Khansara Ya Pakhungu ndi UVB Phototherapy

Kodi chiopsezo chokhala ndi khansa yapakhungu ndi UVB phototherapy ndi chiyani?

Mosiyana ndi cheza cha ultraviolet chochokera ku kuwala kwachilengedwe ndi nyali zoyaka zodzikongoletsera, zaka makumi ambiri zogwiritsidwa ntchito pakhungu zawonetsa kuti UVB/UVB-Narrowband phototherapy (yomwe UVA imasiyanitsidwa kwambiri) si chiopsezo chachikulu cha khansa yapakhungu;
kuphatikizapo basal cell carcinoma (BCC), squamous cell carcinoma (SCC) ndi cutaneous malignant melanoma (CMM).

Kuti muthandizire mawu awa, chonde lingalirani
mfundo zotsatirazi, ndi kukambirana kotsatira:

Kafukufuku wobwerezabwereza wofalitsidwa mu Disembala 2023 wotchedwa
Zochitika ndi mbiri ya khansa yapakhungu mwa odwala omwe amatsatira ultraviolet phototherapy popanda psoralens anamaliza:

 

 

Pazonse, odwala 3506 omwe amathandizidwa ndi Broadband-ultraviolet-B, narrowband-UVB ndi/kapena UVAB ophatikizidwa adawunikidwa ndikutsata zaka 7.3 zomwe zidatsimikizira kuti panalibe chiopsezo chowonjezereka cha khansa ya melanoma ndi khansa ya keratinocyte yomwe idapezeka ndi phototherapy "

Kafukufuku watsopano wosangalatsa wofalitsidwa mu Epulo 2023 wawonetsa "Anthu omwe ali ndi vitiligo ali ndi chiopsezo chochepa cha khansa yapakhungu ya melanoma komanso yomwe si ya melanoma poyerekeza ndi anthu wamba."
Inanenanso kuti "Poganizira zakuti mankhwala ena a vitiligo, monga phototherapy kwa nthawi yayitali, amatha kukulitsa chiwopsezo cha khansa yapakhungu, kuchepa kwachiwopsezo cha khansa yapakhungu kuyenera kukhala kolimbikitsa kwa anthu omwe ali ndi vitiligo komanso azachipatala omwe akuwongolera vutoli."

A phunziro latsopano lofalitsidwa mu Ogasiti 2022 kuchokera ku Vancouver (Kuchuluka kwa khansa yapakhungu kwa odwala omwe ali ndi chikanga chothandizidwa ndi ultraviolet phototherapy) amamaliza kuti:

 

"Ponseponse, kupatula odwala omwe adamwa mankhwala ochepetsa chitetezo chamthupi †, panalibe chiwopsezo chowonjezereka cha melanoma, squamous cell carcinoma, kapena basal cell carcinoma mwa odwala omwe amalandila ultraviolet phototherapy, kuphatikiza narrowband UVB, Broadband UVB, ndi UVA kuphatikiza Broadband. UVB, kuthandizira izi ngati chithandizo chopanda khansa kwa odwala omwe ali ndi atopic eczema. ”

Ndemanga za kafukufuku wa UVB, wa narrowband ndi Broadband, sizikuwonetsa chiopsezo chokhala ndi khansa yapakhungu yopanda melanoma kapena melanoma.

Kuti muwerenge phunziro lonse, tsatirani ulalo uwu:

Chithandizo cha psoriasis ndi chiopsezo cha zilonda.

Patel RV1, Clark LN, Lebwohl M, Weinberg JM.

"Mukafukufuku wamkulu uyu, ndikutsatira kwa zaka 22 kuchokera kuchipatala choyamba ndi NB-UVB, sitinapeze mgwirizano uliwonse pakati pa chithandizo cha NB-UVB ndi BCC, SCC kapena khansa yapakhungu ya melanoma." 

