I-Wart Ejwayelekile: Ukukhula Kwezikhumba Okungapheli

Ama-wart ajwayelekile (verruca vulgaris) yizikhumba ezitholakala ngenxa yokutheleleka nge-human papillomavirus (HPV). Kukhona izinhlobo ezingaphezu kuka-200 ze-HPV ezitholakele, futhi izinhlobo ezahlukene zinezintandokazi ezindaweni ezahlukene zomzimba futhi zenza izinhlobo ezihlukene zama-wart. Ama-wart ajwayelekile ezandleni ajwayelekile abangelwa izinhlobo ze-HPV 2, 4, 27, kanye no-29.

Ama-wart e-plantar ezinyaweni ajwayelekile abangelwa izinhlobo ze-HPV 1, 2, 4, kanye no-63. Ama-wart aphansi afuna izinhlobo ze-HPV 3, 10, 28, kanye no-49. Kubalulekile, izinhlobo ze-HPV ezibangela ama-wart ajwayelekile azifani nezinhlobo ezibangela ama-wart ezitho zangasese noma umdlavuza wesibeletho — lokhu kuyiphutha elivamile elibangela ukukhathazeka okungadingekile.

I-HPV idluliselwa ngokuxhumana ngqo kwesikhumba noma ngokuxhumana okungaqondile ngezindawo ezingcolile. I-virus ingena ezindaweni ezincane eziphukile esikhumbeni — uk cuts, ama-hangnails, ama-cuticles aphukile, noma izindawo zokulimala zesikhumba ezivela ekudleni kwezinyawo noma ekukhipheni ama-hangnails. Izindawo ezimanzi zikhuthaza ukudluliswa, yingakho izindawo zokugeza zomphakathi, izindawo zokubhukuda, nezindawo zokugcina izimpahla zihlala zikhona njengezindawo zokutheleleka zama-wart e-plantar.

Ngemuva kokutheleleka, isikhathi sokukhula sishintsha ukusuka ezinyangeni ezi-1 kuya kwezi-20, okusho ukuthi ungase ube ne-virus isikhathi eside ngaphambi kokuba i-wart ibonakale. I-virus ithinta ama-keratinocytes (izicubu zesikhumba) futhi ithatha amandla okukhula kwabo, ibangela ukukhula okusheshayo okukhulisa ukukhula okuphakeme, okujwayelekile. Izingane nabantu abasha bavame ukuthinteka, ngokuvamile kukhula kakhulu ezingeni lezingane ezikoleni, mhlawumbe ngenxa yokungabi namandla okuvikela okuhle kanye nokuxhumana kwesikhumba okuphindaphindiwe. Abantu abane-immune compromise bahlala bethinteka kakhulu futhi bavame ukuthola ama-wart amaningi, angaphenduli ekwelapheni.

Ama-wart ajwayelekile (verruca vulgaris) avele njengokukhula okuphakeme, okunezindawo ezinzima, ngokuvamile ezandleni, ezitheni, nasemanzini. Ahluka ukusuka ku-1mm kuya phezulu ku-1cm futhi anomumo ophawulekayo ofana ne-cauliflower. Ukuhlola ngokucophelela kuvame ukukhombisa amaphuzu amnyama amancane ngaphakathi kwe-wart — lawa ngama-capillaries aphukile (izitho zegazi ezincane), hhayi 'imbewu' njengoba abantu abavame ukukucabanga.

Ama-wart ajwayelekile aqinile kokuthinta futhi anombala wesikhumba noma ubrown obumnyama. Ama-wart e-periungual akhula ezindaweni ezikhaleni nasemanzini, edala izinselelo ezithile zokwelapha futhi kungenzeka kubangele ukungahambi kahle kwezinyawo uma zikhula zibe zinkulu. Zivame ukutholakala kubantu abashaya izinyawo nezitho ezincane.

