{"id":53774,"date":"2026-01-14T16:15:40","year":"2026","link":"https:\/\/rigasveseliba.lv\/lv\/aktualitates\/adas-keratoze-kliniskas-formas-riski-un-terapijas-iespejas\/","type":"aktualitates","slug":"adas-keratoze-kliniskas-formas-riski-un-terapijas-iespejas","featured_image":"https:\/\/rigasveseliba.lv\/wp-content\/uploads\/2026\/01\/Keratoze.jpg","title":"\u0100das keratoze: kl\u012bnisk\u0101s formas, riski un terapijas iesp\u0113jas","content":"

Keratoze \u2013 \u013coti pla\u0161s termins, kas kopum\u0101 apz\u012bm\u0113 \u0101das biezuma palielin\u0101\u0161anos sakar\u0101 ar keratinoc\u012btu, proti, \u0101das virs\u0113j\u0101 sl\u0101\u0146a \u0161\u016bnu p\u0101rrago\u0161an\u0101s sp\u0113jas izmai\u0146\u0101m. Tas m\u0113dz b\u016bt c\u0113lonis \u0101das slim\u012bbu grupai, k\u0101 ar\u012b \u012bpatn\u0113jiem \u0101das st\u0101vok\u013ciem. Ir j\u0113ga izskat\u012bt visbie\u017e\u0101k sastopam\u0101s \u0101das izmai\u0146as k\u0101 piem\u0113rus keratozei.<\/span><\/p>\n

Akt\u012bnisk\u0101 keratoze <\/strong><\/span><\/h3>\n

Akt\u012bnisk\u0101 keratoze (AK) ir bie\u017ei sastopama \u0101das patolo\u0123ija, kas parasti izpau\u017eas\u00a0 ar multipliem vai solit\u0101riem, labi norobe\u017eotiem roz\u012bgi dzelten\u012bgi kr\u0101sotiem, raupjiem plankumiem uz saulei pak\u013caut\u0101s \u0101das virsmas. Visbie\u017e\u0101k AK per\u0113k\u013cus var atrast uz sejas cilv\u0113kiem gados.<\/span><\/p>\n

Izplat\u012bba ir izteikta un tie\u0161i saist\u012bta ar UV starojuma intensit\u0101ti. Zieme\u013cu valst\u012bs vismaz 1 AK per\u0113klis sastopams 11-25% cilv\u0113ku, bet re\u0123ionos, kas tuv\u0101k ekvatoram, 40-60% pieaugu\u0161o cilv\u0113ku.<\/span><\/p>\n

Pla\u0161\u0101ka izplat\u012bba ir cilv\u0113kiem ar gai\u0161u \u0101du, kas tiek pak\u013cauti augstam saules UV starojumam.<\/span><\/p>\n

V\u012brie\u0161iem \u0161\u012b \u0101das patalo\u0123ija nov\u0113rojama bie\u017e\u0101k, \u012bpa\u0161i \u00a0vecum\u0101 no 65 l\u012bdz 74 gadiem.<\/span><\/p>\n

Akt\u012bniskai keratozei oblig\u0101ti j\u0101piev\u0113r\u0161 uzman\u012bba paaugstin\u0101tas plakan\u0161\u016bnu karcinomas riska d\u0113\u013c: 6-10% gad\u012bjumos AK pacientiem att\u012bst\u0101s \u013caundab\u012bgs process. Palielin\u0101ta riska faktori invaz\u012bvai plakan\u0161\u016bnu karcinomai m\u0113dz b\u016bt atkar\u012bgi no AK lok\u0101cijas \u00a0(l\u016bpas, ausis, ekstremit\u0101tes), veidojuma raksturojuma (iz\u010d\u016blojusi, indur\u0113ta, sabiez\u0113ta, iekais\u012bga, asi\u0146ojo\u0161a virsma, boj\u0101juma dzi\u013cums), pigment\u0101cijas (\u0101tras izskata izmai\u0146as, multipli veidojumi, hronisk\u0101 saules UV starojuma boj\u0101juma \u0101das paz\u012bmes), pavado\u0161u slim\u012bbu esam\u012bbas \u00a0(leik\u0113mija, limfoma), medikamentu lieto\u0161ana (im\u016bnsupres\u0113jo\u0161a, k\u0101 ar\u012b provoc\u0113jo\u0161a saules hipersensitivit\u0101ti terapija).<\/span><\/p>\n

