Blue Nevus: Kungani Amamole Ethile Ebukeka Eblue Futhi Nini Okufanele Ube Nokukhathazeka

I-blue nevus iyisiguli esilungile se-melanocytic — uhlobo lwe-mole — ebukeka eblue, e-blue-gray, noma e-blue-black esikhundleni sombala ojwayelekile obrown noma otan obuhlotshaniswa namamole amaningi. Umbala obuluhlaza awudalwa yimichiza ehlukile ye-pigment kodwa kunalokho ngumphumela wokukhanya ophathelene ne-melanin etholakala ejulile ngaphakathi kwe-dermis. Ngenkathi ama-melanocytes kumamole ajwayelekile ehlala eduze komhlaba wesikhumba ku-epidermis nase-dermis engaphezulu, ama-melanocytes ku-blue nevus atholakala ejulile ngaphakathi kwe-mid-to-lower dermis.

Le ndawo ejulile ikhiqiza ukubukeka kwe-blue okujwayelekile ngempumelelo eyaziwa ngokuthi umphumela we-Tyndall — umqondo ofanayo wokubuka owenza ukuthi isibhakabhaka sibonakale sibe blue nezitho zomzimba zibonakale zibe blue-green ngaphakathi kwesikhumba. Ngesikhathi ukukhanya kungena esikhumbeni, ama-wavelengths amade (obomvu, ophuzi) angena kakhulu futhi abanjwe yi-melanin ejulile, kanti ama-wavelengths amancane (eblue) ayahlakazeka futhi abuyiselwa emlonyeni womlomo, okwakha ukubukeka kwe-blue. Ama-blue nevi ajwayelekile, atholakala cishe kumaphesenti amabili abantu.

Angavela noma kuphi emzimbeni kodwa avame ukutholakala ezandleni nasemathangeni, esikhumbeni, ebusweni, nasemathangeni. Avame ukuvela ebuncaneni noma ebusheni futhi ahlale engashintshi phakathi kokuphila. Iningi lawo alikodwa, lincane (lingaphansi kwe-centimeter eyodwa), futhi alikhathazi. Ngesikhathi umbala obujwayelekile obuluhlaza ungabangele ukukhathazeka, iningi elikhulu lama-blue nevi alikona futhi adinga kuphela ukulandelwa okujwayelekile.

Kukhona izinhlobo eziningi ezihlukene ze-blue nevi, ngayinye inezici ezithile zokwelashwa nezokuhlola. I-blue nevus evamile (uhlobo lwe-Jadassohn-Tieche) iyona evame kakhulu, ibonakala njengendawo encane (ngokuvamile ngaphansi kwecentimeter eyodwa), ecacile, iphapha eliluhlaza-kwazulu noma elimpunga. Iqukethe ama-melanocytes akhula ngokweqile, adidiyelwe phakathi kwe-dermis anemibala eminingi ye-melanin.

I-blue nevi evamile ivame ukutholakala ezandleni nasemathangeni, emqolo, nasebusweni. Ziqinile kakhulu kwi-dermis, ziqinile uma zixhunywe, futhi zinezingxenye ezithambile, ezicacile. Uma seziqhamukile, zihlala ziqinile ngosayizi nembala eminyakeni.

I-cellular blue nevus iyinhlobo enkulu, evame ukukala phakathi kwecentimeter eyodwa kuya kwezintathu, evame ukwenzeka ezindaweni zembobo, endaweni ye-sacrococcygeal, nasekhanda. Ibukeka njengendandatho eluhlaza-kwazulu noma iphakethe futhi iqukethe iziqephu ezinzima zama-epithelioid kanye nama-melanocytes akhula ngokweqile ngaphezu kwama-melanocytes ajwayelekile. I-cellular blue nevus ibalulekile ngokwelashwa ngoba inengozi encane yokuguqulwa ibe yingozi uma iqhathaniswa nohlobo evamile, futhi ingaba nzima ukuyihlukanisa ne-melanoma ngokuhlola.

I-combined blue nevus ibhekisela ku-blue nevus ehambisana nezinye izinhlobo ze-melanocytic nevus (njenge-nevus evamile etholekile noma i-Spitz nevus) ngaphakathi kwalesi sifo, ikhiqiza isifo esinezingxenye ezimnyama neziluhlaza. I-epithelioid blue nevus iyinhlobo ehambisana ne-Carney complex, isifo esiyinqaba esihlanganisa ama-myxomas enhliziyo, ukusebenza ngokweqile kwe-endocrine, kanye nezinkinga zokuphuza. Le nhlobo iqukethe ama-melanocytes aphekiwe kakhulu futhi idinga ukuhlolwa ukuze kuhlolwe lesi sifo esihambisanayo.

Ukuqonda ukuthi kungani i-blue nevi ibonakala iluhlaza kudinga ukuhlola okuncane kwe-physics yokuxhumana kokukhanya nesikhumba. Umphumela we-Tyndall — ogama lakhe livela kumphakathi we-19th-century uJohn Tyndall — uchaza ukusakazeka kokukhanya ngama-particles aphakanyisiwe emithonjeni. Lapho ukukhanya okuphuma emhlophe (okuhlanganisa wonke ama-wavelengths abonakalayo) kungena esikhumbeni, kuhlangana nezakhi ezihlukene ezisakazayo.

