Cutis Laxa

Cutis Laxa wata lalura ce ta fata mai matuƙar wuya da ba kasafai ake samunta ba. Cutar tana faruwa ne sakamakon lalacewar sinadarin elastin da kuma wasu ƙwayoyin da ke cikin matrix na fata (connective tissue). Sinadarin elastin shi ne ke ba wa fata da sauran sassan jiki damar shimfiɗewa da dawowa daidai bayan an ja ko an matsa su. Idan wannan sinadari ya lalace ko kuma bai samar da isasshen ƙarfin da ake buƙata ba, fata tana rasa taushi da inganci, sai ta zama mai laushi, tana ɗaɗɗaurewa ko tana tattarewa, ko kuma ta riƙa saki fiye da yadda ya kamata.

Kalmar Cutis Laxa ta samo asali ne daga harshen Latin, inda Cutis ke nufin fata, Laxa kuma ke nufin saki ko laushi. Saboda haka, sunan yana nufin fata sakakkiya ko wadda ta yi laushi. Ana kuma kiran irin wannan cuta da wasu sunaye a fannin likitanci kamar generalized elastolysis, loose skin disorder, ko dermatochalasis. Duk waɗannan sunaye suna nuni ne da yanayin fata wadda ta rasa ƙarfinta ta zama mai lallausa ko tattararriya.

Dalilan kamuwa cutis laxa

Cutis Laxa na iya faruwa ta hanyoyi daban-daban. A wasu lokuta, ana gadon ta ne daga iyaye, wato tana da alaƙa da gado (hereditary), yayin da a wasu lokuta kuma tana iya faruwa ne bayan haihuwa ko kuma daga wasu abubuwan da suka shafi jiki, wato aukuwa bayan haihuwa (acquired).

• Nau’in gado (hereditary cutis laxa)

Wannan nau’i yana faruwa ne saboda matsaloli a cikin ƙwayoyin halitta (genes) da ke da alhakin samar da sinadarin elastin. Tana iya bayyana tun daga haihuwa ko daga ƙuruciya. Wasu daga cikin kwayoyin da ke da alaƙa da wannan matsala sun haɗa da ELN, FBLN5, da ATP6V0A2. Wannan nau’i cutis laxa ya rabu kamar haka:

• Autosomal dominant cutis laxa: Yakan bayyana idan ɗaya daga cikin iyaye ke ɗauke da ƙwayar halittar cutar.
• Autosomal recessive cutis laxa: Yakan bayyana idan iyaye biyu suna ɗauke da ƙwayar cutar, sannan yaro ya gajeta daga biyun.
• X-linked cutis laxa: Wannan nau’i yafi yawan bayyana ga maza saboda yana da alaƙa da ƙwayar halittar X.

• Nau’in da ke samuwa baya haihuwa (acquired cutis laxa)

Wannan nau’i yana iya bayyana bayan mutum ya kamu da wasu cututtuka, kamar cutar urticaria, erythema multiforme, ko wasu cututtuka masu kumburi. Haka nan ana iya samun ta bayan amfani da wasu magunguna ko kamuwa da cututtuka ko kuma dalilan da suka shafi tsarin garkuwar jiki. Ana danganta hakan da wasu cututtuka ko yanayi kamar:

• Lupus erythematosus: Cutar garkuwar jiki ce (autoimmune disease) wadda kariyar jiki ke kai hari ga sassan jiki kamar fata, huhu, da ƙoda.
• Sarcoidosis: Cuta ce da ke haifar da kumburin ƙwayoyin jiki (granulomas) a huhu, fata, da ƙoda, wanda ke iya jawo matsalar numfashi.
• Multiple myeloma: Wata nau’in sankarar ƙashi ce wadda ke tasowa daga ƙwayoyin plasma cells, tana rage ƙarfi wajen samar da jini da yaƙar ƙwayoyin cuta.

Wasu lokuta kuma, cutar na iya biyo bayan kumburi mai tsanani, amfani da magunguna masu ƙarfi, ko sinadarai masu guba.

