I-Seborrheic Keratosis: Iingxaki ezingonakaliyo ezibukeka zifana kakhulu neHautkrebs

I-seborrheic keratoses (SKs) ziindawo ezingenabungozi (ezingekho ne-cancer) ezivela kwi-skin ezivela kwiimeko ezivamile kakhulu kwiingcali, zichaphazela phantse wonke umntu ophila ixesha elide. Ngexesha elithile ziqanjwa ngothando — okanye ngengqondo engathandekiyo — njenge 'barnacles zokuguga' kuba ziqhuba ngokukhula ngokuhamba kwexesha, ziqala ngokuxhaphakileyo kwi-30s okanye kwi-40s kwaye zikhula zibe zininzi kwiiminyaka ezilandelayo. Ngeminyaka engama-50, uninzi lwabantu abadala lunokufumana okungenani omnye, kwaye abaninzi banokufumana iindidi ezininzi okanye ngaphezulu.

I-SKs ziveliswa kwi-keratinocytes (i-skin cells) ezikhula ukuze zenze umphumo ophawulekayo, onobumba, ophakamileyo obonakala 'ukufakwa' kwi-sikhumba — njengoko ungakha uthathe ngempundu yakho (nangona ungafuni ukuzama). Zihlala ziqhume ukusuka kumthubi omlight ukuya kumnyama omnyama okanye ng even black, ukusuka kumamitha ambalwa ukuya kumacm ambalwa ububanzi, kwaye zisuka kwi-flat ukuya kwi-phakamisa kakhulu. Umphumo wazo unokubukeka unobumba, unomoya, okanye unokubukeka njenge-verrucous (njenge-wart), ngokuqhelekileyo zine-horn cysts (i-pores ezincinci ez filled with keratin) kunye ne-fissures ezibavumela ukuba babonakale njenge cerebriform (njenge-brain) okanye zibe nzima ngaphantsi kokuphindaphinda.

Umthombo we-seborrheic keratoses awuqondwa ngokupheleleyo, kodwa ukulungelelaniswa kwezakhi zofuzo kukhulu — zihlala ziqhuba kwiimfuno. Ukukhanya kwelanga kudlala indima ethile, njengoko i-SKs ziqhelekile kwiindawo ezikhanyayo, nangona zikhula nakwiindawo ezikhuselweyo. Ukuphuculwa kwe-mutations kwiigene ze-growth factor receptors (ngokukodwa i-FGFR3 kunye ne-PIK3CA) ziye zafumaniswa kwi-SKs, kodwa lezi zi-mutations ze-somatic (ezenzeka kwiiseli ezithile) kunokuba zi-mutations ezithathwe. Ngaphandle kokuba ne-mutations ezikhuthazayo, i-SKs ziqinisekisiwe ukuba azinabungozi — azikhuli kwi-hautkrebs kwaye azinayo imisebenzi engonakaliyo.

Nangona zingekho mngcipheko, i-seborrheic keratoses ibandakanya inani elingaphezulu kokufanelekileyo leziqinisekiso eziphuthumayo kwi-dermatology kunye nokukhathazeka kwabantu. Isizathu silula: zingabukeka zikhathazekile. I-seborrheic keratoses ezimnyama zihlala zixhaphakile ukuba zixhaphake kwi-melanoma — i-pigmentation yabo engalunganga, imibala ehlukeneyo (imibala emininzi ye-brown kunye ne-black), kunye nemiphetho engalunganga ibangela ukukhathazeka okufanelekileyo.

Ng even experienced clinicians, kube nzima ukwahlula phakathi kwe-SK emnyama, engalunganga kwi-melanoma ngaphandle kokusebenzisa i-dermoscopy okanye i-biopsy. I-SK ezinzima, ezine-skala zingafana ne-squamous cell carcinoma okanye i-actinic keratosis, ngakumbi kwi-skin eyonakele ngelanga apho i-lesions ezinqabileyo ze-pre-cancerous kunye ne-cancerous zingabakhona kunye ne-SK ezilungileyo. I-SK ezivuthayo okanye eziphazamisayo — ezixhaphakileyo ngempahla, ezixhaphakileyo ngengozi, okanye ezibhekiswe kwi-friction — zingaba mnyama, zikhuluphale, zibe ne-crust, okanye zizele, zifana nokubukeka kwe-lesion ye-skin ehlaselayo.

