[et_pb_section fb_built=“1″ admin_label=“section“ _builder_version=“4.16″ global_colors_info=“{}“][et_pb_row admin_label=“row“ _builder_version=“4.16″ background_size=“initial“ background_position=“top_left“ background_repeat=“repeat“ global_colors_info=“{}“][et_pb_column type=“4_4″ _builder_version=“4.16″ custom_padding=“|||“ global_colors_info=“{}“ custom_padding__hover=“|||“][et_pb_text _builder_version=“4.23″ _module_preset=“c1471b09-4a99-4ba4-a621-4bad6a5e9619″ global_colors_info=“{}“]<\/p>\n
MUDr. Vojt\u011bch Hanul\u00edk, Ph.D.<\/strong>, je atestovan\u00fd l\u00e9ka\u0159 v oborech mikrobiologie<\/strong> a dermatovenerologie<\/strong>, specializuj\u00edc\u00ed se na bakterie rezistentn\u00ed k antibiotik\u016fm a ko\u017en\u00ed onemocn\u011bn\u00ed, jako jsou lup\u00e9nka a atopick\u00fd ekz\u00e9m. P\u0159esahuje hranice laborato\u0159e, aktivn\u011b se v\u011bnuje klinick\u00e9 praxi, antibiotick\u00e9 terapii a komplexn\u00ed p\u00e9\u010di o pacienty s\u00a0dermatologick\u00fdmi (ko\u017en\u00edmi) probl\u00e9my. Jeho pr\u00e1ce spo\u010d\u00edv\u00e1 v kombinaci v\u011bdeck\u00e9ho p\u0159\u00edstupu a p\u0159\u00edm\u00e9 p\u00e9\u010de o pacienty.<\/p>\n Mikrobiologie <\/strong>je ve st\u0159edn\u00ed Evrop\u011b po\u0159\u00e1d sp\u00ed\u0161e laboratorn\u00ed pr\u00e1ce, ale \u010d\u00edm d\u00e1l v\u00edce se p\u0159ekl\u00e1p\u00ed do kliniky, co\u017e obn\u00e1\u0161\u00ed konzultace s\u00a0kolegy v\u00a0nemocnici, doporu\u010dov\u00e1n\u00ed a sledov\u00e1n\u00ed antibioterapie (pozn. autora: l\u00e9\u010dba antibiotiky) u jednotliv\u00fdch pacient\u016f, ale i celkov\u00e9 spot\u0159eby v\u00a0r\u00e1mci nemocni\u010dn\u00edch za\u0159\u00edzen\u00ed.<\/p>\n Dermatologie <\/strong>je klinick\u00fd obor, kter\u00fd spojuje n\u011bkolik oblast\u00ed. Velkou \u010d\u00e1st\u00ed pr\u00e1ce jsou ko\u017en\u00ed choroby jako takov\u00e9 \u2013 lup\u00e9nka, atopick\u00fd ekz\u00e9m, ko\u017en\u00ed alergie. D\u00e1le l\u00e9\u010d\u00edme onemocn\u011bn\u00ed k\u016f\u017ee vznikl\u00e1 na z\u00e1klad\u011b jin\u00e9ho onemocn\u011bn\u00ed, nap\u0159\u00edklad revmatick\u00e9ho \u010di onkologick\u00e9ho. Star\u00e1me se o prevenci, diagnostiku a terapii ko\u017en\u00edch n\u00e1dor\u016f, pe\u010dujeme o akutn\u00ed i chronick\u00e9 ko\u017en\u00ed defekty a pat\u0159\u00ed zde i venerologick\u00e1 onemocn\u011bn\u00ed, tedy pohlavn\u00ed choroby.<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“dd44a80f-e178-438e-ae1f-7d2385f28960″ global_colors_info=“{}“]<\/p>\n Ty jsi p\u016fvodn\u011b studoval mikrobiologii a pak jsi tak\u00e9 s t\u011bmi tit\u011brn\u00fdmi organismy i pracoval\u2026Pro\u010d t\u011b to l\u00e1kalo a pro\u010d ses pozd\u011bji rozhodl pro studium dermatovenerologie?<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“c1471b09-4a99-4ba4-a621-4bad6a5e9619″ global_colors_info=“{}“]<\/p>\n Vojt\u011bch:<\/strong>\u00a0Mikrobiologie, a hlavn\u011b vysoce infek\u010dn\u00ed onemocn\u011bn\u00ed, m\u011b l\u00e1kaly od doby, co jsem si na st\u0159edn\u00ed \u0161kole p\u0159e\u010detl Prestnovu Z\u00e1ke\u0159nou Ebolu. Pr\u00e1ce v\u00a0laborato\u0159i a u mikroskopu m\u011b v\u017edy velice bavila. Pak se ale naskytla p\u0159\u00edle\u017eitost zm\u011bnit obor a j\u00e1 t\u00e9 p\u0159\u00edle\u017eitosti vyu\u017eil. Bylo to jedno z\u00a0nejlep\u0161\u00edch rozhodnut\u00ed v\u00a0m\u00e9m \u017eivot\u011b. Dermatologii d\u011bl\u00e1m opravdu pro sv\u00e9 pot\u011b\u0161en\u00ed<\/strong>. V\u00a0mikrobiologii mi chyb\u011bl hlavn\u011b kontakt s\u00a0pacientem.<\/p>\n V\u00a0dermatologii, jak u\u017e jsem \u0159\u00edkal, je spousta mo\u017enost\u00ed, jak se profilovat. Mn\u011b se l\u00edb\u00ed p\u0159edev\u0161\u00edm mo\u017enost kombinace tohoto oboru s chirurgi\u00ed, kterou m\u00e1m moc r\u00e1d. Nav\u00edc, s\u00a0mikrobiologi\u00ed se prol\u00edn\u00e1 ve spoust\u011b p\u0159\u00edpad\u016f. \u010casto \u0159e\u0161\u00edme ko\u017en\u00ed obt\u00ed\u017ee zp\u016fsoben\u00e9 virov\u00fdm \u010di bakteri\u00e1ln\u00edm p\u016fvodcem, pravideln\u00e9 jsou ko\u017en\u00ed projevy alergick\u00fdch reakc\u00ed na antibiotika<\/strong>, venerologie je \u010dist\u011b infek\u010dn\u00ed z\u00e1le\u017eitost. Ale i p\u0159i terapii chronick\u00e9 r\u00e1ny se l\u00e9ka\u0159 mus\u00ed um\u011bt rozhodnout, zda je r\u00e1na kolonizovan\u00e1 bakteriemi \u010di u\u017e je to infekce a je t\u0159eba celkov\u00e1 terapie antibiotiky. To je n\u011bkdy celkem um\u011bn\u00ed. D\u00edky znalostem z\u00a0mikrobiologie m\u00e1m dle m\u00e9ho ucelen\u011bj\u0161\u00ed pohled na vztah \u010dlov\u011bka a mikroorganism\u016f<\/strong>.