Alamomin cutar cutis laxa

Babban abin da ke bambanta cutar cutis laxa da sauran cututtukan fata shi ne sakwarkwacewar fata wadda ke sa mutum ya yi kamar tsoho, ko da yana yaro. Wannan yanayi yana faruwa ne saboda lalacewar sinadarin elastin da ke cikin fata, wanda ke ba ta ƙarfi da inganci. Alamomin cutar suna iya bambanta daga mutum zuwa mutum, dangane nau’in da ya kamu da ita. Daga cikin alamonin akwai:

• Fata ta zama kamar ta tsofaffi

Fatar mutum tana saki sosai, tana tattarewa ko sakwarkwace musamman a fuska ko kirji ko ciki ko da hannaye. Idan aka ja fatar, tana iya miƙewa sosai amma ba ta komawa daidai da sauri kamar yadda fata ke yi a bisa al’ada. Wannan ita ce babbar alamar da ke bayyana cutar.

• Fuska ta zama kamar ta tsoho

Saboda sakwarkwacewar fata, fuska tana sauya siffa, inda kunci ke sauka, goshi ya yi laush. Wannan yana sa fuskar mutum ta yi kama da ta tsofaffi, koda kuwa yana yaro. Wannan sauyin fuska yana da tasiri sosai a zamantakewa, musamman ga yara ko matashi da ke fama da cutar.

• Matsalar numfashi

Idan cutar ta shafi huhu, mutum yana iya fuskantar matsalolin numfashi kamar emphysema, wato kumburin huhu wanda ke haddasa wahalar shakar iska da fitar da ita. Wannan yana faruwa ne saboda sinadaran elastin da ke taimakawa wajen shimfiɗa huhu sun lalace.

• Matsalar zuciya da jijiyoyin jini

A wasu lokutan cutis laxa tana iya shafar zuciya da jijiyoyin jini. Ana iya samun aortic aneurysm, (faɗaɗar jijiya a zuciya), valvular defects (raunin bawul ɗin zuciya), ko kuma matsalar bugun zuciya. Waɗannan matsaloli suna iya zama masu haɗari idan ba a gano su da wuri ba.

• Matsalolin narkewar abinci

Cutar tana iya tasiri ga hanji da sauran sassan da ke taimaka wa narkewar abinci. Mutum yana iya fuskantar ciwon ciki, rashin narkewar abinci da kyau (indigestion) ko hernia ko kuma kumburi. Wannan yana faruwa ne saboda raunin sinadaran fata da suka kamata su riƙe hanji da sauran sassan ciki.

• Raunin jiki da gajiya

Wasu marasa lafiya, musamman yara, sukan fuskanci raunin tsoka (muscle weakness), jinkirin girma, da gajiya mai tsanani. Wannan yana nuna cewa cutar ta wuce fata kaɗai ta shiga cikin tsarin connective tissues na jiki gabaɗaya.

Ƙarin wasu alamomin

A wasu nau’o’in cutis laxa, musamman na gado (autosomal recessive), ana iya samun:

• Raunin kwakwalwa ko jinkirin ci gaban tunani.
• Rashin iya tafiya da kyau saboda raunin tsoka.
• Kumburin idanu ko raunuka a fatar ido.
• Matsalar kunne saboda raunin fata a wurin.

Bambancin alamomi tsakanin yara da manya

• A jikin yara: Alamomin suna bayyana tun daga haihuwa. Fata takan yi laushi sosai, akan samu jinkirin girma, kuma wani lokaci ana samun raunin jijiyoyin jini da zuciya.
• A jikin manya: Alamomin suna iya bayyana a hankali bayan shekaru, musamman idan nau’in da aka samu daga baya ne (acquired form). Fata ce kawai ke taɓuwa a yawancin lokuta.

Waɗannan alamomi suna taimaka wa likitoci wajen gano cutar da bambanta ta da wasu cututtuka masu kama da ita kamar Ehlers Danlos Syndrome ko Progeria.

Illolin cutar cutis laxa

Cutar cutis laxa ba ta tsaya kan fata kaɗai ba, domin tana iya shafar wasu muhimman gaɓɓan jiki na ciki kamar huhu, zuciya, hanji, tsoka, da ƙwaƙwalwa. Wannan yana faruwa ne saboda lalacewar sinadarin elastin da sauran ƙwayoyin halitta (connective tissue) da ke cikin waɗannan gaɓɓai. Saboda haka cutar tana iya jawo matsaloli masu yawa da ke shafar lafiyar jiki gabaɗaya.