Ama-wavelengths amafushane (ukhanya oluhlaza noluphuzi, cishe phakathi kuka-400 kuya ku-490 nanometers) asakazeka kahle kakhulu kunezikhathi ezide (ukhanya obomvu noluphuzi, cishe phakathi kuka-590 kuya ku-700 nanometers). Ku-mole evamile emnyama, i-pigment ye-melanin itholakala kwi-epidermis nase-dermis ephezulu, eduze kakhulu nendawo yokuphuma ukuze wonke ama-wavelengths okukhanya axhumane nayo futhi athathwe ngokulinganayo, akhiqiza ukubukeka okubomvu. Ku-blue nevus, i-melanin itholakala ejulile — kwi-dermis ephakathi kuya phansi.

Kule datha, ama-wavelengths amade okukhanya angena ngokujulile ukuze athathwe yi-melanin, ekususa kahle izici ezibomvu nezimpunga ezivela ekukhanyeni okukhanyayo. Ngaleso sikhathi, ama-wavelengths amancane aluhlaza asakazeka kakhulu ngama-collagen e-dermal aphakanyisiwe ngaphambi kokufinyelela kwi-melanin ejulile, abuyela emuva kumfundi. Umphumela omkhulu ukuthi amehlo ethu abona kakhulu ama-wavelengths aluhlaza abuyela esikhumbeni phezu kwe-blue nevus. Le mfundiso ifanekisela izimo eziningi eziluhlaza emvelweni nasezokwelapha: ukubukeka okuluhlaza kwemithambo ye-subdermal (i-hemoglobin engashintshiwe empeleni ibomvu emnyama, hhayi iluhlaza), umbala oluhlaza wezinsimbi ezithile ezinezinhlayiya ezijulile, amehlo aluhlaza (awane-pigment eluhlaza), kanye nokubukeka okuphuma kwe-pigments ethile ye-tattoo ezihamba phansi kwi-dermis ngokuhamba kwesikhathi.

Inkinga enkulu yokwelashwa nge-blue nevi ukuthi zingase zixhunywe ne-nodular melanoma noma i-melanoma efana ne-blue nevus, kokubili okungase kubonakale njengama-nodules aluhlaza noma aluhlaza-nombala omnyama. Izici ezihlukile ze-blue nevus evamile zifaka usayizi omncane (ongaphansi kwecentimeter eyodwa), umbala oluhlaza-kwazulu, imingcele ecacile, ubuso obuthambile, kanye nokuzinza kwesikhathi eside ngaphandle kokushintsha. I-melanoma, ngokuphambene, ivame ukukhombisa ukungalingani, imingcele engajwayelekile noma engacacile, ukuhlanganiswa kombala (ukuhlanganiswa kwezindawo eziluhlaza, ezimnyama, ezimnyama, ezibomvu, noma ezimhlophe), usayizi omkhulu, kanye nokuguquguquka ngokuhamba kwesikhathi.

Isici esiyinhloko sokwelashwa esikhuthaza i-blue nevus evamile ukuhlala — isifo esiluhlaza esikhona iminyaka ngaphandle kokushintsha usayizi, isimo, noma umbala sinesiqiniseko sokuthi singenza kahle.!! Ngakolunye uhlangothi, isifo esiluhlaza noma esiluhlaza-nombala omnyama esisha, sikhula, sishintsha isimo noma umbala, sinesimo (sokukhathazeka, sokukhathazeka, noma sokopha), noma sikhulu kunecentimeter eyodwa kufanele sihlolwe ukuze kubhekwane ne-blue nevus engaba yingozi noma i-melanoma. I-malignant blue nevus iyinto eyinqaba kodwa eyaziwayo — i-melanoma eqinile ephuma ngaphakathi noma efana ne-blue nevus.

Ivame ukwenzeka kakhulu ku-cellular blue nevus, ikakhulukazi ezindaweni ezinkulu ekhanda. Izici eziphakamisa ubungozi zifaka ukukhula okusheshayo, usayizi ophakeme kunezintathu, ukuvuvukala, izindawo ezincane, kanye nemingcele engajwayelekile. I-dermoscopy (ukuhlola nge-magnifier yokukhanya okuphakanyisiwe) ingasiza ekuhlukaniseni i-blue nevi evamile ne-melanoma.

I-blue nevi ivame ukukhombisa iphethini eluhlaza-kwazulu elihambisanayo ngaphandle kwenethiwekhi engajwayelekile, izakhiwo zokuhoxiswa, noma iphethini enombala ehlukahlukene ebonakalayo ye-melanoma. Lapho ukuhlolwa kwekliniki kanye ne-dermoscopic kungakwazi ukuhlinzeka ngokuqinisekile ngokuqinisekile, i-biopsy iyadingeka.!!

