Gugu Psoriatic

Psoriatic gugu o se soʻotaga faʻafitauli (gugu) e masani ona tupu ma se paʻu tulaga taʻua o le psoriasis.

O le psoriasis o se faʻafitauli masani o le paʻu e mafua ai mumu mumu i luga o le paʻu. O se faifai pea (faaumiumi) afaina tulaga. Psoriatic gaioiga tupu i le lata i le 7% i le 42% o tagata ma psoriasis. Fao psoriasis e fesoʻotaʻi i le psoriatic gugu.

I le tele o tulaga, psoriasis sau i luma o le gugu. I ni nai tagata, o le gugu e muamua mai le faʻamaʻi o le paʻu. Ae ui i lea, o le ogaoga, lautele-salalau psoriasis foliga mai e faʻateleina ai le avanoa e maua ai psoriatic gugu.

Le mafuaʻaga o le psoriatic gugu e le o iloa. O genes, immune system, ma siʻosiʻomaga mea e ono faia se sao. E foliga mai o le paʻu ma faʻamaʻi soʻoga ono i ai mafuaʻaga tutusa. Peitai, atonu e le tutupu faʻatasi.

O le gugu atonu e agamalu ma aofia ai na o ni soʻoga soʻoga. O sooga i le pito o tamailima poʻo tamaivae e ono aʻafia atili. Psoriatic gugu e masani lava ona le tutusa mafua ai gugu i na o le tasi le itu o le tino.

I nisi tagata, o le faʻamaʻi ono matuia ma afaina ai le tele soʻoga, aofia ai ma le tuasivi. Faʻailoga i le tuasivi aofia ai maʻa ma tiga. E masani ona tupu i le pito i lalo o le tuasivi ma le tapu.

O nisi tagata e maua i le gugu ole psoriatic atonu e iai le pupula o mata.

Tele o taimi, tagata i psoriatic gugu maua le paʻu ma fao fesuiaʻiga o psoriasis. Tele o taimi, e paʻu le paʻu i le taimi e tasi e pei o le gugu.

Tendons mafai ona faʻafefeteina i psoriatic gugu. O faʻataʻitaʻiga e aofia ai le tendon Achilles, le plantar fascia, ma le tendon sheath i le lima.

I le taimi o suʻega faʻaletino, o le a vaʻai le tausi soifua maloloina mo:

• Fula soʻoga
• Paʻu o paʻu (psoriasis) ma tuʻi i fao
• Agamalu
• Fula i mata

E mafai ona faia ave-ave.

E leai ni faʻamaoniga toto mo psoriatic gugu poʻo mo psoriasis. O suʻega e faʻateʻa ai isi ituaiga o gugu e mafai ona faia:

• Rheumatoid vaega
• Aneti-CCP sela

E ono suʻesuʻeina e le tagata o loʻo saunia le genes ua taʻua HLA-B27 Tagata o loʻo aafia le tua e tele na maua latou HLA-B27.

E ono tuʻuina atu i lau kamupani tuʻuina atu fualaʻau faʻafomaʻi e teteʻe ai le mafaufau (NSAIDs) e faʻaititia ai le tiga ma le fulafula o soʻoga.

O le gasegase e le alualu i luma ma le NSAID o le a manaʻomia e togafitia i vailaʻau e taʻu o faʻamaʻi-fesuiaʻi vailaʻau faʻafomaʻi (DMARDs). E aofia ai:

• Methotrexate
• Leflunomide
• Sulfasalazine

Apremilast o leisi vailaʻau faʻaaoga mo le togafitiga o le psoriatic gugu.

Fou vailaʻau biologic e aoga mo alualu i luma psoriatic gugu e le o faʻatonutonuina ma DMARDs. O vailaʻau nei e poloka poloka e taʻua ole tum nekrosis factor (TNF). E masani ona aoga mo le faʻamaʻi o le paʻu ma le faʻamaʻi o le psoriatic arthritis. O nei vailaʻau e avatua i le tui.

O loʻo avanoa isi vailaʻau fou e togafitia ai le psoriatic gugu o loʻo alualu i luma e oʻo lava i le faʻaaogaina o DMARD poʻo soʻotaga anti-TNF. O nei vailaʻau e avatua foʻi ile tui.

O sooga sooga o soʻoga e ono togafitia i tui o le steroid. E faʻaaogaina ia pe a naʻo le tasi poʻo ni nai soʻoga o loʻo aʻafia. Tele tagata atamamai latou te le fautuaina oral oral corticosteroids mo psoriatic gugu. Ole latou faʻaaogaina e ono leaga ai le psoriasis ma faʻalavelave ai ile aʻafiaga o isi vailaʻau.

I ni tulaga seasea tupu, e ono manaʻomia se taotoga e toe faaleleia pe sui ai soʻoga soʻoga.

Tagata e iai le pupula o le mata e tatau ona vaʻai i se fomaʻi mata.

E ono fautuaina e lau kamupani le tuʻufaʻatasiga o malologa ma faʻamalositino. Faʻamalosi tino e mafai ona fesoasoani faʻateleina gaioiga soʻoga. Oe mafai foi faʻaaoga le vevela ma le malulu togafitiga.

O le faʻamaʻi e malu i nisi taimi ma afaina ai na o nai soʻoga. Ae ui i lea, i le tele o tagata ma psoriatic galu faʻaleagaina o soʻoga tupu i totonu o le muamua ni nai tausaga. I nisi tagata, o le gugu tele e ono mafua ai le le atoatoa i lima, vae, ma le tuasivi.

Tele o tagata e maua i le psoriatic gugu e le faaleleia i le NSAIDs e tatau ona vaai i se rheumatologist, o se faʻapitoa i le gugu, faʻatasi ai ma se fomaʻi faʻapitoa mo le vaifofo.

O togafitiga vave e mafai ona faʻamamaina ai le tiga ma puipuia ai le soʻoga faʻatasi, e oʻo lava i tulaga leaga.

Valaʻau lau tautua pe a fai e te maua faʻailoga o le gugu ma faʻamaʻi.

Gugu - psoriatic; Vailaʻau - psoriatic gugu; Spondyloarthritis - gugu gugu; PsA

• Psoriasis - faʻasolo i lima ma le fatafata
• Psoriasis - faʻamama i luga o le alafau

Bruce IN, Ho PYP. Vaʻaiga faʻafomaʻi o le psoriatic gugu. I: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. 7th ed. Filatelefia, PA: Elsevier; 2019: chap 128

Gladman D, Rigby W, Azevedo VF, et al. Tofacitinib mo le psoriatic gugu i tagata mamaʻi ma le lava le tali atu i tagata taofiofi TNF. N Engl J Med. 2017; 377:1525-1536.

Smolen JS, Schöls M, Braun J, et al. Togafitiga axial spondyloarthritis ma peripheral spondyloarthritis, aemaise psoriatic gugu, e taulaʻi i ai: 2017 faʻafouina o fautuaga e le faʻavaomalo galuega faʻamalosi. Ann Rheum Dis. 2018; 77 (1): 3-17. PMID: 28684559 pubmed.ncbi.nlm.nih.gov/28684559/.

Veale DJ, Orr C.Faʻatautaia o le psoriatic gugu. I: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. 7th ed. Filatelefia, PA: Elsevier; 2019: chap 131.