Ukubukeka okungazelelwe kwe-SK ezininzi bekuxhaphakile ukuba kubandakanya i-malignancy yangaphakathi (uphawu lwe-Leser-Trelat), nangona ubungqina bokubaluleka kwalolu xhulumaniso buxoxwa, kwaye i-SK ezivuthayo ezininzi azihambelani ne-cancer. Ukukhathazeka okukhokelela kwi-SK kuyavuma kwaye kuvame ukuba neenzuzo — kuqinisekisa ukuhlolwa kwe-skin okukhumbuza ukuba kube nezinkinga ezinqabileyo. Umgca ubalulekile: abantu abathi bathi 'bana ne-seborrheic keratoses kuphela' bangaba neenkolelo ezingalunganga malunga nezinye iindawo ezikhulayo, bejolise kumphakathi.

I-lesion nganye entsha ifuna ukuhlolwa ngokwahlukileyo. I-melanoma ekhula edlalayo kwi-seborrheic keratosis ib dangerous njengoko ikhula kwi-skin ecacileyo — ukufunda ngama-SK akho akufanele kube yinto yokungabikhathali ngama-spot amasha okanye ashintshayo.!!

Iimpawu ezininzi zifaka isandla ekwahluleni i-seborrheic keratoses kwi-lesions ezikhathazayo, nangona ukwahlula okucacileyo kudinga ukuhlolwa kochwepheshe nge-dermoscopy okanye i-biopsy. Ukubukeka 'okubambekayo' kukhumbuza — i-SKs ibukeka ngathi zihlala phezulu kwesikhumba kunokuba zikhule ngaphakathi, kunye nemiphetho ecacileyo apho ukukhula kuhlangana nesikhumba esiqhelekileyo. I-texture ye-surface ethambileyo, ethambileyo ibonakala kwaye ihluke kwi-surface ye-matte, eqinile ye-actinic keratoses okanye i-smooth, shiny quality ye-basal cell carcinoma.

I-horn cysts — i-pore ezincinci, ezijolise kwi-keratin ezibonakala njengezikhumbuzo ezimhlophe kwi-surface ye-SK — yinto ethile engafumaneki kwi-lesions ezimbi. I-comedo-like openings (i-pores ezimnyama ezifana ne-blackheads) kwi-surface nazo zihlala zikhumbuza. Umbala we-SKs uhlala ungu uniform phakathi kwe-brown-to-black spectrum, kwaye nangona zingaba mnyama kakhulu, zihlala zinganalo uhlobo lwe-jet-black, blue-black, okanye red-blue-white color variation ebona kwi-melanoma.

I-SKs zineemiphetho ezicacileyo, ezilungileyo — nokuba zikhulu, zihlala zineemiphetho ezithambileyo, ezicacileyo kunemiphetho engalunganga, engalunganga ye-melanoma. Usayizi uyahluka kakhulu (2mm ukuya kwi-3cm okanye ngaphezulu) kwaye akuyonto ethembekileyo yokwahlula. I-SKs zingavela naphi na emzimbeni ngaphandle kweemvama kunye neentende, kunye ne-trunk, ubuso, kunye ne-extremities zihlala zixhaphakile.

Aziveli kwi-mucous membranes. Xa ungabaza, sebenzisa lo mthetho: ukuba ukukhula kwesikhumba kukukhathazela nganyathelo — umbala, umfanekiso, utshintsho, iimpawu — qinisekisa ukuba kuhlolwa kochwepheshe.!! ' I-dermoscopy (uhlolo ngesisombululo esikhethekileyo sokwandisa) kwiingcali ziqinisekisa ukwahlula i-SKs kwi-melanoma ngempumelelo ephezulu, ivumela ukugwema i-biopsy.

Nangona i-seborrheic keratoses ezininzi zihlala zikhankanywe ngokukhawuleza, i-biopsy (ukususwa kokuhamba kunye nokuhlolwa kwe-pathologic) ibalulekile kwiimeko ezininzi. Nanyani i-lesion engakwazi ukuxelwa ngokukhawuleza njengengalunganga ngokusekelwe kwi-uhlolo lwe-clinical kunye ne-dermoscopic kufuneka ibiyiswe — xa ungabazi, yenza. Iimeko ezithile zokubiza i-biopsy ziquka i-lesion eguqukileyo ngokukhawuleza ngobungakanani, umfanekiso, okanye umbala (i-SKs zikhula kancinci kwaye zihlala zizinzile; utshintsho olukhawulezayo lubonisa ukuxhaphakile); i-lesion emnyama okanye emnyama apho i-melanoma ingakwazi ukungabikho; i-lesion enezimpawu ezingalunganga ze-SK (imiphetho engalunganga, utshintsho lombala olungahambelani ne-SK, ukungabikho kweempawu ezithile ze-surface); i-lesion eyabuhlungu, ethambileyo, okanye ehlamba rhoqo ngaphandle kokuba neengxaki ezicacileyo; i-lesion enye ebonakala ngathi ihluke kwi-SKs zomgibeli (i-'ugly duckling' phakathi kwe-keratoses); kunye ne-lesion nayiphi na kumgibeli onembali yomntu ye-melanoma, apho umda we-biopsy kufuneka ube phantsi.

