{"id":41411,"date":"2023-08-09T12:18:44","date_gmt":"2023-08-09T10:18:44","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=41411"},"modified":"2023-08-09T12:18:44","modified_gmt":"2023-08-09T10:18:44","slug":"pri-lupence-netrpi-jen-kuze","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=41411","title":{"rendered":"P\u0158I LUP\u00c9NCE NETRP\u00cd JEN K\u016e\u017dE"},"content":{"rendered":"\n

Kdy\u017e se \u0159ekne lup\u00e9nka, v\u011bt\u0161ina z n\u00e1s si p\u0159edstav\u00ed k\u016f\u017ei posetou za\u010dervenal\u00fdmi lo\u017eisky pokryt\u00fdmi silnou vrstvou \u0161upin. Ne ka\u017ed\u00fd ale v\u00ed, \u017ee ko\u017en\u00ed l\u00e9ze nejsou zdaleka jedin\u00fdm projevem onemocn\u011bn\u00ed. D\u016fsledky z\u00e1n\u011btliv\u00fdch proces\u016f postihuj\u00ed cel\u00e9 t\u011blo a mohou v\u00e9st k \u0159ad\u011b v\u00e1\u017en\u00fdch zdravotn\u00edch pot\u00ed\u017e\u00ed, od posti\u017een\u00ed kloub\u016f a\u017e po cukrovku nebo onemocn\u011bn\u00ed jater.<\/strong><\/p>\n\n\n\n

V\u00fd\u010det onemocn\u011bn\u00ed prov\u00e1zej\u00edc\u00edch lup\u00e9nku je pom\u011brn\u011b obs\u00e1hl\u00fd a s postupuj\u00edc\u00edmi znalostmi v oblasti medic\u00edny se st\u00e1le roz\u0161i\u0159uje. Zat\u00edmco v n\u011bkter\u00fdch p\u0159\u00edpadech, jako nap\u0159\u00edklad u psoriatick\u00e9 artritidy, jsou mechanismy jejich vzniku ji\u017e objasn\u011bn\u00e9, u nemoc\u00ed c\u00e9v a srdce a dal\u0161\u00edch p\u0159esnou p\u0159\u00ed\u010dinu prozat\u00edm nezn\u00e1me. O obvykl\u00fdch i m\u00e9n\u011b \u010dast\u00fdch komorbidit\u00e1ch jsme si pov\u00eddali s panem docentem Filipem Robem, p\u0159ednostou a prim\u00e1\u0159em Dermatovenerologick\u00e9 kliniky Fakultn\u00ed nemocnice Bulovka.<\/p>\n\n\n\n

Z\u00e1n\u011bt kloub\u016f, cukrovka, nemoci st\u0159ev i deprese<\/strong><\/p>\n\n\n\n

K nej\u010dast\u011bj\u0161\u00edm komplikac\u00edm pat\u0159\u00ed psoriatick\u00e1 artritida<\/strong>, kter\u00e1 postihuje kolem 30\u201340 % pacient\u016f s lup\u00e9nkou. Toto z\u00e1n\u011btliv\u00e9 revmatick\u00e9 onemocn\u011bn\u00ed, kter\u00e9 se projevuje zejm\u00e9na bolest\u00ed, otoky a ztuhlost\u00ed kloub\u016f, se v\u011bt\u0161inou rozv\u00edj\u00ed a\u017e po n\u00e1stupu ko\u017en\u00edch projev\u016f psori\u00e1zy, p\u0159ibli\u017en\u011b u 10\u201320 % pacient\u016f ale kloubn\u00ed forma p\u0159edch\u00e1z\u00ed ko\u017en\u00edm l\u00e9z\u00edm.<\/p>\n\n\n\n

Lid\u00e9 s lup\u00e9nkou jsou ve v\u011bt\u0161\u00ed m\u00ed\u0159e ohro\u017een\u00ed tak\u00e9 metabolick\u00fdmi poruchami, jako je dyslipidemie <\/strong>neboli zv\u00fd\u0161en\u00e1 hladina tuk\u016f v krvi, obezita<\/strong> nebo cukrovka 2. typu<\/strong> \u2013 nap\u0159\u00edklad posledn\u00edm z jmenovan\u00fdch onemocn\u011bn\u00ed trp\u00ed podle proveden\u00fdch studi\u00ed okolo 12 % psoriatik\u016f, tedy a\u017e dvakr\u00e1t v\u00edce, ne\u017e je tomu v b\u011b\u017en\u00e9 populaci.<\/p>\n\n\n\n