Ama-wart e-plantar akhula ezinyaweni, lapho ingcindezi yokuhamba ibashaya ngaphakathi, idala izilonda eziphakeme noma ezincane ezijolile ezizungezwe umjikelezo wesikhumba esiqinile (callus). Ama-wart e-plantar angaba nobuhlungu obukhulu, okwenza ukuhamba kube nzima, ikakhulukazi uma zikhula ezindaweni ezicindezelayo ezifana ne-heel noma ibhola lezinyawo. Ama-wart e-mosaic ayizixuku zama-wart e-plantar ezihlotshaniswa kakhulu nokwelashwa.

Ama-wart aphansi (verruca plana) amancane (1-5mm), aqinile, aphezulu, futhi aphakeme kancane. Avame ukuvela enanini elikhulu — amakhulu kuya kumakhulu — ebusweni, emakhanda, ezandleni, noma ezinyaweni. Nakuba zincane ngokweqile, umkhuba wazo wokuvela ezixukwini wenza zibe nezinkinga zokubukeka.

Kubantu, zivame ukuvela endaweni ye-beard, lapho ukushefa kusabalalisa i-virus. Ama-wart e-filiform ayizikhumbuzo ezincane, ezinjengemikhono ezivame ukuvela ebusweni, ezindaweni zomlomo, emaphashini, nasezitheni. Zihluke kakhulu ekubukeni kodwa zingaphindwa njengezikhumbuzo zesikhumba. Ukuhlukanisa ama-wart kwezinye izikhumba (ama-seborrheic keratoses, umdlavuza weseli ye-squamous, i-molluscum contagiosum) kubalulekile ngoba izindlela zokwelapha zihluka kakhulu.

Izindlela zokwelapha ama-wart ezitholakala ezitolo zigxile ku-salicylic acid, etholakala njengezinto eziphilayo, ama-gels, ama-pads, kanye nezibopho ezine-concentration ukusuka ku-17% kuya ku-40%. I-salicylic acid isebenza ngokuhlanza kancane i-keratin protein eyakha i-wart kanye nesikhumba esifile esiqinile esiyigubungele, futhi iphinde ibangele impendulo ethile ye-immune. Ukuze uthole imiphumela engcono, gubha i-wart emanzini afudumele imizuzu engu-5-10, bese ufaka phansi isikhumba esiqinile esifile ngombhoxo ophumayo noma itshe le-pumice (ungakabelani nalezi zinsiza), faka i-salicylic acid ngqo ebusweni be-wart, bese uyiqinisekisa ngombhoxo.

Phinda nsuku zonke izinyanga eziyi-8-12. Ukubekezela kubalulekile — ukuphathwa kwe-wart kuyimijaho, hhayi ukuhamba, futhi abantu abaningi bayayeka ukuphathwa masisha. Izinga lokuphumelela kwe-salicylic acid lilinganiselwa ku-50-70% uma isetshenziswa njalo, isikhathi eside.

Izikhwama zokwelapha ezitholakala ezitolo (imikhiqizo yokufriza) zisebenzisa i-dimethyl ether kanye ne-propane mixtures ukuze zifrice ama-wart. Nakuba zikhangiswa njengezilingana ne-cryotherapy yobuchwepheshe, zifinyelela izinga lokushisa elingama-57 degrees Celsius kuphela uma kuqhathaniswa ne-liquid nitrogen enama-196 degrees, okwenza zibe nekhono eliphansi. Zingaba usizo njengokwengeza ku-salicylic acid kodwa zihlala zingaphumeleli njengokwelashwa okuzenzakalelayo kwe-wart esezikhona.

I-duct tape occlusion therapy ihloliwe ngemiphumela ehlukahlukene — umqondo uwukuthi ukuvalela i-wart kubangela ukuvuvukala kwesikhumba futhi kukhuthaze impendulo ye-immune. Uma uzama, faka i-duct tape phezu kwe-wart izinsuku eziyisithupha, uyisuse, gubha futhi ufake i-wart, bese uyishiya ivulekile ubusuku ngaphambi kokuyifaka futhi izinsuku eziyisithupha. Ubufakazi bokusebenza abukhona, kodwa kuphephile.

