{"id":29744,"date":"2017-12-07T18:33:48","date_gmt":"2017-12-07T17:33:48","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=29744"},"modified":"2017-12-07T18:33:48","modified_gmt":"2017-12-07T17:33:48","slug":"lupenka-na-vzestupu-kdyz-prijde-komplikuje-zivot","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=29744","title":{"rendered":"Lup\u00e9nka na vzestupu. Kdy\u017e p\u0159ijde, komplikuje \u017eivot"},"content":{"rendered":"

S lup\u00e9nkou neboli psori\u00e1zou bojuje t\u00e9m\u011b\u0159 \u010dtvrt milionu \u010cech\u016f. Po\u010det pacient\u016f p\u0159itom st\u00e1le nar\u016fst\u00e1. Odhaduje se, \u017ee dokonce stejn\u00fd po\u010det lid\u00ed l\u00e9ka\u0159e ani nevyhled\u00e1. \u010cty\u0159i z p\u011bti pacient\u016f uv\u00e1d\u011bj\u00ed negativn\u00ed dopad nemoci na jejich \u017eivot a zhruba polovina pak poukazuje na naru\u0161en\u00e9 sexu\u00e1ln\u00ed vztahy. Projevy onemocn\u011bn\u00ed m\u00edrn\u00ed vhodn\u00e1 l\u00e9\u010dba, \u017eivotospr\u00e1va i klid.<\/strong> <\/p>\n

Lup\u00e9nka je autoimunitn\u00edm onemocn\u011bn\u00edm, \u0159ad\u00ed se tak po bok roztrou\u0161en\u00e9 skler\u00f3zy, celiakie nebo r\u016fzn\u00fdch druh\u016f alergi\u00ed.<\/p>\n

Podle \u00fadaj\u016f \u010cesk\u00e9 akademie dermatovenerologie j\u00ed trp\u00ed a\u017e \u010dtvrt milionu lid\u00ed, z toho 70 tis\u00edc t\u011b\u017ekou formou. Nej\u010dast\u011bji se projevuje \u010derven\u00fdmi lo\u017eisky se \u0161upinkami na k\u016f\u017ei, objevuje se ale i pod nehty a postihuje rovn\u011b\u017e klouby. Doprov\u00e1z\u00ed ji i nep\u0159\u00edjemn\u00e9 sv\u011bd\u011bn\u00ed.<\/p>\n

Chronick\u00e9 onemocn\u011bn\u00ed dnes nelze zcela vyl\u00e9\u010dit, nen\u00ed v\u0161ak infek\u010dn\u00ed ani naka\u017eliv\u00e9. P\u0159esto 84 procent lid\u00ed s lup\u00e9nkou trp\u00ed diskriminac\u00ed nebo poni\u017eov\u00e1n\u00edm, v \u010cesk\u00e9 republice je to dokonce 91 procent. Vypl\u00fdv\u00e1 to toti\u017e z celosv\u011btov\u00e9ho pr\u016fzkumu spole\u010dnosti GFK.<\/p>\n

Z\u00e1ke\u0159nost tohoto druhu chorob spo\u010d\u00edv\u00e1 ve faktu, \u017ee b\u00fdvaj\u00ed mnohdy doprov\u00e1zeny dal\u0161\u00edmi chronick\u00fdmi projevy. Lup\u00e9nka nav\u00edc m\u016f\u017ee v\u00fdrazn\u011b zhor\u0161ovat kvalitu \u017eivota a psychick\u00fd stav nemocn\u00fdch, kte\u0159\u00ed se kv\u016fli sv\u00e9mu vzhledu \u010dasto setk\u00e1vaj\u00ed s negativn\u00edmi reakcemi okol\u00ed, maj\u00ed probl\u00e9my navazovat partnersk\u00e9 vztahy nebo dokonce pot\u00ed\u017ee sehnat zam\u011bstn\u00e1n\u00ed. Stres p\u0159itom nemoc jen zhor\u0161uje. Od roku 1990 se v\u00fdskyt v Evrop\u011b zv\u00fd\u0161il o v\u00edce ne\u017e sedm procent.<\/p>\n