<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“dd44a80f-e178-438e-ae1f-7d2385f28960″ global_colors_info=“{}“]<\/p>\n Jsi takov\u00fd ten doktor, kter\u00fd se n\u011bco nau\u010dil a u\u017e jen jede star\u00e9 \u201eodrhova\u010dky\u201c, nebo se vzd\u011bl\u00e1v\u00e1\u0161 i nad r\u00e1mec sv\u00e9ho povol\u00e1n\u00ed?<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“c1471b09-4a99-4ba4-a621-4bad6a5e9619″ global_colors_info=“{}“]<\/p>\n Vojt\u011bch:<\/strong>\u00a0Celkem dost bojuji se svou p\u0159irozenou lenost\u00ed a pravda je, \u017ee rutinn\u00ed z\u00e1le\u017eitosti jsou pro m\u011b sv\u00fdm zp\u016fsobem relaxac\u00ed. Ale jist\u011b, l\u00e9ka\u0159 se prost\u011b mus\u00ed neust\u00e1le vzd\u011bl\u00e1vat.\u00a0<\/p>\n P\u0159izn\u00e1v\u00e1m, \u017ee m\u00e1m sv\u00e9 klasick\u00e9 \u201eodrhova\u010dky\u201c co se t\u00fd\u010de strategie l\u00e9\u010dby a terapie vybran\u00fdch nemoc\u00ed obecn\u011b. Je to ale zku\u0161enostmi osv\u011bd\u010den\u00fd z\u00e1klad<\/strong>, kombinace, p\u0159\u00edstup, kter\u00fd u dan\u00e9ho probl\u00e9mu v\u011bt\u0161inou dob\u0159e funguje. Pokud sel\u017ee, d\u00e1 se individu\u00e1ln\u011b upravit. A to u\u017e pak \u010dlov\u011bk mus\u00ed zapojit hlavu, sednout k\u00a0internetu nebo otev\u0159\u00edt knihu.<\/p>\n B\u00fdt v\u00a0obraze a p\u0159in\u00e9st pacientovi to nejlep\u0161\u00ed, co sou\u010dasn\u00e1 medic\u00edna um\u00ed, je dle m\u00e9ho po\u0159\u00e1d z\u00e1sadn\u00ed. Jsou ale oblasti, ve kter\u00fdch jsem dal\u0161\u00ed vzd\u011bl\u00e1v\u00e1n\u00ed se a roz\u0161i\u0159ov\u00e1n\u00ed obzor\u016f vzdal.\u00a0<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“dd44a80f-e178-438e-ae1f-7d2385f28960″ global_colors_info=“{}“]<\/p>\n M\u00e1 na tebe tv\u00e1 pozice vliv? T\u00edm mysl\u00edm, kdy\u017e v\u00ed\u0161, co t\u0159eba zp\u016fsobuje n\u011bkter\u00e9 ko\u017en\u00ed onemocn\u011bn\u00ed, bakterie, viry nebo l\u00e1tky obsa\u017eeny v mastech \u010di kosmetice\u2026 Vyh\u00fdb\u00e1\u0161 se jim?<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“c1471b09-4a99-4ba4-a621-4bad6a5e9619″ global_colors_info=“{}“]<\/p>\n Vojt\u011bch:<\/strong>\u00a0J\u00e1 s\u00e1m dermokosmetiku pravideln\u011b nepou\u017e\u00edv\u00e1m. V\u00a0tomhle jsem asi pr\u016fm\u011brn\u00fd chlap. Osobn\u011b zast\u00e1v\u00e1m n\u00e1zor, \u017ee okolnosti a reklamy n\u00e1s p\u0159esv\u011bd\u010duj\u00ed o a\u017e \u00fazkostn\u00e9 p\u00e9\u010di o k\u016f\u017ei<\/strong>. Kdy\u017e ne pro zdrav\u00ed, tak alespo\u0148 pro kr\u00e1su. Pravdou ale je, \u017ee norm\u00e1ln\u00ed poko\u017eka jinak zdrav\u00e9ho \u010dlov\u011bka nepot\u0159ebuje specifickou p\u00e9\u010di<\/strong>. Dokonce i p\u0159\u00edli\u0161n\u00e9 myt\u00ed m\u00fddly poko\u017ece sp\u00ed\u0161e ubli\u017euje, ne\u017e prosp\u00edv\u00e1. Zdrav\u00e1 k\u016f\u017ee si je sama schopna<\/strong> vytvo\u0159it odolnou ochrannou vrstvu, kam pat\u0159\u00ed i mastnota a t\u011blu vlastn\u00ed bakterie. V\u00a0p\u0159\u00edpad\u011b, \u017ee se myjeme p\u0159\u00edli\u0161 \u010dasto, m\u016f\u017ee doch\u00e1zet k\u00a0naru\u0161en\u00ed t\u00e9to slupky a vzniku ko\u017en\u00edch nemoc\u00ed<\/strong>. N\u00e1chyln\u00ed jsou zejm\u00e9na atopici<\/strong>, kde je ochrann\u00e1 funkce k\u016f\u017ee p\u0159irozen\u011b oslabena. To samoz\u0159ejm\u011b neznamen\u00e1, \u017ee m\u00e1 \u010dlov\u011bk svou hygienu zanedb\u00e1vat. M\u011bl jsem pacientku, kter\u00e1 byla cvi\u010ditelkou aerobiku. Dle jej\u00edch slov byla bu\u010fto zpocen\u00e1, nebo pod sprchou. N\u011bkolikr\u00e1t denn\u011b se myla sprchov\u00fdm gelem a tr\u00e1pila ji neust\u00e1le such\u00e1 a podr\u00e1\u017ed\u011bn\u00e1 poko\u017eka. Sta\u010dilo re\u017eimov\u00e9 opat\u0159en\u00ed a bylo po obt\u00ed\u017e\u00edch \u2013 po cvi\u010den\u00ed sprcha \u010distou vodou, m\u00fddlo na k\u016f\u017ei zhruba ob den a ob\u010das promazat k\u016f\u017ei na noc.\u00a0<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“dd44a80f-e178-438e-ae1f-7d2385f28960″ global_colors_info=“{}“]<\/p>\n S \u010d\u00edm k tob\u011b nej\u010dast\u011bji pacienti chod\u00ed?