{"id":6793,"date":"2013-06-21T06:59:54","date_gmt":"2013-06-21T04:59:54","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=6793"},"modified":"2013-06-21T15:01:17","modified_gmt":"2013-06-21T13:01:17","slug":"i-male-materske-znamenko-muze-zabijet","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=6793","title":{"rendered":"I mal\u00e9 mate\u0159sk\u00e9 znam\u00e9nko m\u016f\u017ee zab\u00edjet"},"content":{"rendered":"

Ultrafialov\u00e9 z\u00e1\u0159en\u00ed zdravou k\u016f\u017ei po\u0161kozuje, ale dob\u0159e d\u00e1vkovan\u00e9 ho pou\u017e\u00edv\u00e1me i k l\u00e9\u010db\u011b, \u0159\u00edk\u00e1 v rozhovoru Lidov\u00fdch novin profesor Petr Arenberger, p\u0159ednosta Dermatovenerologick\u00e9 kliniky FN Kr\u00e1lovsk\u00e9 Vinohrady v Praze.<\/strong><\/p>\n

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– LN Pokud se n\u00e1m na k\u016f\u017ei objev\u00ed nov\u00e9 znam\u00e9nko, pop\u0159\u00edpad\u011b to st\u00e1vaj\u00edc\u00ed zm\u011bn\u00ed barvu a za\u010dne r\u016fst, m\u00e1me se hned b\u00e1t, \u017ee se nejedn\u00e1 jen o kosmetickou z\u00e1le\u017eitost?<\/strong><\/p>\n

Jak\u00e1koli zm\u011bna pigmentov\u00fdch \u00fatvar\u016f je d\u016fvodem k n\u00e1v\u0161t\u011bv\u011b ko\u017en\u00edho l\u00e9ka\u0159e. P\u0159edev\u0161\u00edm v dosp\u011blosti, proto\u017ee v d\u011btsk\u00e9m v\u011bku mate\u0159sk\u00e1 znam\u00e9nka je\u0161t\u011b vznikaj\u00ed a zm\u011bny jejich tvaru a velikosti jsou b\u011b\u017en\u00e9. I u nich je ale jejich vznik vyvolan\u00fd pr\u00e1v\u011b p\u016fsoben\u00edm ultrafialov\u00e9ho z\u00e1\u0159en\u00ed. Je prok\u00e1z\u00e1no, \u017ee pokud vystavujeme d\u011bti slun\u00ed\u010dku, vznik\u00e1 u nich v\u00edce mate\u0159sk\u00fdch znam\u00e9nek a do budoucna maj\u00ed v\u011bt\u0161\u00ed riziko vzniku zhoubn\u00e9ho malign\u00edho melanomu. V dosp\u011blosti se u\u017e mate\u0159sk\u00e1 znam\u00e9nka moc nem\u011bn\u00ed, tak\u017ee jakmile k n\u011bjak\u00e9 zm\u011bn\u011b dojde, ko\u017en\u00ed vy\u0161et\u0159en\u00ed je nam\u00edst\u011b. Na\u0161t\u011bst\u00ed se i tady v\u011bt\u0161inou nejedn\u00e1 o zhoubn\u00fd novotvar, ale laik to nemus\u00ed v\u017edy spr\u00e1vn\u011b rozeznat.<\/strong><\/p>\n

– LN Jak takov\u00fd zhoubn\u00fd \u00fatvar pozn\u00e1 dermatolog? Sta\u010d\u00ed mu na to „\u0161kolen\u00e9 oko“, nebo pot\u0159ebuje p\u0159\u00edstroje?<\/strong><\/p>\n

