{"id":29602,"date":"2017-11-24T09:19:38","date_gmt":"2017-11-24T08:19:38","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=29602"},"modified":"2017-11-24T09:19:38","modified_gmt":"2017-11-24T08:19:38","slug":"co-pri-lecbe-lupenky-hradi-pojistovna","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=29602","title":{"rendered":"Co p\u0159i l\u00e9\u010db\u011b lup\u00e9nky hrad\u00ed poji\u0161\u0165ovna?"},"content":{"rendered":"<p><strong>OT\u00c1ZKA: Jak\u00e9 jsou mo\u017enosti l\u00e9\u010dby lupenky, resp. co p\u0159i l\u00e9\u010db\u011b lupenky hrad\u00ed poji\u0161\u0165ovna?<\/strong><!--more--><\/p>\n<p>ODPOV\u011a\u010e:<\/p>\n<p>Lup\u00e9nka je chronick\u00e9 ko\u017en\u00ed onemocn\u011bn\u00ed, u kter\u00e9ho je mo\u017eno l\u00e9\u010dit jen p\u0159\u00edznaky, proto\u017ee kauz\u00e1ln\u00ed (p\u0159\u00ed\u010dinn\u00e1) l\u00e9\u010dba nen\u00ed zn\u00e1ma. Ko\u017en\u00ed posti\u017een\u00ed \u0159e\u0161\u00ed dermatolog, v m\u00edrn\u00fdch p\u0159\u00edpadech t\u00e9\u017e praktick\u00fd l\u00e9ka\u0159. Z mimoko\u017en\u00edch p\u0159\u00edznak\u016f jsou nej\u010dast\u011bj\u0161\u00ed kloubn\u00ed posti\u017een\u00ed; ta pak o\u0161et\u0159uje revmatolog.<\/p>\n<p>Lo\u017eiskov\u00e1 Lup\u00e9nka postihuje 2-3 % evropsk\u00e9 populace, p\u0159i\u010dem\u017e z 80 % se vyskytuje v m\u00edrn\u00e9 a\u017e st\u0159edn\u011b t\u011b\u017ek\u00e9 form\u011b. M\u00edrn\u00e1 forma onemocn\u011bn\u00ed b\u00fdv\u00e1 l\u00e9\u010dena lok\u00e1ln\u00edmi p\u0159\u00edpravky, tedy r\u016fzn\u00fdmi mastmi apod. Jsou to zejm\u00e9na dehty, kortikosteroidy, deriv\u00e1ty vitam\u00ednu D3, retinoidy nebo inhibitory kalcineurinu. Tyto l\u00e9\u010div\u00e9 p\u0159\u00edpravky jsou v\u011bt\u0161inou pln\u011b nebo \u010d\u00e1ste\u010dn\u011b hrazeny z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed. \u00dahradu ze zdravotn\u00edho poji\u0161t\u011bn\u00ed nemaj\u00ed St\u00e1tn\u00edm \u00fastavem pro kontrolu l\u00e9\u010div stanovenou n\u011bkter\u00e9 dehty, nap\u0159. Ichtoxyl a Pityol, tak\u017ee ty si pacient plat\u00ed (jsou voln\u011b prodejn\u00e9, bez receptu); individu\u00e1ln\u011b vyr\u00e1b\u011bn\u00e9 p\u0159\u00edpravky s obsahem dehtu jsou ale na recept a jsou pln\u011b hrazen\u00e9. Hrazen\u00e9 poji\u0161\u0165ovnami nejsou p\u0159\u00edpravky, kter\u00e9 nemaj\u00ed registraci jako l\u00e9\u010divo a prod\u00e1vaj\u00ed se jako kosmetika, by\u0165 v l\u00e9k\u00e1rn\u00e1ch.<\/p>\n<p>St\u0159edn\u011b t\u011b\u017ek\u00e1 a t\u011b\u017ek\u00e1 forma onemocn\u011bn\u00ed postihuje cca 20 % nemocn\u00fdch. L\u00e9\u010dba pak vy\u017eaduje tak\u00e9 fototerapii UV B z\u00e1\u0159en\u00edm nebo PUVA (a\u0165 u\u017e celkovou \u010di lok\u00e1ln\u00ed), balneofototerapii, l\u00e9\u010dbu monochromatick\u00fdm excimerov\u00fdm sv\u011btlem (pou\u017e\u00edv\u00e1 se excimerov\u00fd laser a lampa emituj\u00edc\u00ed UV za\u0159\u00edzen\u00ed o vlnov\u00e9 d\u00e9lce 308 nm), l\u00e9\u010debn\u00e9 koupele atd. P\u0159\u00edslu\u0161n\u00e9 v\u00fdkony jsou za\u0159azeny v seznamu zdravotn\u00edch v\u00fdkon\u016f pro odbornost dermatovenerologie (mus\u00ed je tedy p\u0159edepsat l\u00e9ka\u0159 \u2013 specialista) a jsou hrazeny z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed. Hrazena je i syst\u00e9mov\u00e1 l\u00e9\u010dba cyklosporinem, metotrex\u00e1tem a retinoidy, kter\u00e1 samoz\u0159ejm\u011b pat\u0159\u00ed tak\u00e9 jen do rukou specialisty.