<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“c1471b09-4a99-4ba4-a621-4bad6a5e9619″ global_colors_info=“{}“]<\/p>\n Vojt\u011bch:<\/strong> J\u00e1 m\u00e1m v\u0161eobecnou ambulanci, tak\u017ee ten rozsah onemocn\u011bn\u00ed je opravdu velk\u00fd. Nej\u010dast\u011bji se ale setk\u00e1v\u00e1m s atopick\u00fdm ekz\u00e9mem, lup\u00e9nkou, b\u00e9rcov\u00fdmi defekty a n\u00e1dorov\u00fdmi zm\u011bnami na k\u016f\u017ei. Velice \u010dasto \u0159e\u0161\u00edm mykotick\u00e9 infekce k\u016f\u017ee a neht\u016f, virov\u00e9 bradavice, svrab, vypad\u00e1v\u00e1n\u00ed vlas\u016f, kontaktn\u00ed alergie, ekz\u00e9my a z t\u011bch akutn\u00edch stav\u016f erysipel, p\u00e1sov\u00e9 opary nebo kop\u0159ivky.<\/p>\n [\/et_pb_text][et_pb_image src=“https:\/\/green-gate.eu\/wp-content\/uploads\/2024\/01\/mykoticka-infekce-pred-a-po-lecbe.jpg“ title_text=“mykoticka-infekce-pred-a-po-lecbe“ _builder_version=“4.23″ _module_preset=“32fecfd5-025d-42fc-9828-d86bb0da2821″ global_colors_info=“{}“][\/et_pb_image][et_pb_text _builder_version=“4.23″ _module_preset=“71bce9ad-9a5c-4bc0-a49d-5ef17a0a743b“ global_colors_info=“{}“]<\/p>\n Zdroj obr\u00e1zku: Vojt\u011bch Hanul\u00edk; Mykotick\u00e1 infekce p\u0159ed a po l\u00e9\u010db\u011b<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“dd44a80f-e178-438e-ae1f-7d2385f28960″ global_colors_info=“{}“]<\/p>\n Kolem sebe pozoruji, jak mnoho lid\u00ed m\u00e1 n\u011bjak\u00e9 z\u00e1n\u011btliv\u00e9 onemocn\u011bn\u00ed k\u016f\u017ee (ekz\u00e9m, atopick\u00fd ekz\u00e9m, dermatitidu\u2026). Pop\u00ed\u0161e\u0161 n\u00e1m pros\u00edm v kr\u00e1tkosti, o\u010d se jedn\u00e1 a v \u010dem je rozd\u00edl?<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“c1471b09-4a99-4ba4-a621-4bad6a5e9619″ global_colors_info=“{}“]<\/p>\n Vojt\u011bch:\u00a0<\/strong>Tohle si pletou i odborn\u00edci a \u010dasto je to slov\u00ed\u010dka\u0159en\u00ed. Dermatitidy jsou zjednodu\u0161en\u011b z\u00e1n\u011btliv\u00e9 onemocn\u011bn\u00ed k\u016f\u017ee, u kter\u00fdch se nep\u0159edpokl\u00e1d\u00e1 alergick\u00fd podklad<\/strong> onemocn\u011bn\u00ed, ekz\u00e9my jsou v\u00a0podstat\u011b stejn\u00e9 z\u00e1n\u011btliv\u00e9 reakce k\u016f\u017ee, ale p\u0159\u00ed\u010dina je spojena s\u00a0n\u011bjak\u00fdm alergenem. Klinick\u00fd rozd\u00edl projev\u016f<\/strong> m\u016f\u017ee b\u00fdt velice podobn\u00fd u obou skupin onemocn\u011bn\u00ed. Velice \u010dasto se tak\u00e9 setk\u00e1v\u00e1me se z\u00e1m\u011bnou t\u011bchto pojm\u016f a m\u016f\u017eeme se tak setkat s\u00a0atopick\u00fdm ekz\u00e9mem i atopickou dermatitidou.<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“dd44a80f-e178-438e-ae1f-7d2385f28960″ global_colors_info=“{}“]<\/p>\n Kdy\u017e se t\u011bchto osob nebo rodi\u010d\u016f d\u011bt\u00ed nap\u0159. s ekz\u00e9mem zept\u00e1m, co ho spou\u0161t\u00ed, nedost\u00e1v\u00e1m stejn\u00e9 odpov\u011bdi. Jak je to tedy se z\u00e1n\u011bty k\u016f\u017ee a pro\u010d jej m\u00e1 tolik lid\u00ed?<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“c1471b09-4a99-4ba4-a621-4bad6a5e9619″ global_colors_info=“{}“]<\/p>\n Vojt\u011bch:\u00a0<\/strong>Atopie je predispozice k\u00a0neadekv\u00e1tn\u00ed ko\u017en\u00ed reakci, \u010d\u00e1ste\u010dn\u011b vrozen\u00e1 a v\u00a0rodin\u011b v\u00e1zan\u00e1. Sv\u00fdm pacient\u016fm to vysv\u011btluji n\u00e1sledovn\u011b. K\u016f\u017ee atopika je podobn\u00e1 \u0161patn\u011b postaven\u00e9 zdi. Pokud m\u00e1 ze\u010f domu vydr\u017eet b\u011b\u017en\u00e9 pov\u011btrnostn\u00ed podm\u00ednky, mus\u00ed b\u00fdt postavena ze spr\u00e1vn\u00fdch cihel, kter\u00e9 jsou spr\u00e1vn\u011b vyp\u00e1len\u00e9, mus\u00ed b\u00fdt pou\u017eita spr\u00e1vn\u00e1 malta, kde je spr\u00e1vn\u00fd pom\u011br vody, p\u00edsku, v\u00e1pna, cementu atd. Pokud tomu tak nen\u00ed, ze\u010f nesnese \u00fa\u010dinky de\u0161t\u011b, slunce a v\u011btru a postupn\u011b ch\u00e1tr\u00e1. Podobn\u00e9 je to s\u00a0atopickou poko\u017ekou, ve kter\u00e9 p\u0159irozen\u011b chyb\u00ed n\u011bkter\u00e9 struktur\u00e1ln\u00ed slo\u017eky nebo naopak p\u0159eb\u00fdvaj\u00ed enzymy<\/strong>, kter\u00e9 tuto na\u0161i ze\u010f rychleji bouraj\u00ed. V\u011bt\u0161inou se nedop\u00e1tr\u00e1me konkr\u00e9tn\u00ed molekuly, nicm\u00e9n\u011b spr\u00e1vnou p\u00e9\u010d\u00ed jsme schopni<\/strong> na\u0161i ko\u017en\u00ed ze\u010f vylep\u0161it a vmaz\u00e1n\u00edm pot\u0159ebn\u00fdch l\u00e1tek jsme schopni ochrannou funkci k\u016f\u017ee, n\u011bkdy i trvale, obnovit<\/strong>.<\/p>\n Atopii komplikuje fakt, \u017ee je spojena i s\u00a0neadekv\u00e1tn\u00ed imunitn\u00ed reakc\u00ed<\/strong>. Proto k\u016f\u017ee rychleji reaguje z\u00e1n\u011btem na stres, suchost, p\u0159emno\u017een\u00ed bakteri\u00ed a jin\u00e9 faktory.