Kuti muwerenge phunziro lonse, tsatirani ulalo uwu:
Kuchuluka kwa khansa yapakhungu mwa odwala 3867 omwe amathandizidwa ndi Narrow-Band UVB Phototherapy
Mverani RMKerr ACRahim KFFerguson JDawe RS.

"Palibe chiwopsezo chowonjezeka cha khansa yapakhungu chomwe chinawonetsedwa m'maphunziro anayi omwe amawunika kuopsa kwa khansa ya NB-UVB."

Kuti muwerenge phunziro lonse, tsatirani ulalo uwu:
Kuopsa kwa Carcinogenic kwa psoralen UV-A therapy ndi Narrowband UV-B Therapy mu Chronic Plaque Psoriasis: Kuwunika Mwadongosolo Mabuku.

Archier E1, Devaux S, Castela E, Gallini A, Aubin F, Le Maître M, Aractingi S, Bachelez H, Cribier B, Joly P, Jullien D, Misery L, Paul C, Ortonne JP, Richard MA.

"Panalibe kusiyana kwakukulu pakati pa nbUVB ndi magulu olamulira. Choncho, nbUVB phototherapy pogwiritsa ntchito nyali za TL-01 ikuwoneka ngati njira yochiritsira yotetezeka kwa odwala omwe ali ndi khungu la phototypes III-V.

Kuti muwerenge phunziro lonse, tsatirani ulalo uwu:
Palibe umboni wakuwonjezeka kwa chiwopsezo cha khansa yapakhungu ku Korea okhala ndi ma phototypes a khungu III-V omwe amathandizidwa ndi UVB phototherapy yopapatiza.

Jo SJ1, Kwon HH, Choi MR, Youn JI.

“Dr. Lebwohl akuti. "Osachepera mpaka pano, zikuwoneka kuti chingwe chocheperako cha UVB sichikuthandizira khansa yapakhungu. Komabe, kwa odwala omwe ali ndi khansa, timasamala za kugwiritsa ntchito phototherapy. ”

Kuti muwerenge phunziro lonse, tsatirani ulalo uwu:
Common psoriasis mankhwala
chikoka mwayi wa odwala omwe ali ndi khansa yapakhungu Dermatology Times May-2017

"Chifukwa chake, kafukufuku wapanoyu samapereka umboni wowonjezereka wa chiwopsezo cha khansa yapakhungu kwa odwala omwe amathandizidwa ndi Broadband kapena narrowband UVB phototherapy" 


Kuti muwerenge phunziro lonse, tsatirani ulalo uwu:
Palibe umboni wowonjezera chiopsezo cha khansa yapakhungu mwa odwala a psoriasis omwe amathandizidwa ndi Broadband kapena narrowband UVB phototherapy: kafukufuku woyamba wobwereza.

Weischer M1, Blum A, Eberhard F, Röcken M, Berneburg M.

"(UVB-Narrowband) Phototherapy ndiyotetezeka komanso yosavuta kuchita. Ngakhale zovuta zingaphatikizepo kutentha kwa dzuwa, sitikuwona khansa yapakhungu, melanoma kapena non-melanoma. Vitiligo mwina imateteza khansa ya pakhungu.” 

Malingaliro atsopano, machiritso a vitiligo - Pearl Grimes - Dermatology Times Aug-2016

"Ngakhale kuda nkhawa ndi kuthekera kwa khansa ya cheza cha ultraviolet, kafukufuku wambiri sanapeze chiopsezo chowonjezereka chokhala ndi khansa yapakhungu yopanda melanoma kapena melanoma mwa odwala omwe amathandizidwa ndi ultraviolet B (broadband and narrowband) ndi ultraviolet A1 phototherapy."

Kuti muwerenge phunziro lonse, tsatirani ulalo uwu:
Mbali yamdima ya kuwala: Phototherapy zotsatira zoyipa.

Valejo Coelho MM1, Apetato M2.