I my dermatologov\u00e9 m\u00e1me leckdy probl\u00e9m odli\u0161it prost\u00fdm okem bezpe\u010dn\u00fd \u00fatvar od zhoubn\u00e9ho n\u00e1doru, ale kdy\u017e nejsme schopni p\u0159esn\u011b diagnostikovat, zda se jedn\u00e1 o pigmentov\u00fd \u00fatvar, nebo t\u0159eba o seboroickou veruku, pou\u017e\u00edv\u00e1me optickou \u010di digit\u00e1ln\u00ed dermatoskopii. Seboroick\u00e1 veruka je nezhoubn\u00fd v\u00fdr\u016fstek, \u0159\u00edk\u00e1 se mu tak\u00e9 sta\u0159eck\u00e1 nebo seniln\u00ed bradavice a je to v podstat\u011b jen zhn\u011bdl\u00e1 rohovina. Naprosto bezpe\u010dn\u00e1. Zd\u00e1lo by se tedy zbyte\u010dn\u00e9 s n\u00ed chodit na vy\u0161et\u0159en\u00ed ke ko\u017en\u00edmu l\u00e9ka\u0159i, ale j\u00e1 v\u017edycky \u0159\u00edk\u00e1m, \u017ee je lep\u0161\u00ed p\u0159ij\u00edt desetkr\u00e1t zbyte\u010dn\u011b ne\u017e jednou pozd\u011b. Jako ur\u010ditou pomoc p\u0159i rozhodov\u00e1n\u00ed k n\u00e1v\u0161t\u011bv\u011b odborn\u00edka doporu\u010duji pod\u00edvat se na na\u0161e webov\u00e9 str\u00e1nky www.melanom.cz, kde jsou vyfoceny p\u0159\u00edklady znam\u00e9nek. Jsou tam pops\u00e1na i krit\u00e9ria, podle kter\u00fdch si ka\u017ed\u00fd m\u016f\u017ee mate\u0159sk\u00e1 znam\u00e9nka s\u00e1m posoudit.<\/p>\n

– LN Jsou v\u0161echny rakoviny k\u016f\u017ee stejn\u011b nebezpe\u010dn\u00e9?<\/strong><\/p>\n

Bazaliom a spinaliom m\u00e9n\u011b ne\u017e melanom. V N\u011bmecku se jim \u0159\u00edk\u00e1 „b\u00edl\u00e1 rakovina“, proto\u017ee tyto ko\u017en\u00ed n\u00e1dory vznikaj\u00ed z jin\u00fdch ne\u017e pigmentotvorn\u00fdch bun\u011bk. Ov\u0161em i ony jsou zhoubn\u00e9. Bazaliom m\u016f\u017ee v k\u016f\u017ei pror\u016fstat do hlub\u0161\u00edch parti\u00ed, m\u016f\u017ee v\u00e1m zlikvidovat chrupavku nosn\u00edho k\u0159\u00eddla, pror\u016fst do oka, do ucha… Sice na n\u011bj neum\u0159eme hned, ale t\u0159eba a\u017e po 10 letech, kdy u\u017e n\u00e1m chyb\u00ed kus obli\u010deje a m\u00e1me t\u011b\u017ek\u00e9 infekce, tedy nebezpe\u010dn\u00fd rozhodn\u011b je. Spinaliom je zase t\u0159eba nen\u00e1padn\u00e1 r\u016f\u017eov\u00e1 skvrnka se \u0161upinkami, kter\u00e1 se postupn\u011b roz\u0161i\u0159uje, tuhne, n\u011bkdy se rozpad\u00e1 \u010di krv\u00e1c\u00ed. M\u016f\u017ee n\u011bkdy metastazovat do m\u00edzn\u00edch uzlin a d\u00e1l ovliv\u0148ovat jin\u00e9 syst\u00e9my. Malign\u00ed melanom je nejnebezpe\u010dn\u011bj\u0161\u00ed. \u00datvar, kter\u00fd vznik\u00e1 z mate\u0159sk\u00e9ho znam\u00e9nka, ale kter\u00fd se nez\u0159\u00eddka objev\u00ed i na norm\u00e1ln\u00ed voln\u00e9 k\u016f\u017ei. Krom\u011b uzlin r\u00e1d metastazuje i do vzd\u00e1len\u011bj\u0161\u00edch m\u00edst, jako je mozek, pl\u00edce, j\u00e1tra, a m\u016f\u017ee n\u00e1s ze v\u0161ech t\u0159\u00ed n\u00e1dor\u016f nejsn\u00e1ze zahubit. P\u0159itom je to „jen“ mal\u00e9 mate\u0159sk\u00e9 znam\u00e9nko, n\u011bkolik milimetr\u016f velk\u00e9.<\/p>\n