<\/p>\n O vyvol\u00e1vac\u00edch faktorech atopick\u00e9 dermatitidy toho v\u00edme celkem dost a ka\u017ed\u00fd atopik si dok\u00e1\u017ee postupem \u010dasu vypozorovat s\u00e1m, co mu projevy zhor\u0161\u00ed<\/strong> a co naopak zlep\u0161\u00ed<\/strong>. O skute\u010dn\u00e9 p\u0159\u00ed\u010din\u011b ale toho moc nev\u00edme. M\u011b osobn\u011b p\u0159ijde velice zaj\u00edmav\u00e1 tzv. hygienick\u00e1 hypot\u00e9za. Ta d\u00e1v\u00e1 souvislost mezi ni\u017e\u0161\u00edm v\u00fdskytem lidsk\u00fdch parazit\u016f v populaci a vzr\u016fst po\u010dtu autoimunitn\u00edch onemocn\u011bn\u00ed v\u00a0posledn\u00edch dek\u00e1d\u00e1ch. Za dv\u011b, t\u0159i generace jsme nevypnuli imunitu proti parazit\u016fm, ta se te\u010f \u010dasto pod\u00edl\u00ed na vzniku \u010di zhor\u0161en\u00ed autoimunitn\u00edch a z\u00e1n\u011btliv\u00fdch onemocn\u011bn\u00ed. Je to ale po\u0159\u00e1d teorie, ve kter\u00e9 ale jako mikrobiolog vid\u00edm velkou logiku. Jak u\u017e to b\u00fdv\u00e1, nevysv\u011btl\u00ed n\u00e1m v\u0161e.<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“dd44a80f-e178-438e-ae1f-7d2385f28960″ global_colors_info=“{}“]<\/p>\n Dle asi 10 rozhovor\u016f, kter\u00e9 jsem vedla s lidmi s\u00a0ATOPICK\u00ddM ekz\u00e9mem, panovala shoda v tom, \u017ee jim l\u00e9ka\u0159i d\u00e1vali hned masti s kortikoidy (kortikosteroidy) \u2013\u00a0 i velmi mal\u00fdm d\u011btem, ani\u017e by po\u0159\u00e1dn\u011b problematiku onemocn\u011bn\u00ed a aplikaci p\u0159\u00edpravk\u016f s kortikoidy vysv\u011btlili\u2026 Co doporu\u010duje dne\u0161n\u00ed v\u011bda a co doporu\u010duje\u0161 ty dle sv\u00e9 praxe?<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“c1471b09-4a99-4ba4-a621-4bad6a5e9619″ global_colors_info=“{}“]<\/p>\n Vojt\u011bch:<\/strong>\u00a0Tohle je docela z\u00e1sadn\u00ed t\u00e9ma. Na jednu stranu se setk\u00e1v\u00e1me s\u00a0p\u0159\u00edsn\u00fdmi odm\u00edta\u010di kortikoid\u016f, na druhou stranu sou\u010dasn\u00e1 medic\u00edna nem\u00e1 na rychl\u00e9 zastaven\u00ed ko\u017en\u00edho z\u00e1n\u011btu v podstat\u011b nic lep\u0161\u00edho a dostupn\u011bj\u0161\u00edho<\/strong>. Existuj\u00ed sice imunomodul\u00e1tory s\u00a0podobn\u00fdm \u00fa\u010dinkem, ten ale nen\u00ed tak rychl\u00fd a spolehliv\u00fd (mluv\u00edm o prepar\u00e1tech s\u00a0takrolinem a pimekrolinem – Protopic, Elidel). Mnoho lid\u00ed p\u0159ich\u00e1z\u00ed do ordinace a \u0159\u00edk\u00e1, \u017ee zevn\u011b kortikoidy nechce, \u017ee se jim po nich projevy stejn\u011b vr\u00e1t\u00ed a n\u011bkdy jsou dokonce je\u0161t\u011b hor\u0161\u00ed. Delik\u00e1tn\u00ed ot\u00e1zkou je to pak u mal\u00fdch d\u011bt\u00ed.<\/p>\n J\u00e1 osobn\u011b na terapii kortikoidy ned\u00e1m dopustit, je ale z\u00e1sadn\u00ed v\u011bd\u011bt kdy a jak je pou\u017e\u00edvat<\/strong>. Pacient by o tom m\u011bl b\u00fdt podrobn\u011b a opakovan\u011b pou\u010den<\/strong>.<\/p>\n Kdy\u017e vyt\u00e1hnu to podstatn\u00e9, kortikoidy n\u00e1m pom\u00e1haj\u00ed uti\u0161it ko\u017en\u00ed z\u00e1n\u011bt. Po zklidn\u011bn\u00ed, a mnohdy ji\u017e b\u011bhem terapie kortikoidy, je ale nem\u00e9n\u011b d\u016fle\u017eit\u00e9 vmaz\u00e1vat vhodn\u00e9 masti. Viz v\u00fd\u0161e, co jsem psal o \u0161patn\u011b postaven\u00e9 zdi. No a po zklidn\u011bn\u00ed p\u0159ech\u00e1z\u00edme na tzv. intervalovou terapii<\/strong>, tzn., \u017ee intenzivn\u011b promaz\u00e1v\u00e1me vhodn\u00fdmi kr\u00e9my a mastmi<\/strong> a ob\u010das p\u0159ima\u017eeme i prepar\u00e1t s\u00a0kortikoidy. Interval mezi aplikac\u00ed kortikoid\u016f se sna\u017e\u00edme co nejv\u00edce prodlu\u017eovat<\/strong>. Na druhou stranu, pokud se z\u00e1n\u011bt zhor\u0161\u00ed, s\u00a0aplikac\u00ed kortikoid\u016f nev\u00e1h\u00e1m a tlum\u00edm projevy z\u00e1n\u011btu na po\u010d\u00e1tku<\/strong>.<\/p>\n U d\u011bt\u00ed a v\u00a0obli\u010deji pou\u017e\u00edv\u00e1me jin\u00e9 kortikoidy ne\u017e na zhrub\u011blou k\u016f\u017ei rukou, v\u00a0tom ale m\u00e1 b\u00fdt ka\u017ed\u00fd dermatolog dob\u0159e vzd\u011bl\u00e1n a mus\u00ed um\u011bt poradit. Alfou a omegou je potom srozumiteln\u011b p\u0159edat tyto informace pacient\u016fm<\/strong>.<\/p>\n \u00dapln\u011b jin\u00fd p\u0159\u00edstup pak nab\u00edz\u00ed fyzik\u00e1ln\u00ed terapie tzv. excimerov\u00fdm laserem<\/strong>. Ten pracuje s\u00a0vlnovou d\u00e9lkou 308 nm, kter\u00e1 ni\u010d\u00ed z\u00e1n\u011btliv\u00e9 bu\u0148ky<\/strong> v\u00a0m\u00edstech projev\u016f. \u00da\u010dinek se rovn\u00e1 pou\u017eit\u00ed zevn\u00edch kortikoid\u016f, bez rizika ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f.