Kukambirana

Ma radiation a Ultraviolet (UVR) ochokera ku dzuwa lachilengedwe
"amatengedwa ngati chinthu chachikulu choyambitsa
poyambitsa khansa yapakhungu”

UVR yagawidwa m'magulu awiri:

UVA
320-400nm
Kutalika kwa mafunde

UVB
280-320nm
Mafunde oyaka moto

UVC
100-280nm
Kusefedwa ndi mlengalenga wa dziko lapansi

UVB UVA
Chifukwa chake, pazolinga za zokambiranazi, UVR=UVA+UVB.

Utali uliwonse wosiyanasiyana wa kuwala umapangitsa mitundu yosiyanasiyana yachilengedwe pakhungu la munthu. Mafunde aatali a UVA amaloŵa mu dermis, pamene UVB imalowa mu epidermis yokha.

Pali mitundu itatu ikuluikulu ya khansa yapakhungu:

BCC

basal cell carcinoma

Chithunzi cha SCC

squamous cell carcinoma

CMM

khansa ya khansa ya khansa ya m'mawere

BCC ndi SCC zimayikidwa pamodzi ngati khansa yapakhungu yopanda melanoma (NMSC), ndipo imadalira kuchuluka kwa UVB kwa moyo wonse. Madera apakhungu omwe adalandira milingo yayikulu ya UVR moyo wawo wonse ndi omwe amakhudzidwa kwambiri, monga mutu, khosi, chifuwa, ndi manja. NMSC imachiritsidwa mosavuta ngati itapezeka msanga.
Khansara yapakhungu ndi UVB Phototherapy
Ngakhale UVB imayambitsa kuyaka kwa khungu (erythema) ndi NMSC, ndizodabwitsanso kuti waveband yomwe imapanga Vitamini D pakhungu ndipo ndiyothandiza kwambiri pochiza matenda osiyanasiyana akhungu.

Kuti muchepetse erythema ndi NMSC popereka chithandizo chamankhwala chapakhungu, UVB-Narrowband (311nm peak, /01) idapangidwa ndi Philips Lighting m'zaka za m'ma 1980 ndipo tsopano ikulamulira phototherapy padziko lonse lapansi. Kuti mudziwe zambiri onani: Kumvetsetsa Narrowband UVB Phototherapy.

Khansara yapakhungu ndi khansa yapakhungu yowopsa kwambiri chifukwa imatha kufalitsa khansa kumadera ena amthupi. “N’kutheka kuti pali zinthu zosiyanasiyana, kuphatikizapo chilengedwe komanso majini, zomwe zimayambitsa melanoma. Komabe, madokotala amakhulupirira kuti kutenthedwa ndi cheza cha ultraviolet (UV) chochokera kudzuŵa ndi kuchokera ku nyale zotentha ndi pabedi ndi zimene zimayambitsa melanoma.”17

Kuwala kwa UV sikumayambitsa ma melanomas onse, makamaka omwe amapezeka m'malo omwe thupi lanu silimawala ndi dzuwa. Izi zikusonyeza kuti pali zinthu zina zomwe zingapangitse kuti mukhale ndi vuto la melanoma. Melanoma imatha kuyambitsidwa ndi UVA ndi UVB, koma pali umboni wina wosonyeza kuti UVA imagwira ntchito yayikulu.3

Zomwe zimayambitsa khansa ya melanoma ndi izi: timadontho ( melanocytic nevi ), mtundu wa khungu (anthu akhungu labwino amakhala pachiwopsezo chachikulu kuposa omwe ali ndi zikopa zakuda), komanso kutentha ndi dzuwa mobwerezabwereza, makamaka paubwana. “Kutentha kwambiri kwa dzuwa nthawi ndi nthawi kumayenderana kwambiri ndi kukula kwa melanoma kusiyana ndi kukhala padzuwa mosalekeza.. " 6

Komabe kufotokozedwa ndi mfundo yakuti "Melanoma imapezeka kawirikawiri pakati pa anthu omwe amagwira ntchito zapakhomo kusiyana ndi anthu omwe amakhudzidwa kwambiri ndi UV (alimi, asodzi, ndi zina zotero).