Izindlela zokwelapha eziphuthumayo okufanele ugweme: ukusika noma ukukhipha ama-wart ngezinsiza ezibukhali kubeka engcupheni yokutheleleka, izilonda, nokukhipha okungaphelele okwandisa i-virus; ukushisa ama-wart ngama-match noma ama-cigarettes kubangela izilonda nezilonda; ukufaka ama-oils ayinhloko angakahlukaniswa noma i-bleach kungabangela izilonda zamakhemikhali. Ungazami ukuphatha ama-wart ebusweni, ezithweni zangasese, noma ezindaweni ezinkulu ngaphandle kokuholwa kochwepheshe.

Uma ukuphathwa kwasekhaya kwehluleka — futhi kuvame ukwenzeka, ikakhulukazi kuma-wart e-plantar, ama-wart e-periungual, kanye nama-wart amaningi — ukuphathwa kobuchwepheshe kunikeza izinketho ezinamandla. I-cryotherapy nge-liquid nitrogen iyindlela evame kakhulu yokwelapha ama-wart. I-liquid nitrogen enama-196 degrees Celsius ifakwa ngqo kwi-wart nge-spray noma i-cotton-tipped applicator, ibangela ukufa kwamaseli ngokwakha ama-crystal e-ice kanye nokuphazamiseka kwezakhiwo.

I-blister ivame ukuvela phakathi nezinsuku eziyi-24. Ukuphathwa kubuhlungu (umjikelezo wokufriza uqobo kanye ne-blister elandelayo), futhi izikhathi eziningi zidingeka njalo ezinyangeni ezi-2-3 ukuze kuphumelele, nezinga elijwayelekile lokwelashwa lilinganiselwa ku-50-75% ngemuva kwezikhathi eziningi. I-Cantharidin iyinsiza yokwakha i-blister ethathwe kwi-blister beetle, efakwa ehhovisi bese ihlanzwa ekhaya ngamahora kamuva.

Ibangela i-blister engabuhlungu ethula i-wart. Ikakhulukazi iyasiza ezinganeni ngoba ukufaka akubuhlungu — i-blister ivela kamuva. I-Electrodesiccation kanye ne-curettage kubandakanya ukuvuvukala endaweni nge-anesthesia yendawo, bese kuthi i-wart igqokwe nge-curette futhi icuthwe.

Lokhu kusebenza kuma-wart ngamunye kodwa kubangela ukulimala okudinga ukuphola phakathi nezinsuku ezi-2-4 futhi kungase kushiye izilonda. I-Intralesional immunotherapy ibandakanya ukufaka ama-antigens (i-Candida antigen ivame ukusetshenziswa) ngqo kwi-wart, ibangela impendulo ye-immune ephikisa i-virus. Ubuhle balolu hlelo ukuthi ivame ukususa ama-wart angakatholakali, angaphathwa ngesikhathi esifanayo njengoba impendulo ye-immune ye-systemic igxile kumaseli athintekile nge-HPV emzimbeni.

Kubalulekile ikakhulukazi kubaguli abane-wart amaningi. I-Bleomycin injection (i-intralesional chemotherapy) igcinwe kuma-wart aqinile, angaphenduli ekwelapheni futhi idiliza isikhumba se-wart ngokuqondile. Kubuhlungu futhi kunobungozi bokulimala kwezinyawo uma isetshenziswa kuma-wart e-periungual.

I-Pulsed dye laser igxile ezithweni zegazi ezinikeza i-wart, ibangela ukushiswa okukhethekile. Kuma-wart angaphenduli, i-topical immunotherapy nge-squaric acid dibutylester (SADBE) noma i-diphencyprone (DPCP) ibangela impendulo ye-allergic yokuxhumana ekhuthaza uhlelo lwe-immune ukuba luhlasela i-wart.