– LN Slunce ale nem\u00e1 na k\u016f\u017ei jen negativn\u00ed vliv, v p\u0159\u00edpad\u011b lup\u00e9nky nebo atopick\u00e9ho ekz\u00e9mu se pou\u017e\u00edv\u00e1 v l\u00e9\u010db\u011b.<\/strong><\/p>\n

Ultrafialov\u00e9 z\u00e1\u0159en\u00ed obecn\u011b zdravou k\u016f\u017ei po\u0161kozuje, ov\u0161em k l\u00e9\u010den\u00ed atopick\u00e9ho ekz\u00e9mu nebo lup\u00e9nky se skute\u010dn\u011b pou\u017e\u00edv\u00e1. Dob\u0159e d\u00e1vkovan\u00fdm UV z\u00e1\u0159en\u00edm lze toti\u017e z\u00e1n\u011btlivou reakci k\u016f\u017ee p\u0159itlumit. Ne pro ka\u017ed\u00e9ho pacienta je v\u0161ak t\u0159eba \u010dtrn\u00e1ctidenn\u00ed pobyt u mo\u0159e t\u00edm spr\u00e1vn\u00fdm l\u00e9\u010debn\u00fdm postupem, kter\u00fd jeho onemocn\u011bn\u00ed na p\u016fl roku potla\u010d\u00ed. V\u017edycky existuje riziko, \u017ee jedinec zareaguje tak, \u017ee se k\u016f\u017ee na slun\u00ed\u010dku sp\u00e1l\u00ed a jeho stav se zhor\u0161\u00ed. Nav\u00edc je p\u0159ed t\u011bmito l\u00e9\u010debn\u00fdmi pobyty d\u016fle\u017eit\u00e9 onemocn\u011bn\u00ed trochu p\u0159edl\u00e9\u010dit. Mus\u00edme m\u00edt z\u00e1n\u011bt ztlumen\u00fd, aby n\u00e1m slun\u00ed\u010dko se slanou vodou k\u016f\u017ei je\u0161t\u011b v\u00edce nepodr\u00e1\u017edily. Tady je vhodn\u00e9 koordinovat v\u0161e s l\u00e9\u010dbou je\u0161t\u011b doma. Nap\u0159\u00edklad v denn\u00edch sanatori\u00edch, kde jsme schopni \u010d\u00e1ste\u010dn\u011b imitovat i pobyt nap\u0159\u00edklad jako u Mrtv\u00e9ho mo\u0159e.<\/p>\n

– LN Mrtv\u00e9 mo\u0159e je pro ko\u017en\u00ed onemocn\u011bn\u00ed lep\u0161\u00ed ne\u017e jin\u00e1 mo\u0159e?<\/strong><\/p>\n