I-phenomenon ye-collision tumors — apho i-melanoma okanye enye i-malignancy ikhula ngaphakathi okanye edlalayo kwi-seborrheic keratosis — iyancipha kodwa ibhalwe, iqinisekisa ukubaluleka kokuhlola iindawo ezihluke kakhulu phakathi kwe-SKs ezijolise. Ukuhlolwa kwe-pathological kwe-SK ebiyiweyo kukhumbuza iimpawu ezithile: i-acanthosis (ukukhuluphala kwe-epidermis), i-papillomatosis (i-projections ezifana nezitho), i-hyperkeratosis (ukukhuluphala kwe-surface layer), kunye ne-horn cysts — umba ophawulekayo ohlawulwayo ngababheki. Ngexesha elithile, i-biopsy ye-lesion eyaziwa ngokukhawuleza njenge-SK ibonisa ukuxhaphakile okungazelelwe — i-melanocytic nevus, i-melanoma in situ, okanye i-squamous cell carcinoma — ibonisa ixabiso lokugcina umbono ofanelekileyo kwi-SKs 'ezicacileyo'.

I-seborrheic keratoses azidingi ukunyanga, njengoko zingekho mngcipheko kwaye azibanga mngcipheko kwimpilo. Nangona kunjalo, abaninzi babantu bafuna ukususwa ngenxa yezizathu zokubukeka, ngenxa yokuphazamiseka okuvela kwiimpahla okanye kwi-jewelry friction, okanye ukuze bathole uxolo emva kokukhathazeka malunga nokukhula okukhathazayo. Indlela yokukhupha eyaziwayo kakhulu yi-cryotherapy — i-nitrogen ye-liquid efakwa ukuze ibhucungulwe, ibangela i-SK ukuba ibhucungule kwaye iwile kwiiveki ezi-1-2.

I-cryotherapy iyashesha, ayibizi kakhulu, kwaye iyasebenza kwi-SKs ezijolise kancinci ukuya kwi-moderately raised, kodwa ingadinga iindlela ezininzi kwi-lesions ezinzima kwaye ingabangela i-hypopigmentation (iindawo ezimhlophe), ngakumbi kwiithoni zesikhumba ezimnyama. I-shave excision (ukususwa kwe-tangential) isebenzisa umphunga ukususa i-SK phezulu okanye kancinci ngaphantsi kwesikhumba emva kokuthambisa. Oku kunika isampulu yesikhumba ukuze kuhlolwe (kuqinisekisa ukuxhaphakile) kwaye kunika imiphumo emihle yokubukeka kwi-SKs ezikhulayo.

Ikakhulu iyasetyenziswa xa kukho nayiphi na ukungaqiniseki kokuxhaphakile, njengoko isikhumba esisuswayo sinokuhlolwa ngaphakathi. I-curettage (ukuxhaphaza) ngoko okanye ngaphandle kwe-electrodesiccation iyasebenza kwi-SKs ezithambileyo, ezikhulayo. Ukukhula kuxhaphazeka ngokuqhuba nge-curette, kwaye umphakamo unokubanjwa kancinci ukuze kuvinjwe ukuhamba kunye nokuvimbela ukuxhaphaza.

I-laser ablation esebenzisa i-CO2 okanye i-erbium lasers ibhucungula isikhumba kwaye ingaphatha i-SKs ezininzi kwi-seshoni enye ngempumelelo yokubukeka. I-electrosurgery isebenzisa umjikelo wombane ukuze ibhubhise i-SK. Kubantu abaninzi be-SKs abafuna ukunyanga, i-hydrogen peroxide 40% topical solution (Eskata) yayiyindlela yokunyanga eyamkelwe yi-FDA eyayixhaphakile i-SKs ngokufaka ngqo, nangona ukufumaneka kungahluka.

Umphanda obalulekileyo: i-insurance coverage yokukhupha i-SK ayihambelani. Xa ukususwa kwenziwa ngeenjongo zokuhlola (i-biopsy ukuze kuhlolwe i-malignancy), ikakhulu ibanjwa. Ukususwa kwe-cosmetic kuphela kungangabikho, kwaye abantu kufuneka bacele ukungena ngaphambi kokuba baqhubeke. Emva kokususwa, i-SKs zingabuyela kwindawo efanayo (ikakhulu ukuba ukususwa bekungaphelelanga) okanye, ngokuqhelekileyo, i-SKs ezintsha zivelisa kwezinye iindawo — ukususwa akuvumeli i-SKs ezizayo ukuba zivele.