Riska faktori:<\/strong><\/span><\/p>\n

Im\u016bnsist\u0113mas pav\u0101jin\u0101ta darb\u012bba jeb im\u016bnsupresija, pak\u013caut\u012bba hroniskam UV starojumam, joniz\u0113jo\u0161am starojumam, cilv\u0113ka papilomas v\u012brusam, sm\u0113\u0137\u0113\u0161anas d\u016bmiem, hroniskas \u010d\u016blas, termiskie apdegumi, ar\u012b \u0123en\u0113tisk\u0101 predispon\u0113t\u012bba.<\/span><\/p>\n

Tipiskie AK boj\u0101jumi rodas no saules boj\u0101tas \u0101das, \u2013 visbie\u017e\u0101k uz sejas, kakla, dors\u0101l\u0101s virsmas plaukst\u0101m un apak\u0161delmiem.<\/span><\/p>\n

\"\"<\/p>\n

1. att\u0113ls. Akt\u012bnisk\u0101 keratoze (James WD et al: Andrews\u2019 diseases of the skin,\u00a0<\/em>ed 12, Philadelphia, 2016, Elsevier).<\/span><\/p>\n

Procesa s\u0101kums izskat\u0101s k\u0101 aps\u0101rtis plankums ar minim\u0101li paman\u0101m\u0101m zv\u012b\u0146\u0101m. Izteikti per\u0113k\u013ci ir raupji, zv\u012b\u0146ojo\u0161i. AK progres\u0113jot, zv\u012b\u0146as progres\u0113 sav\u0101 izteikt\u012bb\u0101, biezum\u0101, paliek dzelten\u0101 kr\u0101s\u0101, ar tausti per\u0113k\u013cus labi var at\u0161\u0137irt no veselas \u0101das \u2013 virsma ir raupja un smil\u0161pap\u012bram l\u012bdz\u012bga.<\/span><\/p>\n

AK procesu var klasific\u0113t vair\u0101k\u0101s kl\u012bnisk\u0101s form\u0101s:<\/span><\/p>\n

    \n
  • Hipertrofisk\u0101 AK forma: m\u0113dz provoc\u0113t \u0101das zv\u012b\u0146u sabiez\u0113jumu, prasa oblig\u0101tu izmekl\u0113\u0161anu, lai izsl\u0113gtu \u013caundab\u012bgo procesu pamatn\u0113.<\/span><\/li>\n
  • Liheno\u012bd\u0101 AK forma: bie\u017e\u0101k var atrast uz rumpja, aug\u0161\u0113j\u0101m ekstremit\u0101t\u0113m k\u0101 s\u0101rtus plankumus.<\/span><\/li>\n
  • Proliferat\u012bv\u0101 AK forma: per\u0113k\u013ci ar izm\u0113ra progresiju, oblig\u0101ti j\u0101izsl\u0113dz \u013caundab\u012bgas izmai\u0146as pamatn\u0113.<\/span><\/li>\n
  • Pigment\u0113ta AK forma: oblig\u0101ti j\u0101izv\u0113rt\u0113 un j\u0101at\u0161\u0137ir no \u013caundab\u012bga melanomas procesa, jo izskat\u0101s k\u0101 pigment\u0113ti plankumi uz \u0101das.<\/span><\/li>\n
  • Akt\u012bniskais heil\u012bts jeb l\u016bpu boj\u0101jums: tiek raksturots \u00a0k\u0101 aps\u0101rtums un pat eroz\u012bvs process ap l\u016bpas \u0101du.<\/span><\/li>\n<\/ul>\n

    Process oblig\u0101ti j\u0101at\u0161\u0137ir no melanomas, nemelanomas tipa onkolo\u0123ijas, seborejisk\u0101s keratozes, ekz\u0113mas, k\u0101rpas, reimatolo\u0123iskiem st\u0101vok\u013ciem, piem\u0113ram, sarkan\u0101s vilk\u0113des \u0101das formas.<\/span><\/p>\n

    Diagnozi prim\u0101ri nosaka kl\u012bniski jeb apskates laik\u0101 ar dermoskopijas metodi. Ret\u0101k ir nepiecie\u0161amas papildus izmekl\u0113\u0161anas metodes, piem\u0113ram, biopsija.<\/span><\/p>\n

    \u00a0<\/strong><\/span><\/p>\n

    K\u0101das \u0101rst\u0113\u0161anas iesp\u0113jas ir pieejamas?<\/strong><\/span><\/p>\n