Zambiri zamabuku asayansi a khansa yapakhungu zimagwirizana ndi zotsatira za kuwala kwa dzuwa (UVR, yomwe nthawi zambiri imakhala ndi UVA, yomwe ikucheperachepera peresenti ya UVB pamene latitude ikuwonjezeka),

Koma bwanji ngati UVB yokha imagwiritsidwa ntchito (yopanda UVA), monga mu UVB / UVB-Narrowband phototherapy yachipatala?

Ngakhale kuti mawonekedwe a NMSC ali pafupi kwambiri ndi UVB osiyanasiyana, kafukufuku pamwambapa akuwonetsa kuti UVB/UVB-Narrowband Phototherapy si vuto lalikulu la khansa yapakhungu; kuphatikizapo basal cell carcinoma (BCC), squamous cell carcinoma (SCC) ndi cutaneous malignant melanoma (CMM).

Kusapezeka kwa UVA yomwe ingakhale yovulaza mwina imakhala ndi gawo, ndipo "Ponseponse, pali umboni wina wosonyeza kuti vitamini D ikhoza kutengapo gawo pa khansa yapakhungu ya nonmelanoma (NMSC) ndi kupewa melanoma, ngakhale pakadali pano palibe umboni wachindunji wosonyeza chitetezo." 14,15 "Kafukufuku wambiri wasonyeza kuti vitamini D imagwira ntchito yoteteza m'matenda osiyanasiyana amkati. Pankhani ya khansa yapakhungu, kafukufuku wa epidemiologic ndi labotale akuwonetsa kuti vitamini D ndi ma metabolites ake angakhale ndi chitetezo chofanana.. " 13

Kuthana ndi nkhawa ndi UVB yochititsa chidwi ndi NMSC, chifukwa imadalira kuchuluka kwa mlingo wa moyo wonse, makamaka kwa anthu akhungu loyera, ndikwanzeru kusiya kuchiritsa madera akhungu omwe safunikira chithandizo ndipo akhala ndi UVR yochuluka m'moyo wa wodwalayo, komanso kuteteza maderawo ku UVR yowonjezera ku dzuwa. Amene ali ndi mbiri komanso / kapena mbiri ya banja la khansa yapakhungu ayenera kuonana ndi dokotala asanatenge UV phototherapy. Ayeneranso “kupimidwa khungu” pafupifupi chaka ndi chaka kuti azindikire khansa yapakhungu; monga momwe aliyense ayenera kuwonera kuwala kwa ultraviolet, kaya kuchokera kumankhwala a UV Phototherapy, zida zodzikongoletsera zodzikongoletsera, kapena kuwala kwa dzuwa.

Kuphatikiza apo, UVR yochokera ku kuwala kwachilengedwe imalandiridwa kwambiri kuchokera pamwamba pa munthu (mwachitsanzo, kuwala kwa dzuwa kuchokera pamwamba pamphumi, makutu ndi mapewa), pomwe thupi lathunthu Phototherapy ya UVB nthawi zambiri imaperekedwa kuchokera kumbali (odwala nthawi zambiri amayimira chithandizo kuchokera pa chipangizo chokwera chokwera), kotero pamakhala kuchepetsedwa kwa mawonekedwe a geometric kumadera omwe ali pachiwopsezo kwambiri. Gawo loyamba la "kuyeretsa" la UVB nthawi zambiri limaphatikizapo Mlingo wokulirapo wa UVB phototherapy m'miyezi ingapo, ndikutsatiridwa ndi chithandizo chanthawi yayitali "chosamalira" pamilingo yocheperako komanso pafupipafupi.