LUP\u00c9NKA \u010cEK\u00c1 NA PODN\u011aT<\/p>\n

Propuknut\u00ed psori\u00e1zy z\u00e1vis\u00ed zejm\u00e9na na jej\u00edch spou\u0161t\u011b\u010d\u00edch. Mezi n\u011b pat\u0159\u00ed nevhodn\u00e9 stravov\u00e1n\u00ed, \u017eivotn\u00ed styl \u010di ne\u017e\u00e1douc\u00ed chemick\u00e9 l\u00e1tky, m\u016f\u017ee se v\u0161ak objevit i p\u0159i po\u0161kozen\u00ed k\u016f\u017ee, a\u0165 u\u017e p\u0159i injek\u010dn\u00edm vpichu, kousnut\u00ed, \u0161kr\u00e1bnut\u00ed anebo po operaci.<\/p>\n

„Jakmile je gen zodpov\u011bdn\u00fd za lup\u00e9nku aktivov\u00e1n, existuj\u00ed t\u0159i cesty jej\u00edho propuknut\u00ed. Bu\u010f na k\u016f\u017ei, nehtech, anebo se projev\u00ed artritidou. V\u0161echny tyto symptomy jsou projevem stejn\u00e9 nemoci, kter\u00e1 ovliv\u0148uje klouby, \u0161lachy, a tedy i pohyblivost, n\u011bkte\u0159\u00ed lid\u00e9 ani nedok\u00e1\u017eou oto\u010dit krk. Onemocn\u011bn\u00ed v\u00fdrazn\u011b ovliv\u0148uje kvalitu jejich \u017eivota,“ vysv\u011btluje profesor Michael Tirant, kter \u00fd se l\u00e9\u010db\u011b ko\u017en\u00edch onemocn\u011bn\u00ed v\u011bnuje ji\u017e n\u011bkolik desetilet\u00ed.<\/p>\n

Pacienti s lup\u00e9nkou trp\u00ed \u010dasto depresemi a \u00fazkostmi. Podle pr\u016fzkumu t\u00e9m\u011b\u0159 polovina nemocn\u00fdch mus\u00ed \u010delit nep\u0159\u00edjemn\u00fdm dotaz\u016fm, zda jsou naka\u017eliv\u00ed. A\u017e 17 procent lid\u00ed s psori\u00e1zou se setk\u00e1v\u00e1 s odm\u00edtnut\u00edm p\u0159i n\u00e1v\u0161t\u011bv\u011b kade\u0159n\u00edka, kosmetiky nebo p\u0159i n\u00e1kupu v obchod\u011b. Sou\u010d\u00e1st\u00ed l\u00e9\u010dby je proto nutn\u00e9 hledat i zp\u016fsoby, jak zhor\u0161uj\u00edc\u00ed se psychick\u00fd stav i stres minimalizovat.<\/p>\n

Je dobr\u00e9 vyzkou\u0161et r\u016fzn\u00e1 cvi\u010den\u00ed, vhodn\u00e1 je tak\u00e9 j\u00f3ga, poslech uklid\u0148uj\u00edc\u00ed hudby \u010di jin\u00fd typ relaxace. Pom\u00e1h\u00e1 jednodu\u0161e i sm\u00edch a dobr\u00e1 n\u00e1lada. „Stav k\u016f\u017ee chronicky nemocn\u00e9ho psoriatika m\u016f\u017ee kol\u00edsat na z\u00e1klad\u011b aktu\u00e1ln\u00edho du\u0161evn\u00edho stavu a pocitu \u017eivotn\u00ed spokojenosti. Stresov\u00e9 podn\u011bty a z\u00e1va\u017en\u00e9 situace se projevuj\u00ed na k\u016f\u017ei a na druh\u00e9 stran\u011b mohou zm\u011bny na k\u016f\u017ei zp\u011btn\u011b velmi intenzivn\u011b p\u016fsobit na emo\u010dn\u00ed pro\u017e\u00edv\u00e1n\u00ed nemocn\u00e9ho a negativn\u011b ovlivnit jeho soci\u00e1ln\u00ed fungov\u00e1n\u00ed,“ uv\u00e1d\u00ed klinick\u00e1 psycholo\u017eka Alena Jav\u016frkov\u00e1, vedouc\u00ed Odd\u011blen\u00ed klinick\u00e9 psychologie Fakultn\u00ed nemocnice Kr\u00e1lovsk\u00e9 Vinohrady.<\/p>\n