• Illoli ga huhu

Idan cutar ta shafi huhu, tana jawo raunin tantanin huhu wanda ke rage kuzarin huhu wajen buɗewa da dawowa daidai. Wannan yana haifar da cuta mai suna emphysema, wadda ke hana huhu yin aiki yadda ya kamata. Mutum yana fara fuskantar wahalar numfashi, musamman idan yana motsa jiki. Idan matsalar ta tsananta, tana iya kai mutum ga rasa isasshiyar iskar oxygen a jini, wanda hakan ke haifar da ƙarancin kuzari da raunin jiki gabaɗaya.

• Illoli ga zuciya da jijiyoyin jini

Cutis Laxa tana iya lalata sinadaran elastin da ke cikin jijiyoyin jini da zuciya. Wannan yana iya haifar da aortic aneurysm, wato faɗaɗar jijiyar da ke fita daga zuciya, wanda idan ta fashe tana iya haifar da mutuwa cikin gaggawa. Haka nan ana iya fuskantar aortic valve insufficiency, wato bawul ɗin zuciya ba ya rufewa yadda ya kamata, yana barin jini ya koma baya, wanda hakan ke jawo matsalar bugun zuciya. Mutum yana iya jin ƙarfi a ƙirji, bugun zuciya da sauri, ko zafin kirji lokacin motsa jiki.

• Illoli ga hanji da aikin narkewar abinci

A tsarin narkewar abinci, lalacewar tantanin connective tissue na iya jawo rauni. Wannan yana sa mutum ya fuskanci ciwon ciki da kumburi, rashin narkewar abinci da sosai, ko cutar hernia ko rashin daidaiton fitsari da bahaya saboda raunin tsoko. Matsalolin narkewar abinci suna iya jawo raguwar nauyi, ƙarancin kuzari, da ƙarancin abinci mai gina jiki.

• Illoli ga tunani da halin rayuwa

Sauyin kamannin fata, musamman a fuska, yana iya shafar tunani da ƙwarin gwiwar mutum sosai. Mutum yana iya jin kunya ko rashin yarda da kansa saboda fuskar da ta yi kama da ta tsofaffi. A wasu lokuta yara da ke fama da cutis laxa suna iya fuskantar tsangwama a makaranta, wanda ke sa su zama masu fushi, jin kunya, ko yin nesa daga jama’a. Haka nan, matsalolin da ke tattare da numfashi, gajiya, da ciwon ciki suna iya jawo damuwa da bakin ciki (depression).

• Illoli ga tsokoki da jijiyoyi

Cutar tana iya lalata jijiyoyin da ke riƙe tsokoki da ƙasusuwa. Hakan na sa jiki ya zama mai rauni, gwiwoyi sukan karkace ko mutum ya kasa tsayawa da kyau. A wasu lokuta ana samun matsalar tafiya da ciwon ƙashi saboda raunin tsoka. Mutum yana iya zama marar kuzari da ƙarfin jiki, musamman idan cutar ta shafi gaɓoɓin motsi da mahaɗar gwiwa.

• Illoli ga rayuwar lafiya gabaɗaya

Saboda rashin ƙarfi a fata da sassan ciki, marasa lafiya suna iya fama da rashin kuzari da gajiya kullum, jinkirin girma da ci gaban jiki musamman ga yara, rashin barci saboda wahalar numfashi da ciwon kai ko kumburin jiki a wasu lokuta. Waɗannan matsaloli suna rage ƙarfin jiki da lafiyar masu lalurar gabaɗaya.