<\/p>\n<p>Nejt\u011b\u017e\u0161\u00ed formy onemocn\u011bn\u00ed lup\u00e9nkou postihuj\u00ed zpravidla k\u016f\u017ei cel\u00e9ho t\u011bla a v\u00fdrazn\u011b zat\u011b\u017euj\u00ed nemocn\u00e9ho nejen fyzicky, ale i psychicky. B\u011b\u017en\u011b dostupn\u00e9 l\u00e9\u010debn\u00e9 prost\u0159edky a metody uveden\u00e9 v\u00fd\u0161e jsou v t\u011bchto p\u0159\u00edpadech kombinov\u00e1ny s l\u00e9\u010dbou tzv. biologiky. Jedn\u00e1 se o velmi n\u00e1kladnou l\u00e9\u010dbu, proto prob\u00edh\u00e1 ve specializovan\u00fdch centrech, kter\u00e1 maj\u00ed na \u00fahradu t\u011bchto l\u00e9\u010div\u00fdch p\u0159\u00edpravk\u016f uzav\u0159enou zvl\u00e1\u0161tn\u00ed smlouvu s poji\u0161\u0165ovnou. V centrech mohou b\u00fdt l\u00e9\u010deni nejen pacienti s t\u011b\u017ek\u00fdm ko\u017en\u00edm posti\u017een\u00edm, ale rovn\u011b\u017e revmatologi\u010dt\u00ed pacienti s t\u011b\u017ek\u00fdm kloubn\u00edm posti\u017een\u00edm, kter\u00e9 n\u011bkdy onemocn\u011bn\u00ed lup\u00e9nkou prov\u00e1z\u00ed.<\/p>\n<p>L\u00e1ze\u0148sk\u00e1 terapie je ur\u010dena jen pro t\u011b\u017ek\u00e9 formy onemocn\u011bn\u00ed \u2013 pro generalizovanou a artropatickou psori\u00e1zu. Tato l\u00e9\u010dba je indikov\u00e1na v p\u0159\u00edm\u00e9 n\u00e1vaznosti na hospitalizaci na l\u016f\u017ekov\u00e9m odd\u011blen\u00ed dermatovenerologie nebo jako alternativa t\u00e9to p\u00e9\u010de. Doba pobytu je 21 dn\u016f, opakov\u00e1n\u00ed komplexn\u00ed p\u00e9\u010de je mo\u017en\u00e9 jako alternativa l\u016f\u017ekov\u00e9 p\u00e9\u010de v oboru dermatovenerologie 1x za 24 m\u011bs\u00edc\u016f. U d\u011bt\u00ed trv\u00e1 komplexn\u00ed l\u00e1ze\u0148sk\u00e1 p\u00e9\u010de 28 dn\u016f, s mo\u017enost\u00ed prodlou\u017een\u00ed. M\u016f\u017eeme p\u0159ipomenout, \u017ee u d\u011bt\u00ed je lup\u00e9nka tak\u00e9 indikac\u00ed k \u00fa\u010dasti na l\u00e9\u010debn\u011b-ozdravn\u00e9m pobytu Mo\u0159sk\u00fd kon\u00edk.<\/p>\n<p>L\u00e1ze\u0148skou l\u00e9\u010dbu m\u016f\u017ee pacientovi doporu\u010dit dermatovenerolog, rehabilita\u010dn\u00ed l\u00e9ka\u0159 nebo revmatolog. Smluvn\u00edmi l\u00e1ze\u0148sk\u00fdmi m\u00edsty jsou Hodon\u00edn, Jesen\u00edk, Karlova Stud\u00e1nka, L\u00e1zn\u011b Darkov, L\u00e1zn\u011b Kyn\u017evart, Ostro\u017esk\u00e1 Nov\u00e1 Ves, Slatinice, Velk\u00e9 Losiny; dosp\u011bl\u00fdm pacient\u016fm m\u016f\u017ee l\u00e9ka\u0159 p\u0159\u00edpadn\u011b navrhnout i l\u00e1ze\u0148sk\u00e9 l\u00e9\u010den\u00ed na Slovensku v l\u00e1zn\u00edch Smrd\u00e1ky. L\u00e9\u010dba psori\u00e1zy u Mrtv\u00e9ho mo\u0159e, na kterou se klienti n\u011bkdy ptaj\u00ed, nen\u00ed z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed hrazena.<\/p>\n<p>Mgr. Old\u0159ich Tich\u00fd vedouc\u00ed tiskov\u00e9ho odd\u011blen\u00ed a tiskov\u00fd mluv\u010d\u00ed <\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>OT\u00c1ZKA: Jak\u00e9 jsou mo\u017enosti l\u00e9\u010dby lupenky, resp. co p\u0159i l\u00e9\u010db\u011b lupenky hrad\u00ed poji\u0161\u0165ovna?<\/p>\n<\/div>","protected":false},"author":1,"featured_media":17871,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-29602","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/29602","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=29602"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/29602\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/17871"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=29602"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=29602"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=29602"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}