MO\u017dNOSTI L\u00c9\u010cBY.
\n\u017dIVOTOSPR\u00c1VA JAKO PRVN\u00cd KROK<\/p>\n

Zna\u010dn\u00fd vliv na projevy lup\u00e9nky m\u00e1 i vhodn\u00fd stravovac\u00ed re\u017eim. Psoriatici by se m\u011bli vyvarovat p\u00e1liv\u00fdch pokrm\u016f zah\u0159\u00edvaj\u00edc\u00edch organismus a opatrn\u00ed by m\u011bli b\u00fdt tak\u00e9 p\u0159i konzumaci cukru a soli. Obez\u0159etnost plat\u00ed pro alkohol, k\u00e1vu, ale i histamin, kter\u00fd se vyskytuje nap\u0159\u00edklad v raj\u010datech, lilku nebo \u0161pen\u00e1tu a hraje velkou roli p\u0159i sv\u011bd\u011bn\u00ed.<\/p>\n

B\u011b\u017en\u00fdm a \u00fa\u010dinn\u00fdm prost\u0159edkem pro l\u00e9\u010dbu projev\u016f lup\u00e9nky jsou l\u00e9ky s obsahem kortikosteroid\u016f, terapie je ale kv\u016fli mnoha vedlej\u0161\u00edm \u00fa\u010dink\u016fm vhodn\u00e1 jen kr\u00e1tkodob\u011b. V z\u00e1va\u017en\u00fdch p\u0159\u00edpadech dne\u0161n\u00ed medic\u00edna vyu\u017e\u00edv\u00e1 biologickou l\u00e9\u010dbu, ta je v\u0161ak obt\u00ed\u017en\u011b dostupn\u00e1 a finan\u010dn\u011b n\u00e1kladn\u00e1. Ani ta v\u0161ak lup\u00e9nku nedok\u00e1\u017ee zcela odstranit.<\/p>\n

„L\u00e9\u010dbu vol\u00edme podle typu psori\u00e1zy, v\u011bku pacienta, lokalizace a rozsahu posti\u017een\u00ed a p\u0159edchoz\u00ed l\u00e9\u010dby. Z takzvan\u00fdch p\u0159\u00edrodn\u00edch metod m\u00e1me velmi dobr\u00e9 zku\u0161enosti s p\u0159\u00edpravky Dr. Michaels. Jde o p\u0159\u00edrodn\u00ed kosmetiku, kter\u00e1 obsahuje p\u0159edev\u0161\u00edm ovocn\u00e9 kyseliny a esenci\u00e1ln\u00ed oleje. Na z\u00e1klad\u011b rozs\u00e1hl\u00fdch klinick\u00fdch studi\u00ed p\u0159esahuje \u00fasp\u011b\u0161nost t\u011bchto p\u0159\u00edpravk\u016f v l\u00e9\u010db\u011b lup\u00e9nky 80 procent jak u dosp\u011bl\u00fdch, tak u d\u011bt\u00ed,“ \u0159\u00edk\u00e1 dermatolo\u017eka Anna Jir\u00e1kov\u00e1.<\/p>\n

—<\/p>\n

Rozhovor<\/p>\n

Bez kortikoid\u016f to zat\u00edm nejde<\/p>\n

Profesorka Jana Hercogov\u00e1, p\u0159ednostka Dermatovenerologick\u00e9 kliniky 2. LF UK, Nemocnice Na Bulovce v Praze, www.dermahelp.cz<\/p>\n