Lup\u00e9nka ne\u0161et\u0159\u00ed ani srdce a c\u00e9vy. Spole\u010dn\u011b se z\u00e1va\u017enost\u00ed ko\u017en\u00edch projev\u016f lup\u00e9nky stoup\u00e1 tak\u00e9 pravd\u011bpodobnost vysok\u00e9ho krevn\u00edho tlaku<\/strong>. \u201eTen je spole\u010dn\u011b s v\u00fd\u0161e uveden\u00fdmi poruchami metabolismu rizikov\u00fdm faktorem pro ischemickou chorobu srde\u010dn\u00ed <\/strong>\u010dili nedostate\u010dn\u00e9 prokrven\u00ed srdce, infarkt myokardu<\/strong> nebo c\u00e9vn\u00ed mozkovou p\u0159\u00edhodu<\/strong>,\u201c \u0159\u00edk\u00e1 doc. MUDr. Filip Rob, Ph.D.<\/p>\n\n\n\n

S psori\u00e1zou je spojen\u00fd tak\u00e9 \u010dast\u011bj\u0161\u00ed v\u00fdskyt jatern\u00ed steat\u00f3zy<\/strong> neboli ztu\u010dn\u011bn\u00ed jater, kter\u00e9 m\u016f\u017ee vy\u00fastit v nevratn\u00e9 po\u0161kozen\u00ed tohoto org\u00e1nu. Ve vy\u0161\u0161\u00ed m\u00ed\u0159e trp\u00ed lid\u00e9 s lup\u00e9nkou tak\u00e9 z\u00e1n\u011btliv\u00fdmi chorobami st\u0159ev \u2013 ulcer\u00f3zn\u00ed kolitidou<\/strong> a Crohnovou chorobou<\/strong>.Z\u00e1n\u011bty se nevyh\u00fdbaj\u00ed ani o\u010d\u00edm. \u201ePokud se u nemocn\u00e9ho psori\u00e1zou objev\u00ed za\u010derven\u00e1n\u00ed oka prov\u00e1zen\u00e9 bolest\u00ed, citlivost\u00ed na sv\u011btlo, rozmazan\u00fdm vid\u011bn\u00edm \u010di zv\u00fd\u0161en\u00fdm v\u00fdskytem z\u00e1kalk\u016f v zorn\u00e9m poli, je t\u0159eba neprodlen\u011b nav\u0161t\u00edvit oftalmologa. Vin\u00edkem m\u016f\u017ee b\u00fdt uveitida, p\u0159i n\u00ed\u017e hroz\u00ed v krajn\u00edm p\u0159\u00edpad\u011b a\u017e ztr\u00e1ta zraku,\u201c upozor\u0148uje pan docent.<\/p>\n\n\n\n

Svou da\u0148 si lup\u00e9nka vyb\u00edr\u00e1 tak\u00e9 na psychick\u00e9 pohod\u011b nemocn\u00fdch. Negativn\u00ed pocity spojen\u00e9 s viditeln\u00fdmi ko\u017en\u00edmi projevy, zv\u00fd\u0161en\u00e1 m\u00edra stresu, ale z\u0159ejm\u011b tak\u00e9 samotn\u00e9 z\u00e1n\u011btliv\u00e9 pochody v t\u011ble zvy\u0161uj\u00ed n\u00e1chylnost k \u00fazkostem <\/strong>a depres\u00edm<\/strong>. Se siln\u00fdmi \u00fazkostmi se pot\u00fdk\u00e1 odhadem ka\u017ed\u00fd p\u00e1t\u00fd pacient s psori\u00e1zou, deprese pak tr\u00e1p\u00ed p\u0159ibli\u017en\u011b ka\u017ed\u00e9ho \u010dtvrt\u00e9ho nemocn\u00e9ho.<\/p>\n\n\n\n

Kroky k \u00fasp\u011b\u0161n\u00e9 l\u00e9\u010db\u011b: zkrocen\u00ed z\u00e1n\u011btu i pe\u010dliv\u011b pl\u00e1novan\u00e1 spolupr\u00e1ce<\/strong><\/p>\n\n\n\n