<\/strong> Vyu\u017e\u00edt se d\u00e1 u velk\u00e9 \u0161k\u00e1ly ko\u017en\u00edch nemoc\u00ed (lup\u00e9nka, atopick\u00fd ekz\u00e9m, alopecie, vitiliga, pustul\u00f3zy, l\u00e9\u010dba mykoticky posti\u017een\u00fdch neht\u016f a mnoho jin\u00fdch). Nev\u00fdhodou ale je, \u017ee v\u011bt\u0161ina zdravotn\u00edch poji\u0161\u0165oven plat\u00ed terapii jen u projev\u016f lup\u00e9nky.<\/strong> Zde jsou v\u0161ak v\u00fdsledky opravdu v\u00edce ne\u017e dobr\u00e9 a tak\u00e9 dlouhodob\u00e9<\/strong>. Ne ka\u017ed\u00fd excimerov\u00fd laser na trhu je stejn\u011b \u00fa\u010dinn\u00fd, proto je t\u0159eba k\u00a0terapii vybrat vysoce v\u00fdkonn\u00e9 p\u0159\u00edstroje. (Pozn. autora: jde o laser, kter\u00fd pulzem paprsk\u016f odstra\u0148uje jednotliv\u00e9 \u010d\u00e1ste\u010dky tk\u00e1n\u011b bez po\u0161kozen\u00ed okol\u00ed.)<\/em><\/span>\u00a0 V\u00a0\u010cesk\u00e9 Republice se takov\u00fd nach\u00e1z\u00ed prakticky v\u00a0ka\u017ed\u00e9m krajsk\u00e9m m\u011bst\u011b.<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“dd44a80f-e178-438e-ae1f-7d2385f28960″ global_colors_info=“{}“]<\/p>\n Kdy\u017e je n\u011bjak\u00e9 poran\u011bn\u00ed k\u016f\u017ee, nap\u0159. ekz\u00e9m, \u0161kr\u00e1banec, r\u016fzn\u00e9 pup\u00ednky, alergick\u00e9 projevy atd., takov\u00e9 naru\u0161en\u00ed poko\u017eky umo\u017e\u0148uje snaz\u0161\u00ed vstup r\u016fzn\u00fdch slo\u017eek d\u00e1le do t\u011bla. To m\u016f\u017ee b\u00fdt probl\u00e9m hlavn\u011b u dlouhodob\u00e9 aplikace p\u0159\u00edpravk\u016f se \u0161kodliv\u00fdmi l\u00e1tkami. Je tedy vhodn\u00e9 mazat masti\u010dky a kr\u00e9my na n\u011bjak poran\u011bnou k\u016f\u017ei? Co se obecn\u011b doporu\u010duje, ale moc se to nev\u00ed?\u00a0<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“c1471b09-4a99-4ba4-a621-4bad6a5e9619″ global_colors_info=“{}“]<\/p>\n Vojt\u011bch:<\/strong>\u00a0Tady bych asi rozli\u0161oval mezi akutn\u011b vznikl\u00fdm defektem k\u016f\u017ee v\u00a0podob\u011b r\u00e1ny \u010di od\u0159eniny a mezi chronick\u00fdmi stavy, kam pat\u0159\u00ed ji\u017e zmi\u0148ovan\u00e9 ekz\u00e9my. Pokud dlouhodob\u011b aplikuji jak\u00fdkoliv p\u0159\u00edpravek na chronick\u00fd projev<\/strong>, ve kter\u00e9m prob\u00edh\u00e1 z\u00e1n\u011btliv\u00e1 reakce, v\u017edy existuje riziko v\u011bt\u0161\u00edho pr\u016fniku slo\u017eek p\u0159\u00edpravku do k\u016f\u017ee a p\u0159\u00edpadn\u00e1 alergizace. Na akutn\u00ed defekty ale ur\u010dit\u011b ka\u017ed\u00fd zn\u00e1 n\u011bjakou vhodnou mast, kter\u00e1 m\u00e1 podpo\u0159it hojen\u00ed.\u00a0<\/p>\n J\u00e1 se ze z\u00e1sady dr\u017e\u00edm zaveden\u00fdch firem, kter\u00e9 se dermokosmetikou a l\u00e9\u010dbou ko\u017en\u00edch onemocn\u011bn\u00ed zab\u00fdvaj\u00ed dlouhodob\u011b. Jedn\u00e1 se o firmy, kter\u00e9 maj\u00ed sv\u00e9 produkty p\u0159ipraveny tak, aby co nejm\u00e9n\u011b dr\u00e1\u017edily a \u0161kodily, jsem o tom alespo\u0148 p\u0159esv\u011bd\u010den. Nicm\u00e9n\u011b ka\u017ed\u00e9mu vyhovuje n\u011bco jin\u00e9ho, n\u011bkomu m\u016f\u017ee sta\u010dit i dom\u00e1c\u00ed konopn\u00e1 mast.\u00a0\u00a0<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“dd44a80f-e178-438e-ae1f-7d2385f28960″ global_colors_info=“{}“]<\/p>\n Znam\u00e9nka a rakovina k\u016f\u017ee, s t\u00edm se asi tak\u00e9 setk\u00e1v\u00e1\u0161, \u017ee? Je rakovina k\u016f\u017ee v \u010cR b\u011b\u017en\u00e1? Lze ji dob\u0159e l\u00e9\u010dit?<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“c1471b09-4a99-4ba4-a621-4bad6a5e9619″ global_colors_info=“{}“]<\/p>\n Vojt\u011bch:<\/strong>\u00a0Rakovina k\u016f\u017ee pat\u0159\u00ed v\u00a0\u010cR k\u00a0velice \u010dast\u00fdm n\u00e1dorov\u00fdm onemocn\u011bn\u00edm a v\u00fdskyt ko\u017en\u00edch malignit v\u00a0populaci roste. Je d\u016fle\u017eit\u00e9 rozli\u0161ovat malign\u00ed melanomy a nemelanomov\u00e9 n\u00e1dory k\u016f\u017ee. Melanomy zjednodu\u0161en\u011b vych\u00e1zej\u00ed ze znam\u00e9nek<\/strong> a vyskytuj\u00ed se kdekoliv na k\u016f\u017ei a v\u00a0podstat\u011b v\u00a0kter\u00e9mkoliv v\u011bku. Nemelanomov\u00e9 n\u00e1dory se vyskytuj\u00ed p\u0159edev\u0161\u00edm u star\u0161\u00edch lid\u00ed a zejm\u00e9na na k\u016f\u017ei, kter\u00e1 je dlouhodob\u011b vystavena slune\u010dn\u00edmu z\u00e1\u0159en\u00ed, projevuj\u00ed se nej\u010dast\u011bji jako nehoj\u00edc\u00ed se ko\u017en\u00ed v\u0159\u00eddky<\/strong>.