukhawuleza, itshintsha, ibonisa iimpawu, okanye ibonakala ingakhathazeki kufuneka ibiyoposwe ngaphandle kokuba ibonakale njani i-dermatofibroma eqhelekileyo. Umxholo ubalulekile — i-nodule eqinileyo kumguli ongenamandla okanye kumntu onembali ye-skin cancer ifuna umngcipheko ophantsi kwi-biopsy.

Ngenxa yokuba i-dermatofibromas zingezona zinto zikhumbuzo kwaye azinayo imingcipheko yokuguqulwa kwezinto ezinzima, ukwelashwa akukhuthazwanga ngokwezonyango. Abaninzi babaguli bafunda ukuphila ne-dermatofibromas zabo xa beqonda ubungqina bokukhula. Nangona kunjalo, ukususwa kungafunwa ngezizathu ezininzi: ukukhathazeka kokubukeka, ngakumbi kwi-lesions kwiindawo ezibonakalayo ezifana ne-shins okanye iintso; ukungonwabi okuphindaphindiweyo ngenxa yokuthambisa, ukuxhaphaza kwezingubo, okanye ukulimala okuphindaphindiweyo; ubuhlungu obuqhubekayo okanye ubuhlungu (abanye i-dermatofibromas zikhathaza xa ziqhutywa); ukungaqinisekiswa kokuxilongwa apho i-biopsy ifunwa ukuze kuqinisekiswe i-lesion engakhathazayo; okanye ukukhathazeka okukhulu komguli nangona beqinisekisiwe.

Ukususwa ngokupheleleyo kwe-surgical kukuphendula okugqibeleleyo kodwa kuza ne-caveat ebalulekileyo: kuba i-dermatofibromas zikhula ng глубоко kwi-dermis kwaye ngamanye amaxesha kwi-fat ye-subcutaneous, ukususwa ngokupheleleyo kudinga ukusika ngokujulile, oku kubangela i-surgical scar engabukekiyo kakhulu kunesikhumba sokuqala — ngakumbi kwiinyawo, apho ukuphola kwe-scar kuhlala kunciphile kwaye kubonakala kakhulu. Abaguli kufuneka bacebise ngale mngcipheko ngaphambi kokuba baqhubeke. Ukususwa kwe-shave (ukususwa kwe-tangential) kususa ingxenye ebonakalayo ye-dermatofibroma efana okanye ngaphantsi komgangatho wesikhumba, kushiya i-scar eflethi.

Nangona kunjalo, kuba ingxenye ejulile ihlala, iimeko zokuphinda zikhula ziphakamisa — zibalwa kwi-20 percent okanye ngaphezulu. I-cryotherapy nge-liquid nitrogen inganciphisa i-dermatofibromas kodwa ayivamile ukuyisusa ngokupheleleyo kwaye ingashiya iimpawu ezimnyama. Ukwelashwa kwe-laser kusebenze ngempumelelo eyahlukeneyo. Kubaninzi babaguli, indlela efanelekileyo kukuhlola kunye nokuqinisekisa, ukugcina ukususwa kwi-lesions ezibonisa iimpawu, ukungaqinisekiswa kokuxilongwa, okanye ukunciphisa ukukhathazeka kokubukeka.

Ukufumanisa umphunga oqinileyo kwisikhumba sakho kucacisa imibuzo kwaye ngamanye amaxesha kukhathazeka. Ngaba kukhulu i-dermatofibroma engonakali, okanye ingaba kukhulu okungaphezulu? I-Skinscanner ibonelela ngohlalutyo olukhawulezayo lwe-AI xa uthathela umfanekiso we-nodule yesikhumba ekhathazayo, ihlola iimpawu ezifana nemibala, umfanekiso, iimpawu zomda, kunye nomgangatho wesikhumba ukuze kuncedise ukucacisa ukuba i-lesion iyahambelana ne-dermatofibroma engonakali okanye ibonisa iimpawu ezifunekayo zokuhlola ngochwepheshe.

I-AI iyakwazi ukufumanisa iimpawu ezivamile ezihambelana ne-dermatofibromas — ukungcoliseka okumnyama, umfanekiso omjoliso, kunye nomgangatho opholileyo — kwaye iyahlula kwiimpawu ezikhumbuza i-lesions ezikhathazayo ezifana ne-dermatofibrosarcoma protuberans okanye i-melanoma. Kubantu abaninzi be-dermatofibromas, i-Skinscanner inceda ukulandelela i-lesions ezikhoyo ukuze kubekho nawaphi na utshintsho kwaye ibone iindawo ezintsha ezahluke kwi-pattern esele ibekwe. Nangona uphawu lwe-dimple lungakwazi ukungabikho ngokuqinisekileyo ngumbono, iimpawu ezibanjwe kumfanekiso ophezulu ziza neenkcukacha ezibalulekileyo zokuxilongwa.

I-Skinscanner ibaluleke kakhulu njengomphumo wokuqala wokuhlola kwiimeko ezivamile zokufumanisa umphunga oqinileyo omtsha kwaye ifuna umkhombandlela ophuthumayo ukuba ukuxilongwa okuphuthumayo kuyafuneka. Ayikwenzi indawo yokuhlola klinikali — nayiphi na i-nodule ekhula, itshintsha, ibonisa iimpawu, okanye ibonakala ingakhathazeki nangona i-AI iqinisekisa kufuneka ihloliswe ngodokotela wesikhumba onokwenza i-palpation, dermoscopy, kunye ne-biopsy ukuba kuyafuneka.