Nangona i-seborrheic keratoses zihlala zingekho mngcipheko, zisebenza njengomkhumbuzo ophumelelayo wokujolisa kwi-skin yakho. Qinisekisa ukuba uhamba kudokotela ukuba uvelisa ukukhula kwesikhumba okumnyama kakhulu (okumnyama) okanye okuneemibala emininzi ngaphakathi, njengoko i-melanoma kufuneka ikhutshwe. Nanyani ukukhula okuguqukayo ngokukhawuleza kwiintsuku ukuya kwiiveki kudinga ukuhlolwa — i-SKs zikhula kancinci kwiinyanga ukuya kwiminyaka; utshintsho olukhawulezayo lubonisa into eyahlukeneyo.

Funa ukuhlolwa kwezinye i-skin growths eziphuma ngokuqhelekileyo okanye rhoqo ngaphandle kokuphazamiseka okucacileyo. Ukuba ukukhula kuba buhlungu okanye kuthambile ngaphandle kokuphazamiseka okucacileyo, ukuhlolwa kochwepheshe kuyafuneka. Ukubukeka okungazelelwe kwe-SKs ezininzi (uphawu lwe-Leser-Trelat) kufuneka kukhuthaze ukuhlolwa kwezonyango, njengoko kungabandakanya i-malignancy yangaphakathi.

Ukuba unengxaki yokwahlula i-SKs zakho kwezinye i-lesions kwi-skin yakho — ngakumbi ukuba unokuphazamiseka kwelanga, i-actinic keratoses, okanye imbali ye-skin cancer — ukuhlolwa kwe-skin okujolise kuqinisekisa ukuba i-SKs ezilungileyo azifihli i-lesions ezikhathazayo. Ngemiba yokubukeka, cela udokotela we-dermatologist malunga neendlela zokukhupha ezifanelekileyo kwi-lesions zakho ezithile, uhlobo lwesikhumba, kunye nolindelo. Ungazami ukususa i-SKs ekhaya usebenzisa ukusika, ukutshisa, okanye i-agent ye-chemical enamandla — oku kubeka umngcipheko wokubangela i-scarring, ukutheleleka, ukususa okungaphelelanga, kunye nokuphosa i-malignancy engalunganga.

Enye yezizathu ezivamile zokuthi abantu basebenzise amathuluzi okuhlola isikhumba ukuhlole ukukhula abakubone futhi banqume ukuthi kungenzeka kube yinto okufanele bayikhathalele. I-Skinscanner ibaluleke kakhulu kulokhu ngoba ama-seborrheic keratoses avame ukudideka nezinye izimo ezinzima. Ngokuthwebula isithombe sokukhula okukhathazayo, uthola ukuhlaziywa kwe-AI okusheshayo kwezici zayo — kuhlanganisa nezici ezikhombisa i-SK (ukubukeka okungafani, umumo we-waxy, ama-horn cysts) uma kuqhathaniswa nezici ezikhombisa ukukhathazeka nge-melanoma noma ezinye izifo zomdlavuza (imikhawulo engajwayelekile, ukwehluka kwemibala, ukungalingani).

Lokhu kuhlola kokuqala kusiza ukwenza isinqumo esinengqondo sokuthi kufanele ufune ukuhlolwa kochwepheshe ngokushesha, ngesikhathi sokuhlangana kwakho okujwayelekile, noma ungakwenzi nhlobo. Kulabo abanama-seborrheic keratoses amaningi, i-Skinscanner inikeza indlela esebenzayo yokubheka ukukhula kwakho okukhona futhi ibonakale ama-seborrheic keratoses amasha abukeka ehlukile kumaphethini akho ajwayelekile. Umqondo 'wempungushe engalungile' — i-lesion ebukeka kakhulu ehlukile kwezinye — awuhambisani kuphela namamole kodwa nase-SKs.

Ukukhula okungahambisani nokubukeka okujwayelekile kwezinye zakho ama-keratoses kudinga ukunakwa okukhulu. Ukuhlola njalo kudala uhlu lwezithombe lwezikhumba zakho, kwenza kube lula ukuthola ama-lesions amasha aqinile emuva kwemvelaphi ye-benign esele. I-Skinscanner ayifaki ukuhlolwa kwe-dermatologic — noma yikuphi ukukhula okunezici ezikhathazayo zokukhathazeka kudinga ukuhlolwa kochwepheshe futhi kungenzeka kube ne-biopsy. Kodwa inikeza ukuhlaziywa okutholakala kalula, okusheshayo okwenza kube lula ukuphatha inkinga evamile yokuhlukanisa ama-seborrheic keratoses angalimazi nezilonda ezidinga ukunakwa kwezokwelapha.