Hanyoyin gano cutar cutis laxa

Gano cutar cutis laxa yana buƙatar cikakken bincike daga ƙwararrun likitoci, saboda alamominta suna iya kama da wasu cututtukan fata. A mafi yawan lokuta, gano cutar ya haɗa da nazarin jiki, gwaje-gwajen sinadarai da na gado, da kuma duba yadda cutar ta shafi wasu sassan jiki kamar huhu da zuciya. Ga yadda ake gano ta:

• Binciken jiki

Mataki na farko wajen gano cutar shi ne cikakken binciken jiki da likita zai yi. Likita zai duba laushi da siffar fata, musamman yadda take shimfiɗuwa ko ta zama ta yi laushi fiye da ƙima. Za a duba ko fata tana komawa daidai bayan an ja ta ko kuma tana ci gaba da zama sako-sako. Haka nan ana lura da wuraren da suka fi nuna wannan sauyi, kamar fuska, wuya, hannaye, da ciki. Idan fuskar ta yi kama da ta tsofaffi ko ta nuna rashin tauri, wannan yana iya zama alamar cutis laxa.

• Gwajin ƙwayoyin halittar gado (genetic test)

Domin tabbatar da cewa cutar ta samo asali daga matsalar gado, ana yin gwajin DNA ko genetic testing. Wannan gwaji yana taimaka wa likitoci wajen gano irin canjin ƙwayoyin halitta (mutations) da suka haddasa cutar, musamman a cikin ƙwayoyin ELN, FBLN5, ko ATP6V0A2. Gwajin ƙwayoyin halittar gado yana da matuƙar muhimmanci domin yana taimakawa wajen gano nau’in cutis laxa (domin akwai nau’o’i daban-daban), da kuma tantance yiwuwar yaɗuwar cutar daga iyaye zuwa yara. Haka nan, gwajin ƙwayoyin halittar gado na taimaka wa iyalai wajen shirin haihuwa da shawarwarin ƙwayoyin halitta (genetic counseling).

• Gwaje-gwajen huhu, zuciya da ƙoda

Saboda cutis laxa tana iya shafar gaɓɓan ciki, likitoci kan yi gwaje-gwaje don gano ko ta taɓa huhu, zuciya, ko ƙoda.

• A ɓangaren huhu, ana yin X-ray ko CT scan domin ganin ko akwai alamun emphysema ko sauran matsalolin numfashi.
• A ɓangaren zuciya, ana yin echocardiogram ko electrocardiogram (ECG) domin duba yadda zuciya ke bugawa, da kuma yanayin bawulolinta.
• A ƙoda kuma, ana yin gwaje-gwajen jini da fitsari don tabbatar da cewa aikin ƙoda yana tafiya yadda ya kamata, domin wasu lokuta cutis laxa tana iya lalata jijiyoyin ƙoda.

• Gwajin biopsy

Wannan gwaji na ɗaya daga cikin hanyoyin da ke tabbatar da cutis laxa kai tsaye. Ana gutsirar ƙaramin ɓangare na fata (biopsy) daga wurin da aka ga alamun cutar, sannan a duba shi a ƙarƙashin microscope.

A lokacin binciken, masana kimiyyar lafiya za su duba sinadarin elastin da collagen da ke cikin fata. Idan aka samu cewa sinadaran elastin sun lalace ko sun ragu sosai, wannan yana nuna tabbacin cewa mutum na fama da cutis laxa. Wannan gwaji yana taimaka wa likita wajen bambance cutar daga wasu cututtuka masu kama da ita, kamar ehlers-danlos syndrome.

Ƙarin gwaje-gwaje na ciki da tsoka

A wasu lokuta, idan alamomin cutar sun nuna cewa tana iya shafar wasu gaɓɓan jiki, ana yin ƙarin gwaje-gwaje kamar MRI ko ultrasound don duba yanayin hanji, ciki, da tsokoki. Wannan yana taimaka wa likitoci wajen kimanta yadda cutar ta bazu da kuma tsara irin kulawar da ya kamata a bayar.

Maganin cutar cutis laxa

A halin yanzu babu wani magani da zai iya warkar da cutis laxa gabaɗaya, saboda cutar tana da alaƙa da lalacewar ƙwayoyin halitta (genetic disorder) da kuma sinadarin elastin da ke cikin fata da jijiyoyi. Duk da haka, ana iya amfani da hanyoyi daban-daban domin rage tasirin cutar, inganta lafiyar marar lafiya, da hana ta ƙara tsananta. Kulawa mai kyau daga ƙwararrun likitoci na iya taimaka wa marar lafiya ya rayu cikin nutsuwa da ƙananan matsaloli. Wasu daga cikin hanyoyin rage cutar sun haɗa da:

• Tiyata

Ɗaya daga cikin manyan hanyoyin magance illolin cutis laxa shi ne tiyatar gyaran fata wadda ake kira plastic surgery ko cosmetic surgery. Ana yin wannan tiyata ne domin gyara sassan jikin da fatar ta yi laushi ko ta tattare, musamman a fuska, wuya, da kirji. Tiyata tana taimaka wa mutum wajen samun kyakkyawan kamanni, ta rage sakwarkwacewar fata, ta kuma ƙara ƙwarin gwiwa a zamantakewa. Amma sakamakon wannan tiyata ba ya warkar da cutar gabaɗaya, domin bayan wani lokaci fata na iya sake yin tattarewa saboda yanayin gado. Saboda haka, ana iya buƙatar sake tiyata bayan wasu shekaru idan fata ta sake lalacewa.

• Amfani da magunguna

Wasu marasa lafiya suna fuskantar kumburi, ciwo ko rauni a jiki saboda raunin fata da tsoka. Likitoci kan ba da magunguna kamar steroids ko anti-inflammatory drugs domin rage kumburi da sauƙaƙa zafi. Wannan yana taimaka wa jiki wajen rage damuwa da rashin jin daɗi. Sai dai, amfani da waɗannan magunguna na buƙatar kulawa sosai saboda yawan amfani da su ba tare da shawarar likita ba na iya jawo wasu matsaloli ga hanta, zuciya, ko ƙoda. Don haka, duk wani magani ya zama ƙarƙashin kulawar ƙwararren likita.

• Kulawa daga masana a fannoni daban-daban

• Likitocin fata (dermatologists) su ne ke lura da yanayin fata da kuma magance lalacewar ta.
• Likitocin zuciya (cardiologists) suna kula da matsalolin jijiyoyin jini da bugun zuciya.
• Likitocin huhu (pulmonologists) kuma suna sa ido kan yanayin numfashi da aikin huhu.
• Idan cutar ta taɓa hanji ko ƙoda, to likitocin ciki (gastroenterologists) da na ƙoda (nephrologists) sukan shigo cikin kulawa.
• A gefe guda, likitocin kwakwalwa da masu ba da shawara (psychologists) suna taimaka wa marasa lafiya wajen fuskantar canjin kamanni da ƙarancin ƙwarin gwiwa da cutar ke haifarwa.

Shawarwarin kula da kai

Baya ga magunguna da tiyata, akwai wasu shawarwari da ke taimakawa wajen rage tasirin cutar. Ana ba da shawara ga marasa lafiya su guji abubuwan da ke iya lalata fata kamar hasken rana mai zafi, shan taba, ko amfani da sinadarai masu tsanani a jiki.

Haka nan, shan ruwa da yawa, cin abinci mai ƙunshe da sinadaran protein, vitamin C, da collagen na taimaka wajen ƙarfafa fata da rage lalacewar ta. Motsa jiki mai sauƙi kuma yana ƙara jini a jiki da taimakawa wajen inganta lafiyar tsoka da fata.

Kasancewar cutis laxa tana da alaƙa da gado, ya kamata mutanen ke da tarihin cutar su nemi shawarari (genetic counseling) kafin haihuwa. Wannan yana taimaka wa ma’aurata su fahimci yiwuwar yaɗuwar cutar ga ‘ya’yansu, da kuma shirin samun kulawa ta musamman tun kafin haihuwa idan an gano alamar cutar a jikin jariri.

Manazarta

Mohamed, M., Kouwenberg, D., Gardeitchik, T., Kornak, U., Wevers, R. A., & Morava, E. (2011). Metabolic cutis laxa syndromes. Journal of Inherited Metabolic Disease, 34(4), 907–916.

Morava, E., Wopereis, S., Coucke, P., Gillessen-Kaesbach, G., Voit, T., Smeitink, J., & Grünewald, S. (2005). Defective protein glycosylation in patients with cutis laxa syndrome. European Journal of Human Genetics, 13(4), 414–421.

Urban, Z., & Davis, E. C. (2013). Cutis laxa: Intersection of elastic fiber biogenesis, TGFβ signaling, the secretory pathway and metabolism. Matrix Biology, 33, 16–22.

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