      \n
    • Krioterapija ar \u0161\u0137idro sl\u0101pekli \u2013 veca, laba, uzticama metode, kas joproj\u0101m ir izv\u0113les metode izol\u0113tiem un pl\u0101niem AK per\u0113k\u013ciem.<\/span><\/li>\n
    • Fotodin\u0101misk\u0101 terapija<\/span><\/li>\n
    • CO2 l\u0101zeris<\/span><\/li>\n
    • Dermabr\u0101zija<\/span><\/li>\n
    • \u0136\u012bmiskais p\u012blings<\/span><\/li>\n
    • Kiret\u0101\u017ea<\/span><\/li>\n
    • Eksc\u012bzija<\/span><\/li>\n<\/ul>\n

      P\u0113d\u0113j\u0101 laik\u0101 arvien vair\u0101k pielieto meto\u017eu kombin\u0101ciju, piem\u0113ram, krioterapijas un lok\u0101l\u0101s terapijas apvienojumu.<\/span><\/p>\n

      Lok\u0101l\u0101s terapijas opcijas iek\u013cauj\u00a0 vair\u0101kus topik\u0101lus a\u0123entus \u2013 5 fluorurac\u012bla l\u012bdzek\u013cus, imikvimoda, diklofen\u0101ka l\u012bdzek\u013cus un citus.<\/span><\/p>\n

      AK ir svar\u012bgs un jut\u012bgs indikators UV hroniskai ietekmei, kas stipri nosaka varb\u016bt\u012bbu plakan\u0161\u016bnu karcinomas att\u012bst\u012bbai.<\/span><\/p>\n

      K\u0101 <\/strong>to <\/strong>var <\/strong>nov\u0113<\/strong>rst?<\/strong><\/span><\/p>\n

      Izvair\u012bties no akt\u012bv\u0101s saules stariem (stund\u0101s ar visaugst\u0101ko UV indeksu), lietot uz atkl\u0101t\u0101m viet\u0101m aizsargkr\u0113mus, veikt regul\u0101ru \u0101das pa\u0161kontroli (1 reizu m\u0113nes\u012b).<\/span><\/p>\n

       <\/p>\n

      Keratosis pilaris\u00a0<\/em>jeb\u00a0zos\u0101da<\/em><\/strong><\/span><\/h3>\n

      Keratosis\u00a0pilaris<\/em> jeb \u201czosu \u0101da\u201d ir bie\u017ei sastopams \u0101das st\u0101voklis, kad sausai \u0101dai kerat\u012bna akumul\u0101cija notiek pastiprin\u0101ti matu folikulu apvid\u016b.<\/span><\/p>\n

      Lat\u012b\u0146u valod\u0101 v\u0101rds \u201ckeratosis\u201d apz\u012bm\u0113 \u00a0\u201c\u0101das zv\u012b\u0146u\u201d, un \u201cpilaris\u201d apz\u012bm\u0113 \u00a0\u201cmatu\u201d. Keratosis pilaris<\/em> bie\u017ei s\u0101kas b\u0113rn\u012bb\u0101, ta\u010du ir \u00a0vair\u0101k paman\u0101ma \u00a0pusaud\u017eu gados. \u0160is st\u0101voklis nav kait\u012bgs un\u00a0 lip\u012bgs.<\/span><\/p>\n

      Tas skar 50\u201370% jaunie\u0161u un 40% pieaugu\u0161o. KP ir saist\u012bta ar t\u0101d\u0101m \u0101das slim\u012bb\u0101m k\u0101 atopiskais dermat\u012bts un ihtioze. To var sastapt uz sejas, aug\u0161delma, apak\u0161stilba, rumpja \u0101das.<\/span><\/p>\n

      Keratosis pilaris<\/em> att\u012bst\u0101s abnorm\u0101l\u0101s keratiniz\u0101cijas d\u0113\u013c matu folikula aug\u0161\u0113j\u0101 da\u013c\u0101. Kerat\u012bns aizpilda matu folikulu norm\u0101l\u0101 lob\u012b\u0161anas procesa viet\u0101.<\/span><\/p>\n

      KP ra\u0161an\u0101s c\u0113lonis joproj\u0101m piln\u012bb\u0101 nav noskaidrots, ta\u010du ir noteikta \u0123en\u0113tisk\u0101 predispon\u0113t\u012bba.<\/span><\/p>\n

      Keratosis pilaris<\/em> parasti vair\u0101k izteikts ziemas m\u0113ne\u0161os, kas dr\u012bz\u0101k saist\u012bts ar apkures sezonu un sauso gaisu iek\u0161telp\u0101s.<\/span><\/p>\n