Zat\u00edmco star\u0161\u00ed typy l\u00e9\u010dby nejsou c\u00edlen\u00e9 a maj\u00ed tak krom\u011b vlivu na ko\u017en\u00ed projevy lup\u00e9nky i \u010detn\u00e9 potenci\u00e1ln\u00ed ne\u017e\u00e1douc\u00ed \u00fa\u010dinky, nebo\u0165 zasahuj\u00ed do proces\u016f bun\u011bk v cel\u00e9m t\u011ble, modern\u00ed l\u00e9ky um\u00ed zac\u00edlit na konkr\u00e9tn\u00ed z\u00e1n\u011btliv\u00e9 procesy spojen\u00e9 s rozvojem lup\u00e9nky. D\u00edky tomu je tato l\u00e9\u010dba bezpe\u010dn\u011bj\u0161\u00ed a \u00fa\u010dinn\u011bj\u0161\u00ed. \u201eP\u0159\u00edzniv\u00e9 \u00fa\u010dinky terapie se projev\u00ed nejen zhojen\u00edm k\u016f\u017ee, ale tak\u00e9 ochranou p\u0159ed po\u0161kozen\u00edm kloub\u016f a dal\u0161\u00edch org\u00e1n\u016f. Riziko rozvoje \u0159ady komorbidit se tak sni\u017euje,\u201c vysv\u011btluje pan docent v\u00fdhody c\u00edlen\u00e9 l\u00e9\u010dby.<\/p>\n\n\n\n

Vzhledem k rozmanitosti pr\u016fvodn\u00edch onemocn\u011bn\u00ed je nezbytn\u00e9 l\u00e9\u010dbu lup\u00e9nky tak\u00e9 pe\u010dliv\u011b koordinovat. \u201eTerapie mus\u00ed b\u00fdt komplexn\u00ed, multioborovou z\u00e1le\u017eitost\u00ed, kter\u00e1 stav\u00ed na spolupr\u00e1ci \u0159ady specialist\u016f \u2013 dermatolog\u016f, revmatolog\u016f, ale tak\u00e9 kardiolog\u016f, internist\u016f, psychiatr\u016f a dal\u0161\u00edch odborn\u00edk\u016f. Syst\u00e9m zdravotn\u00ed p\u00e9\u010de na tento model nen\u00ed prozat\u00edm dob\u0159e p\u0159ipraven\u00fd. Za\u010d\u00ednaj\u00ed se ale formovat iniciativy, kter\u00e9 prosazuj\u00ed konkr\u00e9tn\u00ed zm\u011bny, kter\u00e9 mohou p\u0159in\u00e9st v\u00fdrazn\u00e9 zkvalitn\u011bn\u00ed l\u00e9\u010dby nemocn\u00fdch s psori\u00e1zou.\u201c<\/p>\n\n\n\n

\u201eZodpov\u011bdnost je ale tak\u00e9 na samotn\u00fdch pacientech,\u201c p\u0159ipom\u00edn\u00e1. \u201eD\u016fle\u017eit\u00e9 je dodr\u017eov\u00e1n\u00ed l\u00e9\u010debn\u00e9ho re\u017eimu i komunikace s l\u00e9ka\u0159i. V\u011bd\u011bt, co nemocn\u00ed pot\u0159ebuj\u00ed a jak\u00e9 jsou jejich p\u0159edstavy o l\u00e9\u010db\u011b, je pro n\u00e1s d\u016fle\u017eit\u00e9,\u201c dod\u00e1v\u00e1 doc. MUDr. Filip Rob, Ph.D.<\/p>\n\n\n\n

Informace o nejmodern\u011bj\u0161\u00edch zp\u016fsobech l\u00e9\u010dby psori\u00e1zy naleznou pacienti i jejich bl\u00edzc\u00ed na webov\u00fdch str\u00e1nk\u00e1ch <\/em><\/strong>www.lupenkapodkontrolou.cz<\/em><\/strong><\/a>. Velk\u00fd prostor web v\u011bnuje ot\u00e1zce efektivn\u00ed komunikace mezi pacientem a l\u00e9ka\u0159em, nab\u00edz\u00ed odpov\u011bdi na \u010dasto kladen\u00e9 ot\u00e1zky souvisej\u00edc\u00ed s psori\u00e1zou a p\u0159ehled center pro jej\u00ed l\u00e9\u010dbu. <\/em><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

Kdy\u017e se \u0159ekne lup\u00e9nka, v\u011bt\u0161ina z n\u00e1s si p\u0159edstav\u00ed k\u016f\u017ei posetou za\u010dervenal\u00fdmi lo\u017eisky pokryt\u00fdmi silnou vrstvou \u0161upin. Ne ka\u017ed\u00fd ale v\u00ed, \u017ee ko\u017en\u00ed l\u00e9ze nejsou zdaleka […]<\/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":[11],"tags":[],"class_list":["post-41411","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\/41411","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=41411"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/41411\/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=41411"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=41411"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=41411"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}