<\/p>\n L\u00e9\u010dba je jednoduch\u00e1 v\u00a0prvn\u00edch st\u00e1di\u00edch, kdy sta\u010d\u00ed n\u00e1dor v\u00a0lok\u00e1ln\u00ed anestezii vy\u0159ezat a pacienta d\u00e1le pravideln\u011b sledovat.<\/strong> V\u00a0p\u0159\u00edpad\u011b, \u017ee se jedn\u00e1 o pokro\u010dilej\u0161\u00ed st\u00e1dia je terapie komplexn\u011bj\u0161\u00ed a n\u00e1ro\u010dn\u011bj\u0161\u00ed. Jedn\u00e1 se nej\u010dast\u011bji o kombinaci chirurgick\u00e9ho \u0159e\u0161en\u00ed a n\u00e1sledn\u00e9 onkologick\u00e9 l\u00e9\u010dby.\u00a0<\/p>\n Pozdn\u00ed st\u00e1dia melanomu maj\u00ed velmi \u0161patnou progn\u00f3zu<\/strong>, stejn\u011b tak pokro\u010dil\u00e9 nemelanomov\u00e9 ko\u017en\u00ed n\u00e1dory, um\u00edst\u011bn\u00e9 nav\u00edc v\u00a0anatomicky nep\u0159\u00edzniv\u00e9 lokalit\u011b. Ka\u017ed\u00fd by proto m\u011bl vyu\u017e\u00edt mo\u017enosti alespo\u0148 jednou ro\u010dn\u011b zkontrolovat znam\u00e9nka.\u00a0<\/strong><\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“dd44a80f-e178-438e-ae1f-7d2385f28960″ global_colors_info=“{}“]<\/p>\n Sice to bylo zm\u00edn\u011bno na r\u016fzn\u00fdch webech a publikac\u00edch, ale m\u016f\u017ee\u0161 n\u00e1m \u0159\u00edci, na co si d\u00e1t pozor? Kdy j\u00edt k l\u00e9ka\u0159i\u2026 n\u011bkdy znam\u00e9nka vypadaj\u00ed dost divn\u011b a nejsou \u201evadn\u00e1\u201c, pro\u010d se tak najednou v\u016fbec stane?<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“c1471b09-4a99-4ba4-a621-4bad6a5e9619″ global_colors_info=“{}“]<\/p>\n Vojt\u011bch:<\/strong>\u00a0Pro vznik melanomu je rizikem p\u0159edev\u0161\u00edm opakovan\u00e9 sp\u00e1len\u00ed se na slunci<\/strong>. Pro vznik nemelanomov\u00fdch n\u00e1dor\u016f k\u016f\u017ee pak hraje z\u00e1sadn\u00ed roli mno\u017estv\u00ed slune\u010dn\u00edch paprsk\u016f, kter\u00e9 za \u017eivot na k\u016f\u017ei dopadly, tedy intenzita slun\u011bn\u00ed<\/strong>. Z\u00e1sadn\u00ed je samoz\u0159ejm\u011b i genetick\u00e1 predispozice<\/strong>. Zn\u00e1me rodiny, kde je v\u011bt\u0161\u00ed genetick\u00e1 z\u00e1t\u011b\u017e a vy\u0161\u0161\u00ed pravd\u011bpodobnost vzniku ko\u017en\u00edho tumoru. Pokud se tedy v\u00a0rodin\u011b (rodi\u010d\/sourozenci) vyskytuje n\u011bjak\u00fd typ ko\u017en\u00edho n\u00e1doru, je vhodn\u00e9 pravideln\u00e9 vy\u0161et\u0159en\u00ed dermatologem. A jak jsem \u0159\u00edkal, ka\u017ed\u00fd pacient si m\u016f\u017ee nechat pravideln\u011b preventivn\u011b kontrolovat znam\u00e9nka. K\u00a0vy\u0161et\u0159en\u00ed u dermatovenerologa nen\u00ed nutn\u00e1 \u017e\u00e1danka praktick\u00e9ho l\u00e9ka\u0159e<\/strong> a pacient se m\u016f\u017ee objednat s\u00e1m.<\/p>\n Znam\u00e9nka se vy\u0161et\u0159uj\u00ed tzv. dermatoskopem. Existuj\u00ed klasick\u00e9 a digit\u00e1ln\u00ed. Klasick\u00fd dermatoskop je v\u00a0podstat\u011b osv\u011btlen\u00e1 lupa, kterou prohl\u00ed\u017e\u00edme jednotliv\u00e1 znam\u00e9nka a hled\u00e1me zde rizikov\u00e9 znaky, jejich vyhodnocen\u00edm pot\u00e9 ur\u010dujeme, zda je projev vhodn\u00fd k\u00a0excizi (pozn. autora: chirurgick\u00e9 vy\u0159\u00edznut\u00ed) \u010di ho budeme jen sledovat. Digit\u00e1ln\u00ed dermatoskop toto d\u011bl\u00e1 automaticky pomoc\u00ed po\u010d\u00edta\u010dov\u00e9ho algoritmu. Plat\u00ed ale, \u017ee p\u0159esn\u011bj\u0161\u00ed v\u00a0diagnostice ko\u017en\u00edch tumor\u016f je zku\u0161en\u00fd dermatolog s\u00a0klasick\u00fdm dermatoskopem<\/strong>, ne\u017e nezku\u0161en\u00fd s\u00a0digit\u00e1ln\u00edm dermatoskopem. V\u00fdhodu digit\u00e1ln\u00edho dermatoskopu je pak schopnost snadn\u011bji uchovat fotku jednotliv\u00fdch l\u00e9z\u00ed a v\u00a0\u010dase porovnat jejich p\u0159\u00edpadn\u00e9 zm\u011bny. Existuje i digit\u00e1ln\u00ed dermatoskop kombinovan\u00fd s\u00a0celot\u011blov\u00fdm scanerem, kter\u00fd je schopen rozpoznat zm\u011bny znam\u00e9nek na t\u011ble v\u00a0pr\u016fb\u011bhu del\u0161\u00edch \u010dasov\u00fdch interval\u016f. To je vhodn\u00e9 u pacient\u016f s\u00a0v\u011bt\u0161\u00edm po\u010dtem znam\u00e9nek.<\/p>\n Poctiv\u00fd dermatolog<\/strong> se mimo jin\u00e9 pozn\u00e1 tak, \u017ee p\u0159i vy\u0161et\u0159en\u00ed znam\u00e9nek se pod\u00edv\u00e1 na cel\u00fd povrch t\u011bla, tedy i do vlas\u016f, \u017een\u00e1m na prsa, v\u0161em pak na plosky nohou a nehty. Zde v\u0161ude m\u016f\u017ee b\u00fdt ko\u017en\u00ed n\u00e1dor bez pov\u0161imnut\u00ed schov\u00e1n.