      \"\" \"\"<\/p>\n

      2., 3. att\u0113ls. <\/span>Keratosis pilaris\u00a0<\/em>jeb\u00a0zos\u0101da<\/em><\/span><\/p>\n

      K\u0101das kop\u0161anas un \u0101rst\u0113\u0161anas iesp\u0113jas ir pieejamas?<\/strong><\/span><\/p>\n

      Skrub\u0113jo\u0161o a\u0123entu lieto\u0161ana m\u0101jas kop\u0161an\u0101, mitrino\u0161o l\u012bdzek\u013cu lieto\u0161ana ar ur\u012bnvielu vai sk\u0101b\u0113m (salicilsk\u0101be, piensk\u0101be, alfahidroksisk\u0101be). Ir iesp\u0113jama ar\u012b specifisk\u0101 terapija, ko veic \u0101rsts p\u0113c noteikta pl\u0101na (lok\u0101lie medikamenti, l\u0101zera proced\u016bras).<\/span><\/p>\n

      Keratosis pilaris<\/em> st\u0101vokli nevar piln\u012bb\u0101 iz\u0101rst\u0113t, bet tas labi padodas kop\u0161anai un, ja nepiecie\u0161ams, specifiskai terapijai \u0101rsta uzraudz\u012bb\u0101. KP var pa\u0161limit\u0113ties, proti, p\u0101riet pats no sevis vai laika gait\u0101 samazin\u0101ties. Lai izveidotu pareizu kop\u0161anas pl\u0101nu, ir j\u0101v\u0113r\u0161as pie dermatologa, \u012bpa\u0161i KP procesam izpau\u017eoties uz sejas, jo pats process, k\u0101 ar\u012b p\u0101r\u0101k agres\u012bva st\u0101vok\u013ca korekcija m\u0113dz norit\u0113t ar sare\u017e\u0123\u012bjumiem t\u0101diem k\u0101 sekudr\u0101r\u0101 infekcija, procesa hiperpigment\u0101cija, matu folukilu atrofija un r\u0113to\u0161anas process.<\/span><\/p>\n

       <\/p>\n

      Seborejisk\u0101 keratoze <\/strong><\/span><\/h3>\n

      Seborejisk\u0101 keratoze (SK) ir labdab\u012bgs epiderm\u0101ls tumors, kas sast\u0101v no keratinoc\u012btiem. Ra\u0161an\u0101s meh\u0101nismi l\u012bdz galam nav noskaidroti, bet nov\u0113rota saikne ar vecumu \u2013 visiem cilv\u0113kiem virs 65 gadiem SK ir atrodama vair\u0101k nek\u0101 90% gad\u012bjumu.<\/span><\/p>\n

      SK izskat\u0101s k\u0101 pie \u0101das piel\u012bm\u0113tas vaskotas vai zv\u012b\u0146ainas papulas, ar pla\u0161u kr\u0101sas grad\u0101ciju \u2013 no maigas, gai\u0161i dzeltenas l\u012bdz br\u016bnai un melnai.<\/span><\/p>\n

      Neskatoties uz SK labdab\u012bgo un vesel\u012bbai nekait\u012bgo dabu, ir v\u0113lama veidojumu verifik\u0101cija pie dermatologa, \u012bpa\u0161i gad\u012bjumos, kad SK izskat\u0101s cit\u0101d\u0101k nek\u0101 p\u0101r\u0113jie \u0101das veidojumi vai s\u0101k trauc\u0113t ar subjekt\u012bv\u0101m izj\u016bt\u0101m (s\u0101pes, nieze), vizu\u0101l\u0101m izmai\u0146\u0101m (palielin\u0101s izm\u0113r\u0101, lob\u0101s, asi\u0146o u.tml.) . \u012apa\u0161i nav v\u0113lama elementu destrukcija m\u0101jas apst\u0101k\u013cos, ja to nav apl\u016bkojis \u0101rsts . Diem\u017e\u0113l SK var sajaukt ar b\u012bstam\u0101m \u013caundab\u012bg\u0101m \u0101das izmai\u0146\u0101m, t\u0101p\u0113c ir gad\u012bjumi, kad\u00a0 ir nepiecie\u0161ama elementa histolo\u0123isk\u0101 izmekl\u0113\u0161ana.<\/span>
      \nSK var spont\u0101ni atrisin\u0101ties p\u0113c traumas vai iekaisuma. Ta\u010du bie\u017e\u0101k SK progres\u012bvi aug izm\u0113r\u0101, skaitliski palielin\u0101s\u00a0 ar vecumu. Da\u017eos avotos SK tiek sauktas par s\u0113n\u012bl\u0101m keratoz\u0113m \u2013 \u012bpatn\u0113js \u0101das vecuma r\u0101d\u012bt\u0101js. J\u0101atz\u012bst, ka b\u0113rniem SK nav sastopama, ta\u010du pirmie simptomi m\u0113dz par\u0101d\u012bties jau pusaud\u017eu vecum\u0101.<\/span><\/p>\n