Dzuwa la Thupi Lonse
Chida Chathunthu cha Thupi
UVB Phototherapy safuna kuti wodwala atenthedwe ndi dzuwa, ndipo Mlingo wa UVB wocheperako ndi wothandiza pakukonza kwanthawi yayitali "Kodi Narrow-band Ultraviolet B Home Units Ndi Njira Yotheka Yochiritsira Kupitilira kapena Kusamalira Matenda a Khungu Ojambula zithunzi?”,18 ndi kusunga Vitamin D wokwanira. 09,11,12

Zida zonse za SolRx UVB-Narrowband ndi Health Canada zogwirizana ndi "Vitamini-D Deficiency" monga "chizindikiro chogwiritsidwa ntchito", zomwe zikutanthauza kuti zatsimikiziridwa kukhala zotetezeka komanso zogwira mtima, motero zikhoza kugulitsidwa mwalamulo ku Canada. 10

Ponena za Kunyumba phototherapy, njira yotopetsa yolandira chithandizo ndi chibadwa cha munthu imatsogolera wodwalayo kuti angotenga kuchuluka kwa UVB kofunikira kuti khungu likhale loyera kapena lowoneka bwino. Odwala phototherapy kunyumba nthawi zambiri amakhala akatswiri pa kuchuluka kwa UVB yomwe iyenera kutengedwa komanso nthawi yaing'ono, yomwe imakondedwa ndi ambiri.

Phototherapy yakunyumba imapangitsanso kuti zisakhale zovuta kuti chithandizo chiphonyedwe ndipo chithandizo chotsatira chimatulutsa kutentha ndi dzuwa. Kuti, "Ultraviolet B Phototherapy kunyumba ndiyothandizanso pochiza psoriasis ngati ultraviolet B phototherapy m'malo ogonera kunja ndipo sizitanthauza kuti palibe zoopsa zina zachitetezo popewa kuwunikira komwe sikunalembedwe. Kuphatikiza apo, chithandizo chapakhomo chimachepetsa mtolo, chimayamikiridwa bwino, ndipo chimapereka kuwongolera kofananako kwa moyo. Ambiri mwa odwalawo adanena kuti angakonde chithandizo chamtsogolo cha ultraviolet B kunyumba kusiyana ndi kujambula zithunzi m'malo ogonera. 16

Solarc Systems ilandila malingaliro aliwonse kuti apititse patsogolo nkhaniyi.

ZINDIKIRANI

Ndikofunika kuti UVB ndi UVB-Narrowband phototherapy asasokonezedwe ndi PUVA (psoralen + UVA kuwala), monga "ntchito ya PUVA therapy pa khungu carcinogenesis mwa anthu omwe ali ndi psoriasis yasonyezedwa bwino" [Kuopsa kwa carcinogenic kwa PUVA ndi nbUVB mu chronic plaque psoriasis_ kuwunika mwadongosolo mabuku 2012] PChifukwa chake, UVA nthawi zambiri imangokhala pamankhwala 200 mpaka 300, komanso pamilandu yowopsa kwambiri yomwe yalephera UVB kapena UVB-Narrowband phototherapy.   

Zothandizira:

1 Brenner, Michaela, ndi Vincent J. Kumva. “Ntchito Yoteteza Melanin Polimbana ndi Kuwonongeka kwa UV pa Khungu la Munthu. " Photochemistry ndi Photobiology,vol. 84, ayi. 3, 2007, pp. 539-549., doi: 10.1111 / j.1751-1097.2007.00226.x.

2 “Khansara Ya Pakhungu / Melanoma Center: Zizindikiro, Chithandizo, Zizindikiro, Mitundu, Zomwe Zimayambitsa, ndi Mayesero. WebMD

3 Setlow, RB, et al. “Ma Wavelengths Ogwira Ntchito Poyambitsa Malignant Melanoma.Proceedings of the National Academy of Sciences,vol. 90, ayi. 14, 1993, masamba 6666-6670., doi:10.1073/pnas.90.14.6666.

4 Berneburg, Mark, ndi Lena Krieger. "Faculty of 1000 Evaluation for Melanoma Induction ndi Ultraviolet A koma Osati Ultraviolet B Radiation Imafuna Melanin Pigment." F1000 - Ndemanga ya Anzathu a Post-Publication ya Biomedical Literature, 2012, doi:10.3410/f.717952967.793458514.