Je to ide\u00e1ln\u00ed mo\u0159e pro lup\u00e9nku. M\u00e1 vysok\u00fd obsah sol\u00ed, kter\u00e9 obsahuj\u00ed protiz\u00e1n\u011btliv\u00e9 magnezium, z\u00e1rove\u0148 jeho hodn\u011b slan\u00e1 voda v\u00fdborn\u011b od\u0161upuje lup\u00e9nkov\u00e1 lo\u017eiska a oproti hladin\u011b jin\u00fdch sv\u011btov\u00fdch mo\u0159\u00ed m\u00e1 minusovou nadmo\u0159skou v\u00fd\u0161ku. Tud\u00ed\u017e i tlust\u0161\u00ed vrstvu atmosf\u00e9ry ne\u017e jinde, kterou mus\u00ed proch\u00e1zet ultrafialov\u00e9 z\u00e1\u0159en\u00ed, proto se zde v\u00edce filtruje kr\u00e1tkovlnn\u00e1 slo\u017eka B ultrafialov\u00e9ho z\u00e1\u0159en\u00ed, vyvol\u00e1vaj\u00edc\u00ed sp\u00e1len\u00ed. U Mrtv\u00e9ho mo\u0159e jsou mimo to i lo\u017eiska dehtov\u00fdch l\u00e1tek, kter\u00fdmi se pacienti mohou namazat. Dehet p\u016fsob\u00ed protiz\u00e1n\u011btliv\u011b a v kombinaci s ultrafialov\u00fdm z\u00e1\u0159en\u00edm se zvy\u0161uje jeho \u00fa\u010dinnost.<\/p>\n

– LN Jak\u00fd druh ultrafialov\u00e9ho z\u00e1\u0159en\u00ed po\u0161kozuje k\u016f\u017ei nejv\u00edc?<\/strong><\/p>\n

Ultrafialov\u00e9 z\u00e1\u0159en\u00ed C, ale to se na zemsk\u00e9m povrchu na\u0161t\u011bst\u00ed t\u00e9m\u011b\u0159 nevyskytuje. Z um\u011bl\u00fdch zdroj\u016f bylo nap\u0159\u00edklad v tzv. horsk\u00e9m slun\u00ed\u010dku, tedy v t\u011bch klasick\u00fdch rtu\u0165ov\u00fdch tlakov\u00fdch v\u00fdbojk\u00e1ch, kter\u00e9 se pou\u017e\u00edvaly \u00fapln\u011b na za\u010d\u00e1tku ultrafialov\u00e9 fototerapie a po\u0161kozovaly k\u016f\u017ei nejv\u00edc. S UVB z\u00e1\u0159en\u00edm se u\u017e b\u011b\u017en\u011b setk\u00e1v\u00e1me, stejn\u011b jako se z\u00e1\u0159en\u00edm UVA. Rozd\u00edl je ve vlnov\u00e9 d\u00e9lce a s t\u00edm souvisej\u00edc\u00ed agresivit\u011b v\u016f\u010di k\u016f\u017ei. UVB z\u00e1\u0159en\u00ed vyvol\u00e1v\u00e1 z\u010derven\u00e1n\u00ed k\u016f\u017ee, sp\u00e1len\u00ed, ale z\u00e1rove\u0148 nejv\u00edce a nejl\u00e9pe aktivuje vitamin D. Naopak v sol\u00e1ri\u00edch, kde je UVB slo\u017eka potla\u010dena, se pou\u017e\u00edv\u00e1 p\u0159edev\u0161\u00edm z\u00e1\u0159en\u00ed UVA. U n\u011bj z hlediska u\u017eivatele, kter\u00fd nem\u00e1 dozimetr, chyb\u00ed informace, jakou d\u00e1vku ultrafialov\u00e9ho z\u00e1\u0159en\u00ed dostal, proto\u017ee mu po n\u011bm k\u016f\u017ee z\u010derven\u00e1 na rozd\u00edl od pobytu na p\u0159irozen\u00e9m slunci s p\u0159\u00edm\u011bs\u00ed UVB jen v\u00fdjime\u010dn\u011b.<\/p>\n

– LN Znamen\u00e1 to, \u017ee sol\u00e1ria jsou pro opalov\u00e1n\u00ed rizikov\u011bj\u0161\u00ed ne\u017e slunce?<\/strong><\/p>\n