– Pacienti s lup\u00e9nkou se \u010dasto setk\u00e1vaj\u00ed s l\u00e9\u010dbou pomoc\u00ed kortikoid\u016f. Nemohou p\u0159i dlouhodob\u00e9m u\u017e\u00edv\u00e1n\u00ed naopak u\u0161kodit?<\/p>\n

M\u00edstn\u00ed l\u00e9\u010dba kortikoidy v podob\u011b kr\u00e9m\u016f, mast\u00ed, gel\u016f \u010di \u0161amponu je v kombinaci s deriv\u00e1ty vitam\u00ednu D3 prvn\u00ed l\u00e9\u010debnou volbou pro m\u00edrnou formu lup\u00e9nky. Bez kortikoid\u016f se tedy nem\u016f\u017eeme obej\u00edt nejen u lup\u00e9nky, ale ani u jin\u00fdch ko\u017en\u00edch chorob. Prvn\u00ed probl\u00e9m se t\u00fdk\u00e1 n\u00e1sledk\u016f po vst\u0159eb\u00e1n\u00ed kortikoidu do krevn\u00edho ob\u011bhu, co\u017e m\u016f\u017ee m\u00edt i v\u00e1\u017en\u00e9 n\u00e1sledky \u2013 nap\u0159\u00edklad v podob\u011b ovlivn\u011bn\u00ed r\u016fstu u d\u011bt\u00ed. Uveden\u00fd ne\u017e\u00e1douc\u00ed \u00fa\u010dinek je v\u0161ak vz\u00e1cn\u00fd a doch\u00e1z\u00ed k n\u011bmu, kdy\u017e se m\u00edstn\u00ed l\u00e9k s obsahem kortikoidu pou\u017e\u00edv\u00e1 dlouhodob\u011b na velk\u00e9 plochy k\u016f\u017ee. Druh\u00fdm ne\u017e\u00e1douc\u00edm \u00fa\u010dinkem, kter\u00fd je naopak relativn\u011b \u010dast\u00fd a nevratn\u00fd, je zten\u010den\u00ed k\u016f\u017ee. Proto je mo\u017en\u00e9 vyu\u017e\u00edvat n\u011bkter\u00e9 l\u00e9\u010div\u00e9 p\u0159\u00edpravky a l\u00e9\u010debnou kosmetiku, kter\u00e9 kortikoidy neobsahuj\u00ed. Hod\u00ed se v\u0161ak op\u011bt jen pro chronickou formu lup\u00e9nky. N\u011bkter\u00e9 mohou b\u00fdt dokonce tak \u00fa\u010dinn\u00e9, \u017ee jsou podez\u0159\u00edv\u00e1ny z obsahu kortikoid\u016f, i kdy\u017e je neobsahuj\u00ed. Takov\u00e1 situace nastala t\u0159eba u australsk\u00e9 p\u0159\u00edrodn\u00ed kosmetiky Dr. Michaels v Rakousku. \u00da\u010dinnost l\u00e9ka\u0159e natolik p\u0159ekvapila, \u017ee se rozhodli pro laboratorn\u00ed rozbor ov\u011b\u0159uj\u00edc\u00ed nulov\u00fd obsah kortikoid\u016f.<\/p>\n

– Psori\u00e1za reaguje na z\u00e1klad\u011b „spou\u0161t\u011b\u010d\u016f“. Jak\u00e9 jsou ty nej\u010dast\u011bj\u0161\u00ed?<\/p>\n

U d\u011bt\u00ed a mladistv\u00fdch to b\u00fdv\u00e1 akutn\u00ed streptokokov\u00e9 onemocn\u011bn\u00ed, jako je prost\u00e1 ang\u00edna, kdy se na trupu a kon\u010detin\u00e1ch objev\u00ed stovky \u010derven\u00fdch skvrnek a pup\u00ednk\u016f, je\u017e maj\u00ed na povrchu \u0161upinky. Rodi\u010de to zpravidla vyd\u011bs\u00ed, zejm\u00e9na kdy\u017e se v rodin\u011b objev\u00ed poprv\u00e9. Dal\u0161\u00edmi spou\u0161t\u011b\u010di zhruba po \u010dty\u0159ic\u00e1t\u00e9m roce \u017eivota mohou b\u00fdt stres, ale i p\u0159idru\u017een\u00e1 choroba nebo u\u017e\u00edv\u00e1n\u00ed n\u011bkter\u00fdch l\u00e9k\u016f. Dnes u\u017e se tak\u00e9 v\u00ed, \u017ee lup\u00e9nku zhor\u0161uje alkohol a kou\u0159en\u00ed.<\/p>\n