5 Brenner, Michaela, ndi Vincent J. Kumva. “Ntchito Yoteteza Melanin Polimbana ndi Kuwonongeka kwa UV pa Khungu la Munthu. " Photochemistry ndi Photobiology,vol. 84, ayi. 3, 2007, pp. 539-549., doi: 10.1111 / j.1751-1097.2007.00226.x.

6 Rhodes, A.Zowopsa za Melanoma. " AIM ku Melanoma, Fitzpatrick's Dermatology mu General Medicine

7 Juzeniene, Asta, ndi Johan Moan. “Ubwino Wogwiritsa Ntchito Ma radiation a UV Kupatulapo Kupanga Vitamini D. " Dermato-Endocrinology,vol. 4, ayi. 2, 2012, pp. 109-117., doi: 10.4161 / derm.20013.

8 Maverakis, Emanual, et al. “Kuwala, Kuphatikizapo Ultraviolet. " National Institute of Health, May 2010, doi:10.1016/j.jaut.2009.11.011.

9 United States, Congress, National Toxicology Program. “Broad-SpectrumUltraviolet (UV) RadiationndiUVA, ndi UVB, ndi UVC.Broad-SpectrumUltraviolet (UV) Radiation ndi UVA, ndi UVB, ndi UVC, Technology Planning and Management Corporation, 2000.

10 "Zidziwitso Zowongolera." Malingaliro a kampani Solarc Systems Inc.,

11 Bogh, Mkb, et al. “Narrowband Ultraviolet B Katatu pa Sabata Imathandiza Kwambiri Pochiza Kuperewera kwa Vitamini D kuposa 1600IU Oral Vitamin D3 pa Tsiku: Kuyesa Kwachipatala Kwachisawawa. " Briteni Journal of Dermatology,vol. 167, ayi. 3, 2012, pp. 625-630., doi: 10.1111 / j.1365-2133.2012.11069.x.

12 Ala-Houhala, Mj, et al. “Kuyerekeza kwa Narrowband Ultraviolet B Exposure ndi Oral Vitamin D Substitution pa Serum 25-Hydroxyvitamin D Concentration.Briteni Journal of Dermatology,vol. 167, ayi. 1, 2012, masamba 160-164., doi:10.1111/j.1365-2133.2012.10990.x

13 Tang, Jean Y., et al. “Vitamini D mu Cutaneous Carcinogenesis: Gawo I.National Institute of Health, Nov. 2012, doi:10.1016/j.jaad.2012.05.044.

14 Tang, Jean Y., et al. “Vitamini D mu Cutaneous Carcinogenesis: Gawo II.National Institute of Health, Nov. 2012, doi:10.1016/j.jaad.2012.05.044.

15 Navarrete-Dechent, Cristián, et al. “Kuzungulira kwa Vitamini-D Kumanga Mapuloteni ndi Kukhazikika Kwaulere kwa 25-Hydroxyvitamin D mwa Odwala Odwala Melanoma: Phunziro Lowongolera."Journal ya American Academy of Dermatology,vol. 77, ayi. 3, 2017, pp. 575-577., doi:10.1016/j.jaad.2017.03.035.

16 Koek, M. BG, et al. “Kunyumba motsutsana ndi Odwala Akunja Ultraviolet B Phototherapy kwa Ofatsa mpaka Kwambiri Psoriasis: Pragmatic Multicentre Randomized Controlled Non-Inferiority Trial (Phunziro la PLUTO). Bmj,vol. 338, ayi. may07 2, July 2009, doi:10.1136/bmj.b1542.

17 https://www.mayoclinic.org/diseases-conditions/melanoma/symptoms-causes/syc-20374884

18 Kodi Narrow-band Ultraviolet B Home Units Ndi Njira Yotheka Yochiritsira Kupitilira kapena Kusamalira Matenda a Khungu Ojambula zithunzi?"