Takov\u00e9 opalov\u00e1n\u00ed je mnohem nebezpe\u010dn\u011bj\u0161\u00ed a z\u00e1ludn\u011bj\u0161\u00ed. Nav\u00edc v k\u016f\u017ei UVA v\u00fdrazn\u011b po\u0161kozuje elastick\u00e1 vl\u00e1kna, tak\u017ee se tvo\u0159\u00ed vr\u00e1sky. Akdo hned nedostane rakovinu k\u016f\u017ee, tomu se rozhodn\u011b urychluje jej\u00ed st\u00e1rnut\u00ed, proto\u017ee za st\u00e1rnut\u00ed k\u016f\u017ee je nejv\u00edce zodpov\u011bdn\u00e9 pr\u00e1v\u011b ultrafialov\u00e9 z\u00e1\u0159en\u00ed A. Krom\u011b toho kolegov\u00e9 ve \u0160v\u00e9dsku provedli velk\u00e9 popula\u010dn\u00ed studie s lidmi, kte\u0159\u00ed do sol\u00e1ria chodili i nechodili, a zjistilo se, \u017ee malign\u00ed melanom vznik\u00e1 mnohem \u010dast\u011bji u lid\u00ed, kte\u0159\u00ed do sol\u00e1ri\u00ed chod\u00ed. UVA z\u00e1\u0159en\u00ed, kter\u00e9 se d\u0159\u00edve pova\u017eovalo za bezpe\u010dn\u011bj\u0161\u00ed variantu UV paprsk\u016f, ale vyvol\u00e1v\u00e1 rakovinu k\u016f\u017ee stejn\u011b spolehliv\u011b jako z\u00e1\u0159en\u00ed UVB.<\/p>\n

– LN Co byste jako dermatolog vyznava\u010d\u016fm sol\u00e1rn\u00ed hn\u011bdi vzk\u00e1zal?<\/strong><\/p>\n

A\u0165 pou\u017e\u00edvaj\u00ed sol\u00e1ria jen v nejnutn\u011bj\u0161\u00edch p\u0159\u00edpadech, pokud musej\u00ed m\u00edt k\u016f\u017ei pigmentovanou t\u0159eba z pracovn\u00edch d\u016fvod\u016f. A i tady bych zv\u00e1\u017eil alternativu samoopalovac\u00edch kr\u00e9m\u016f nebo n\u00e1st\u0159ik\u016f, kter\u00e9 obarv\u00ed jen rohovou vrstvu poko\u017eky a nepokou\u0161\u00ed pigmentotvorn\u00e9 bu\u0148ky. Ka\u017ed\u00fd se mne pt\u00e1, jak \u010dasto m\u016f\u017ee nav\u0161t\u011bvovat sol\u00e1rium, aby to bylo „je\u0161t\u011b“ bezpe\u010dn\u00e9. Ale s UV z\u00e1\u0159en\u00edm je to jako s kou\u0159en\u00edm. Kolik cigaret je bezpe\u010dn\u00fdch, abyste si „nevyrobila“ rakovinu plic? Vobou p\u0159\u00edpadech je slo\u017eit\u00e9 to kvantifikovat, ale pokud chce populace sly\u0161et, zda existuje hranice, tak \u010d\u00edm m\u00e9n\u011b, t\u00edm l\u00e9pe. Nejl\u00e9pe v\u016fbec. Apokud se n\u011bkdo sol\u00e1ria i p\u0159esto nedok\u00e1\u017ee vzd\u00e1t, \u0159ekn\u011bme, \u017ee dvakr\u00e1t deset d\u00e1vek za rok je p\u0159ijateln\u00fdch.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Ultrafialov\u00e9 z\u00e1\u0159en\u00ed zdravou k\u016f\u017ei po\u0161kozuje, ale dob\u0159e d\u00e1vkovan\u00e9 ho pou\u017e\u00edv\u00e1me i k l\u00e9\u010db\u011b, \u0159\u00edk\u00e1 v rozhovoru Lidov\u00fdch novin profesor Petr Arenberger, p\u0159ednosta Dermatovenerologick\u00e9 kliniky FN […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12,11],"tags":[],"class_list":["post-6793","post","type-post","status-publish","format-standard","hentry","category-rozhovory","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/6793","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=6793"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/6793\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=6793"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=6793"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=6793"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}