– M\u00e1 onemocn\u011bn\u00ed vliv i na jin\u00e9 \u010d\u00e1sti t\u011bla ne\u017e jen na k\u016f\u017ei?<\/p>\n

Ano, postihuje rovn\u011b\u017e klouby. Psoriatick\u00e1 artritida b\u00fdv\u00e1 u lup\u00e9nky p\u0159\u00edtomna a\u017e ve 40 procentech p\u0159\u00edpad\u016f. M\u016f\u017ee ale postihovat klouby i bez zasa\u017een\u00ed k\u016f\u017ee. Pacienti s lup\u00e9nkou by m\u011bli b\u00fdt sledov\u00e1ni u ko\u017en\u00edho nebo praktick\u00e9ho l\u00e9ka\u0159e, m\u011bla by jim b\u00fdt m\u011b\u0159ena hladina cukru, krevn\u00ed tlak a mus\u00ed se u nich hl\u00eddat cukrovka, obezita, vy\u0161\u0161\u00ed krevn\u00ed tlak, Crohnova choroba \u010di deprese. D\u016fle\u017eit\u00e1 je zdrav\u00e1 strava, vyh\u00fdbat se kou\u0159en\u00ed i alkoholu a nevynech\u00e1vat fyzickou aktivitu.<\/p>\n

Tipy<\/p>\n

Mo\u0159sk\u00fd kon\u00edk<\/p>\n

P\u0159\u00edmo\u0159sk\u00e9 l\u00e9\u010debn\u011b-ozdravn\u00e9 pobyty Mo\u0159sk\u00fd kon\u00edk po\u0159\u00e1d\u00e1 VZP pro sv\u00e9 mal\u00e9 klienty trp\u00edc\u00ed n\u011bkter\u00fdmi chronick\u00fdmi onemocn\u011bn\u00edmi, zejm\u00e9na lup\u00e9nkou, atopick\u00fdm ekz\u00e9mem, bronchi\u00e1ln\u00edm astmatem, obstruktivn\u00ed plicn\u00ed nemoc\u00ed a dal\u0161\u00edmi onemocn\u011bn\u00edmi.<\/p>\n

Internetov\u00e1 poradna o lup\u00e9nce<\/p>\n

http:\/\/spae-cr.webnode.cz\/ Str\u00e1nky p\u0159ipravuje Spolek psoriatik\u016f a atopick\u00fdch ekzematik\u016f.<\/p>\n

Chronick\u00e9 onemocn\u011bn\u00ed dnes nelze zcela vyl\u00e9\u010dit, nen\u00ed v\u0161ak infek\u010dn\u00ed ani naka\u017eliv\u00e9. P\u0159esto 84 procent lid\u00ed s lup\u00e9nkou trp\u00ed diskriminac\u00ed nebo poni\u017eov\u00e1n\u00edm, v \u010cesk\u00e9 republice je to dokonce 91 %.<\/p>\n

DENIS DRAHO\u0160
\nBrunt\u00e1lsk\u00fd a Krnovsk\u00fd den\u00edk
\nhttp:\/\/bruntalsky.denik.cz\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

S lup\u00e9nkou neboli psori\u00e1zou bojuje t\u00e9m\u011b\u0159 \u010dtvrt milionu \u010cech\u016f. Po\u010det pacient\u016f p\u0159itom st\u00e1le nar\u016fst\u00e1. Odhaduje se, \u017ee dokonce stejn\u00fd po\u010det lid\u00ed l\u00e9ka\u0159e ani nevyhled\u00e1. \u010cty\u0159i […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":17871,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-29744","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/29744","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=29744"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/29744\/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=29744"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=29744"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=29744"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}