I-blue nevi eziningi zihlolwa ngokwelashwa ngokusekelwe ekubukekeni kwazo okujwayelekile — indawo encane, ecacile, eluhlaza noma eluhlaza-kwazulu, eqhubekayo isikhathi eside. I-dermoscopy ithuthukisa ukunemba kokuxilongwa ngokukhombisa iphethini eluhlaza-kwazulu elihambisanayo noma elikhanyayo elijwayelekile le-blue nevi, ehlukile kumaphethini ahlukahlukene abonakala kwi-melanoma. Ezandleni ezichwepheshile, ukuhlolwa kwekliniki kanye ne-dermoscopic kukhululekile ukuphatha i-blue nevi evamile ngaphandle kwe-biopsy.

Nokho, i-biopsy iyalulekwa nganoma iyiphi indawo eluhlaza eshintshile usayizi, umbala, noma isimo; noma iyiphi indawo eluhlaza enkulu kunecentimeter eyodwa; i-cellular blue nevi, ikakhulukazi ezinkulu ekhanda noma kwi-sacrum; izindawo eziluhlaza ezinezingxenye ezingajwayelekile, ukungalingani, noma ukuhlanganiswa kombala; izindawo ezintsha eziluhlaza ezivela kubantu abadala abangaphezu kweminyaka engama-40; kanye nanoma iyiphi indawo eluhlaza edala ukungaqiniseki kokuxilongwa. I-excisional biopsy — ukususa indawo yonke enezinhlangothi ezincane — ikhethwa kune-biopsy engaphelele, njengoba ivumela ukuhlolwa kwe-histopathologic okuphelele kanye nokuxilongwa okuqinisekile. Ukuhlolwa kwezokwelapha kwe-blue nevus kukhombisa ama-melanocytes adidiyelwe kakhulu e-dermal dendritic anemibala ye-melanin, nezindlela ezithile zihluka ngohlobo.

Uma i-blue nevus iqinisekiswe njengebenign, ukuhlola okujwayelekile kuyafaneleka. Ukuhlolwa kwesikhumba konyaka kufanele kufake ukuhlola i-blue nevi eyaziwayo ngezinguquko. Abaguli kufanele bafundiswe ngezimpawu ezidinga ukubuyela ekuhlolweni — ukukhula, ushintsho lombala, izinguquko ezithintekayo, noma ukungalingani kwemingcele. Ku-cellular blue nevi, abanye odokotela bezikhumba baphakamisa ukususa ngokuphelele ukuze kuqedwe ingozi encane yokuguqulwa ibe yingozi, ikakhulukazi ezindaweni ezinkulu.

Indawo eluhlaza noma eluhlaza-nombala omnyama esikhumbeni iyakhathaza — umbala ongajwayelekile ubonisa ngokushesha ukuthi kukhona okungahambi kahle uma kuqhathaniswa ne-mole evamile. I-Skinscanner inikeza ukuhlolwa okuphuthumayo okusekelwe ku-AI uma uthatha isithombe sendawo yesikhumba eluhlaza, ihlaziya ukujwayeleka kwayo kombala, ukujwayeleka kwemingcele, ukulingana, usayizi, nezici zendawo ukuze kutholakale ukuthi ihambisana ne-phethini evamile ye-blue nevus noma ibonisa izici ezidinga ukuhlolwa kochwepheshe. I-AI ifundiswe ukukhomba ukubukeka okujwayelekile kwe-blue nevi eluhlaza-kwazulu futhi ikwazi ukuhlonza izici ezikhathazayo ezifana nokuhlanganiswa kombala, imingcele engajwayelekile, nokungalingani okungase kubonise i-melanoma.

Lokhu kuhlola kokuqala kubalulekile ngoba izindawo eziluhlaza zidalela ukukhathazeka okungafanele — umbala wazo ongajwayelekile wenza zibonakale zikhathaza kakhulu kunezindawo ezimnyama noma ezibomvu nakuba zingase zibe zinhle. I-Skinscanner isiza ukuhlinzeka ngemininingwane efanele mayelana nezindawo eziluhlaza, ichaza umphumela we-Tyndall kanye nemvelo evamile ye-blue nevi ezinzile ngenkathi ibonisa kahle izindawo ezihamba phambili ezihambisana ne-phethini elindelekile. Kubantu abanama-blue nevi aziwayo, uhlelo lwenza kube lula ukulandela izinguquko ngokuhamba kwesikhathi ngokuthatha izithombe ezilandelanayo, kudala irekhodi elibonakalayo elenza kube lula ukuthola noma yiziphi izinguquko ngosayizi, umbala, noma izici zemingcele.

I-Skinscanner ayithathi indawo yokuhlola ye-dermoscopic ngudokotela oqeqeshiwe — noma iyiphi indawo eluhlaza enezici ezingajwayelekile noma izinguquko ezikhathazayo idinga ukuhlolwa kochwepheshe nge-biopsy engase ibekhona. Kodwa esimweni evamile sokuthola indawo eluhlaza nokuzibuza ukuthi ingabe iyingozi, i-Skinscanner inikeza umhlahlandlela ofinyeleleka, ophuthumayo.