Izinga lokuphindaphinda lama-wart ngemuva kokwelashwa liphakathi kokukhathazeka — izilinganiso zihluka ukusuka ku-20% kuya ku-70% kuye ngendlela yokwelapha kanye nezitho zomuntu. Ukuqonda ukuthi kungani kubonisa indlela yokuvimbela. Ama-wart aphindaphinda ngoba ukuphathwa kudiliza i-wart ebonakalayo kodwa akuhlanzi zonke izicubu ezithintekile nge-HPV, ikakhulukazi lezo ezikhaleni kwe-wart noma esikhumbeni esikhaleni.

I-virus ingahlala isesimweni esifihlekile ezicubeni ezizungezile, ibuyisela uma izimo zikhuthaza. Abantu abane-immune compromise bahlala bethinteka kakhulu ngenxa yokuthi izinhlelo zabo zokuvikela azikwazi ukuhlinzeka impendulo eqinile edingekayo ukuze kususwe i-virus. Ukususa ama-wart kubantu abaphilile kuncike ekutheni uhlelo lwe-immune luyawuqaphela futhi luhlasela amaseli athintekile nge-HPV — izindlela zokwelapha zisebenza ngokunciphisa umthwalo we-virus nokukhuthaza ukunakwa kwe-immune, kodwa ukususa okokugcina kudinga impendulo ye-immune esebenzayo.

Lokhu kungukuthi cishe u-65% wama-wart kubantu abane-immune competent azosuswa ngokwabo phakathi nezinyanga ezimbili ngaphandle kokwelashwa — uhlelo lwe-immune ekugcineni luthola impendulo esebenzayo. Ukuvimbela ukusabalala nokuphindaphinda kubandakanya izindlela eziningana: gwema ukuthinta noma ukukhipha ama-wart, njengoba lokhu kusabalalisa i-virus ezindaweni ezintsha (autoinoculation); gcina ama-wart agqokwe ngombhoxo ngesikhathi sokwelashwa ukuze uvimbele ukusabalalisa i-virus kwabanye nasemazweni amasha; ungabelani ngezinto zomuntu ezifana namathawula, ama-razor, ama-nail clippers, noma ama-files; gqoka ama-flip-flops noma izicathulo zamanzi ezindaweni zokugeza zomphakathi, ezindaweni zokubhukuda, nezindawo zokugcina izimpahla; gcina isikhumba sikhululekile futhi sithambile ngoba isikhumba esiqinile sincane kakhulu ekuthinteni i-HPV; gwema ukusika izinyawo nokukhipha ama-hangnails njengoba lokhu kudala izindawo zokungena ze-virus ezandleni; phatha ama-wart ngokushesha esikhundleni sokulinda, njengoba ama-wart amancane aphendula kangcono ekwelapheni futhi akhiphe i-virus encane. Kubantu abancane ikakhulukazi, ukubhekana nama-wart kusenesikhathi kuvimbela isithunzi somphakathi kanye nomthelela wokuphsychological ongase uvele njengoba ama-wart eqhubeka nokubonakala.

Ngenkathi ama-wart amaningi engabi nobungozi futhi ezilungisa, izimo ezithile zidinga ukuhlolwa kobuchwepheshe. Bheka udokotela uma ungazi ukuthi ukukhula kuyinto ye-wart — ikakhulukazi kubantu abadala abangaphezu kweminyaka engu-50, lapho ukukhula okusha okuphakeme kungase kube ama-keratoses e-actinic noma umdlavuza weseli ye-squamous kunokuba kube ama-wart. Noma iyiphi i-lesion ehluleka kalula, ekhula ngokushesha, iguqula umbala, noma ithuthukisa imikhawulo engajwayelekile idinga ukuhlolwa kobuchwepheshe ukuze kuqinisekiswe ukuthi akukhona okubi.