<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“dd44a80f-e178-438e-ae1f-7d2385f28960″ global_colors_info=“{}“]<\/p>\n J\u00e1 osobn\u011b m\u00e1m mal\u00e9 znam\u00e9nko na tv\u00e1\u0159i (podobn\u011b jak m\u00e1 Cindy Crawford \ud83d\ude42), je lep\u0161\u00ed jej odstranit, kdy\u017e je velmi \u010dasto vystaven\u00e9 slune\u010dn\u00edmu z\u00e1\u0159en\u00ed?<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“c1471b09-4a99-4ba4-a621-4bad6a5e9619″ global_colors_info=“{}“]<\/p>\n Vojt\u011bch:<\/strong>\u00a0K\u00a0odstran\u011bn\u00ed znam\u00e9nka mus\u00ed b\u00fdt d\u016fvod. Pokud m\u00e1me podez\u0159en\u00ed na malign\u00ed proces \u010di je znam\u00e9nko mechanicky dr\u00e1\u017ed\u011bno<\/strong> je nutn\u00e9 znam\u00e9nko v\u00a0lok\u00e1ln\u00ed anestezii \u0161etrn\u011b vy\u0159ezat a nechat vy\u0161et\u0159it patologem. Pokud je d\u016fvod \u010dist\u011b estetick\u00fd, je tato problematika malinko jin\u00e1. Existuj\u00ed metody odstran\u011bn\u00ed nap\u0159\u00edklad laserem \u010di kauterem. Indikovat jej ale sm\u00ed pouze dermatolog a to opravdu zku\u0161en\u00fd. Zde bych cht\u011bl varovat p\u0159ed nekritick\u00fdm odstra\u0148ov\u00e1n\u00edm znam\u00e9nek lasery. V\u011bt\u0161inou je lep\u0161\u00ed \u0161etrn\u00e1 \u0161it\u00e1 excize p\u0159\u00edpadn\u011b snesen\u00ed projevu a jeho vy\u0161et\u0159en\u00ed patologem. P\u0159i odstran\u011bn\u00ed frak\u010dn\u00edm laserem se znam\u00e9nko vy\u0161et\u0159it v\u011bt\u0161inou ned\u00e1. Nav\u00edc, opakovan\u011b se setk\u00e1v\u00e1m s\u00a0p\u0159\u00edpady, kdy l\u00e9ka\u0159, kter\u00fd nen\u00ed dermatolog, odstran\u00ed laserem znam\u00e9nko, vezme si za to celkem dost pen\u011bz<\/strong>, a po p\u00e1r letech v\u00a0m\u00edst\u011b jizvi\u010dky za\u010dne op\u011bt r\u016fst ne\u00fapln\u011b odstran\u011bn\u00e9ho znam\u00e9nka. Takov\u00fdto projev ji\u017e nelze b\u011b\u017en\u00fdm vy\u0161et\u0159en\u00edm validn\u011b zhodnotit a vy\u0159ez\u00e1n\u00ed je zde pak nutnost\u00ed.<\/p>\n Obecn\u011b toti\u017e neplat\u00ed, \u017ee znam\u00e9nko, kter\u00e9 je na sluncem exponovan\u00e9 \u010d\u00e1sti poko\u017eky, je v\u00edce n\u00e1chyln\u00e9 ke vzniku melanomu. Tohle spolu nesouvis\u00ed. Odstran\u011bn\u00ed takov\u00e9to kosmetick\u00e9 nedokonalosti nahrad\u00edme v\u00edce \u010di m\u00e9n\u011b uspokojiv\u00fdm jin\u00fdm kosmetick\u00fdm defektem. Toto rozhodnut\u00ed je pak sp\u00ed\u0161 na pacientovi.\u00a0\u00a0\u00a0<\/p>\n [\/et_pb_text][et_pb_image src=“https:\/\/green-gate.eu\/wp-content\/uploads\/2024\/01\/melanom-maligni-melanom.jpg“ title_text=“melanom-maligni-melanom“ _builder_version=“4.23″ _module_preset=“32fecfd5-025d-42fc-9828-d86bb0da2821″ global_colors_info=“{}“][\/et_pb_image][et_pb_text _builder_version=“4.23″ _module_preset=“71bce9ad-9a5c-4bc0-a49d-5ef17a0a743b“ global_colors_info=“{}“]<\/p>\n Zdroj obr\u00e1zku: Vojt\u011bch Hanul\u00edk; Melanom, malign\u00ed melanom<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“dd44a80f-e178-438e-ae1f-7d2385f28960″ global_colors_info=“{}“]<\/p>\n Jsi p\u0159\u00edznivcem opalovac\u00edch kr\u00e9mu, nebo rad\u011bji doporu\u010duje\u0161 lehk\u00e9 bavln\u011bn\u00e9 oble\u010den\u00ed, klobouk atd.?<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“c1471b09-4a99-4ba4-a621-4bad6a5e9619″ global_colors_info=“{}“]<\/p>\n Vojt\u011bch:\u00a0<\/strong>Ur\u010dit\u011b ano. Pro lidi, kte\u0159\u00ed holduj\u00ed slun\u00ed\u010dku, je to ide\u00e1ln\u00ed varianta, jak p\u0159edej\u00edt bu\u010fto ko\u017en\u00edm n\u00e1dor\u016fm \u010di \u010dasn\u00e9mu n\u00e1stupu projev\u016fm st\u00e1rnut\u00ed k\u016f\u017ee. Kombinace s\u00a0k\u0161iltovkou nebo kloboukem je z\u00e1sadn\u00ed u mu\u017e\u016f, kte\u0159\u00ed ztratili vlasy na hlav\u011b<\/strong>.<\/p>\n Z\u00a0m\u00e9ho pohledu je asi jedno, kter\u00fd typ opalovac\u00edho kr\u00e9mu se pou\u017e\u00edv\u00e1. S\u00e1m za sebe ale doporu\u010duji vy\u0161\u0161\u00ed SPF a hlavn\u011b nesm\u00edme zapom\u00ednat p\u0159et\u00edrat opalovac\u00ed kr\u00e9m v\u00a0pravideln\u00fdch \u010dasov\u00fdch intervalech.<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“dd44a80f-e178-438e-ae1f-7d2385f28960″ global_colors_info=“{}“]<\/p>\n A jak vn\u00edm\u00e1\u0161 z pohledu poko\u017eky d\u011bti vs. slunce, d\u011bti vs. masti a kr\u00e9my?