      Liel\u0101koties diagnoze tiek noteikta apskates laik\u0101, ta\u010du v\u0113lama dermatoskopisk\u0101 verifik\u0101cija vismaz 1 reizi gad\u0101 k\u0101 visiem \u0101das veidojumiem, jo SK ir vair\u0101kas diferenci\u0101l\u0101s diagnozes, proti, kad veidojums uz \u0101das izskat\u0101s k\u0101 seborejisk\u0101 keratoze, bet diagnoze ir cita.<\/span><\/p>\n

      \"\"<\/p>\n

      4.att. Klasisk\u0101 izskata gai\u0161a seborejisk\u0101 keratoze<\/span><\/p>\n

      \"\"<\/p>\n

      5.att. \u00a0Vair\u0101ki SK elementi acu zon\u0101, kas m\u0113dz b\u016bt ekzofitozie jeb piepacelti virs \u0101das virsmas<\/span><\/p>\n

      \"\"<\/p>\n

      6.att. Tum\u0161i pigment\u0113ts SK rets paveids (melanoakantoma), kas atg\u0101dina melanomu, nepiecie\u0161ama elementa p\u0101rbaude (Joanna Burch Collection, Aurora, CO.)<\/span><\/p>\n

      \"\"<\/p>\n

      7.att. \u00a0Paciente ar dermatosis papulose nigricans <\/em>kl\u012bnisko seborejisk\u0101s keratozes variantu<\/span><\/p>\n

      Seborejisko keratozi var sajaukt (diferenci\u0101l\u0101s diagnozes) ar \u0101das dzimumz\u012bm\u0113m jeb n\u0113vusiem, pigmentplankumiem, k\u0101rp\u0101m, \u013caundab\u012bg\u0101m \u0101das izmai\u0146\u0101m, dermatofibromu. \u0145emot v\u0113r\u0101 izteiktu diferenci\u0101l\u0101s diagnostikas saraktu, ir ieteicams visus \u0101das veidojumus verific\u0113t pie dermatologa.<\/span><\/p>\n

      SK bie\u017ei ir atrodama uz sejas, muguras, kr\u016bt\u012bm. M\u0113dz b\u016bt visur, iz\u0146emot palm\u0101r\u0101s un plant\u0101r\u0101s virsmas.<\/span><\/p>\n

      SK dab\u012bgo \u0101das kroku apvid\u016b, piem\u0113ram, periokul\u0101ri uz kakla, padus\u0113s, cirk\u0161\u0146os bie\u017ei ir papilomatoz\u0101 veid\u0101, ko var viegli sajaukt ar \u0101das fibroepiteli\u0101liem polipiem vai \u0101das papilom\u0101m<\/span><\/p>\n

      Dermatosis papulosa nigra<\/em> (DPN), kas ir viena no SK kl\u012bniskaj\u0101m form\u0101m un izpau\u017eas k\u0101 nelieli tum\u0161i veidojumi ap ac\u012bm un vaigiem cilv\u0113kiem ar tum\u0161\u0101ku fototipu.<\/span><\/p>\n

      Visiem aizdom\u012bgiem elementiem, kas cilv\u0113ku satrauc (\u0101tri progres\u0113, main\u0101s, asi\u0146o, nedz\u012bst, nav l\u012bdz\u012bgi p\u0101r\u0113jiem \u0101das elementiem), ir nepiecie\u0161ama dermatoskopisk\u0101 un varb\u016bt pat histolo\u0123isk\u0101 verifik\u0101cija, ko noteiks tikai \u0101rsts.<\/span><\/p>\n

      Vairum\u0101\u00a0 gad\u012bjumu SK terapiju neprasa. Ja pacientam nepat\u012bk vizu\u0101lais izskats vai elements trauc\u0113, var tikt veikta elementa destrukcija. Ta\u010du ir j\u0101atg\u0101dina, ka jebkura veida destrukciju veic \u00a0tikai p\u0113c elementa verifik\u0101cijas pie \u0101rsta.<\/span><\/p>\n

      K\u0101das \u0101rst\u0113\u0161anas iesp\u0113jas ir pieejamas?<\/strong><\/span><\/p>\n