Ama-wart ebusweni kufanele aphathwe ngobuchwepheshe ngoba ukuphathwa kwasekhaya okuphuthumayo kubeka engcupheni yokushiya izilonda ezindaweni ezithintekayo. Ama-wart ezitho zangasese noma ezikhaleni zidinga ukuhlolwa kobuchwepheshe nokwelashwa, njengoba zingase zibe ngenxa yezinhlobo ze-HPV eziphakeme futhi zibe nezidingo ezihlukile zokwelapha. Ama-wart e-plantar abanga ubuhlungu obukhulu noma aphazamisa ukuhamba afanele ukuphathwa kobuchwepheshe.

Uma ukuphathwa kwasekhaya kwehluleka ngemuva kwezinyanga eziyi-12 zokufaka njalo, ukungenelela kobuchwepheshe kunikeza izinketho ezisebenzayo kakhulu. Abaguli abane-diabetes kanye nalabo abane-peripheral neuropathy noma i-peripheral vascular disease akufanele bazame ukuphatha ama-wart ezinyaweni — ukungabi nembono nokuhamba kwandisa ubungozi bezinkinga. Abaguli abane-immune suppression (abathola ukuhlinzwa kwezinso, abantu abane-HIV, labo abathola imishanguzo yokunciphisa i-immune) kufanele bafune ukunakekelwa kobuchwepheshe kuzo zonke ama-wart, njengoba laba baguli bathola ama-wart amaningi, aqinile, futhi angaphenduli ekwelapheni anobungozi obuphakeme bokuguqulwa kokubi.

Ama-wart amaningi akhula ngokushesha abonisa ukungabi namandla kwe-immune futhi adinga ukuhlolwa kwezokwelapha. Izingane ezine-wart ezikhaleni ezithinta ukukhula kwezinyawo kufanele zibonane nodokotela wezikhumba, njengoba ama-wart e-periungual angabangela ukungahambi kahle kwezinyawo uma engaphathwa kahle.

Ukuhlukanisa ama-wart kwezinye izikhumba akuhlali kulula — ama-seborrheic keratoses, i-molluscum contagiosum, ama-calluses, futhi ngisho nemikhakha ethile yomdlavuza wesikhumba ingafana nama-wart emehlweni angafundile. I-Skinscanner inikeza ukuhlola kokuqala okutholakalayo, ikusize uqonde ukuthi ukukhula okuphakeme kungenzeka kube i-wart noma okuthile okudingayo ukunakwa okuhlukile. I-AI yethu ifundiswe ukuqaphela izici ezithile zama-wart ahlukene — umumo ophakeme ofana ne-cauliflower, ama-capillaries aphukile abukeka njengamaphuzu amnyama, kanye nomumo wesurface ye-keratotic ehlukanisa ama-wart kwezinye izikhumba.

Kulabo abaphila ama-wart, ukurekhoda ama-wart akho ngezithombe ezivamile kuhlinzeka ngobufakazi obungokoqobo bokuphendula kokwelapha. Kungaba nzima ukuhlole ukuthi i-wart e-plantar iyancipha uma uyibuka nsuku zonke, kodwa izithombe ezithathwe ziqhathaniswa ezivela ezinsukwini ezahlukene zenza intuthuko (noma ukungabi khona kwayo) ibonakale kahle. Lokhu kuqopha kusiza ukukhetha isikhathi sokuhlala nokuphathwa okwamanje noma isikhathi sokukhuphula ukuya kokunakekelwa kobuchwepheshe.

I-Skinscanner iphinde isize ukuqapha ama-wart amasha avela kwezinye izindawo, ikakhulukazi ngesikhathi sokwelashwa lapho ubungozi be-autoinoculation bukhuphuka. Ngenkathi ama-wart evame ukuba nezinzuzo futhi engabuhlungu, ukuwuhlola kusiza ukuqinisekisa ukuthi uphatha isimo esifanele ngendlela efanele — futhi kuvikela izinsuku eziningi zokuphathwa okungasebenzi uma ukukhula kuvela kube okuthile okungaphezu kwe-wart.