<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“c1471b09-4a99-4ba4-a621-4bad6a5e9619″ global_colors_info=“{}“]<\/p>\n Vojt\u011bch:<\/strong> A\u010d ani j\u00e1 ani m\u00e1 \u017eena netrp\u00edme atopick\u00fdm ekz\u00e9mem, na\u0161e dv\u011b d\u011bti v\u00a0m\u00edrn\u00e9 form\u011b ano. Zejm\u00e9na u mlad\u0161\u00ed dcery je poko\u017eka na podzim velice such\u00e1. Mastem a kr\u00e9m\u016fm se tedy u sv\u00fdch d\u011bt\u00ed ani u m\u00fdch d\u011btsk\u00fdch pacient\u016f nevyh\u00fdb\u00e1m. Vol\u00edm ale prioritn\u011b oby\u010dejn\u00e9 mas\u0165ov\u00e9 z\u00e1klady jako ambiderman, leniens nebo cutilan. Zejm\u00e9na p\u0159i prvn\u00edch paprsc\u00edch a na dovolen\u00e9 v\u00a0zahrani\u010d\u00ed se pak s\u00a0\u017eenou sna\u017e\u00edme d\u011bti chr\u00e1nit p\u0159ed sp\u00e1len\u00edm<\/strong> se na slunci. Jak jsem uvedl d\u0159\u00edve, je to jeden z\u00a0v\u00fdrazn\u00fdch rizikov\u00fdch faktor\u016f vzniku ko\u017en\u00edch tumor\u016f v\u00a0dosp\u011blosti a st\u00e1\u0159\u00ed.<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“dd44a80f-e178-438e-ae1f-7d2385f28960″ global_colors_info=“{}“]<\/p>\n A n\u011bjak mi to ned\u00e1\u2026 pro\u010d je spojen\u00ed k\u016f\u017ee a pohlavn\u00edch chorob jako obor dohromady?<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“c1471b09-4a99-4ba4-a621-4bad6a5e9619″ global_colors_info=“{}“]<\/p>\n Vojt\u011bch:<\/strong> Nad t\u00edm jsem taky kdysi p\u0159em\u00fd\u0161lel. D\u016fvodem z\u0159ejm\u011b je, \u017ee m\u00e1 historicky nejv\u00fdznamn\u011bj\u0161\u00ed pohlavn\u011b p\u0159enosn\u00e1 choroba – syfilis, charakteristick\u00e9 ko\u017en\u00ed projevy ve v\u0161ech st\u00e1di\u00edch onemocn\u011bn\u00ed. Na po\u010d\u00e1tc\u00edch modern\u00ed medic\u00edny tedy asi terapie syfilis ko\u017en\u00edmi l\u00e9ka\u0159i dala vzniku venerologii jako takov\u00e9. <\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“dd44a80f-e178-438e-ae1f-7d2385f28960″ global_colors_info=“{}“]<\/p>\n Jak vn\u00edm\u00e1\u0161 r\u016fzn\u00e9 p\u0159\u00edpravky na intimn\u00ed hygienu hlavn\u011b u \u017een, ale i u mu\u017e\u016f. Obecn\u011b gynekologov\u00e9 nedoporu\u010duj\u00ed se patlat kde \u010d\u00edm, ale reklamy \u0159\u00edkaj\u00ed n\u011bco jin\u00e9ho\u2026 T\u0159eba m\u011b kdysi \u0159ekl gynekolog, kdy\u017e jsem m\u011bla n\u011bjak\u00e9 probl\u00e9my, \u017ee se mus\u00edm um\u00fdvat m\u00e9n\u011b a hlavn\u011b bez n\u011bjak\u00e9ho p\u0159\u00edpravku, ono to pomohlo :). Zn\u00e1\u0161 n\u011bco takov\u00e9ho i ze sv\u00e9 praxe?<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“c1471b09-4a99-4ba4-a621-4bad6a5e9619″ global_colors_info=“{}“]<\/p>\n Vojt\u011bch:\u00a0<\/strong>Je to velice podobn\u00e9 tomu, co jsem uvedl v p\u0159\u00edpad\u011b p\u00e9\u010de o atopickou poko\u017eku. \u010clov\u011bk by ur\u010dit\u011b nem\u011bl j\u00edt c\u00edtit, ale p\u0159\u00edli\u0161n\u00e9 myt\u00ed m\u00fddly vede d\u0159\u00edve nebo pozd\u011bji k vy\u010derp\u00e1n\u00ed ochrann\u00e9 kapacity k\u016f\u017ee<\/strong> a dojde ke vzniku ko\u017en\u00edch obt\u00ed\u017e\u00ed. V oblasti genit\u00e1lu to \u010dasto b\u00fdvaj\u00ed kvasinkov\u00e9 infekce. Op\u011bt, velice \u010dasto za mnou chod\u00ed mlad\u00ed chlapci a p\u00e1nov\u00e9 s t\u00edm, \u017ee maj\u00ed za\u010dervenal\u00fd \u017ealud a sv\u011bdiv\u00e9 za\u010derven\u00e1n\u00ed v oblasti genit\u00e1lu. Du\u0161uj\u00ed se, \u017ee se poctiv\u011b n\u011bkolikr\u00e1t denn\u011b myj\u00ed, a to je \u010dasto ten z\u00e1sadn\u00ed probl\u00e9m. D\u00e1me zklid\u0148uj\u00edc\u00ed kr\u00e9m, \u0159ekneme si re\u017eimov\u00e1 opat\u0159en\u00ed a do n\u011bkolika dn\u00ed je v\u011bt\u0161inou po probl\u00e9mu. Podobn\u011b je to u d\u011bv\u010dat. K intimn\u00ed hygien\u011b sta\u010d\u00ed v\u011bt\u0161inou \u010dist\u00e1 voda, a v p\u0159\u00edpad\u011b pot\u0159eby volit p\u0159\u00edpravky ur\u010den\u00e9 k intimn\u00ed hygien\u011b, kter\u00e9 jsou \u0161etrn\u00e9 k ochrann\u00fdm vrstv\u00e1m k\u016f\u017ee. M\u00e9n\u011b je n\u011bkdy v\u00edce.<\/p>\n [\/et_pb_text][et_pb_text _builder_version=“4.23″ _module_preset=“dd44a80f-e178-438e-ae1f-7d2385f28960″ global_colors_info=“{}“]<\/p>\n Moc d\u011bkuji za tv\u016fj \u010das!<\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":" M\u00e9n\u011b je n\u011bkdy v\u00edce, i co se t\u00fdk\u00e1 p\u0159ehnan\u00e9 p\u00e9\u010de o poko\u017eku. Co je m\u00e1lo a co moc?<\/p>\n","protected":false},"author":1,"featured_media":17295,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[94],"tags":[],"ppma_author":[161],"yoast_head":"\n