Домой Бородавки Самое опасное заболевание кожи стоп: бородавки

Самое опасное заболевание кожи стоп: бородавки

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Самое опасное заболевание кожи стоп: бородавки


Внешне подошвенные бородавки выглядят подчас даже безобиднее грибкового поражения. Основная проблема с их своевременным распознаванием заключается в том, что они обычно очень похожи на сухие мозоли. Такие же полупрозрачные, глубоко врастающие, с корнем в виде конуса…

Поэтому пока бородавка одна или их всего несколько, мы часто лечим их как сухие мозоли – ведь мы привыкли, что бородавка отличается от кожи темным цветом, покрыта волосками и достигает больших размеров. В действительности же это не вся правда о бородавках. Они могут иметь любой цвет (вплоть до зеленого или багрового), располагаться в любом месте (а не только на лице или спине) и иметь любой диаметр. Фактическое различие между родинками и бородавками не столь уж велико. И заключается оно в том, что с родинками мы рождаемся, а бородавки – это приобретенные разрастания. Но обратим внимание: многие родинки появляются у нас уже в течение жизни, на месте угрей и других точечных поражений кожи. А многие бородавки вырастают как на гладкой коже, так и на месте родинок.

Происхождение заболевания

Все это кажется запутанной историей, но реальность проста. Дело в том, что как родинки, так и бородавки естественны не всегда. Иногда они вызываются особым вирусом – вирусом папилломы человека. То есть мы можем родиться с пятнами на коже, унаследованными от родителей. Но можем и приобрести другие разрастания, заразившись вирусом папилломы. Как правило, момент заражения нам установить не удастся, ведь этот вирус вызывает только изменения в эпителиальных клетках кожи. От него не повышается температура, не наступает насморк, не появляются боли… Вирус папилломы «подкрадывается» к нам тихо, незаметно. И в организме взрослых людей в среднем одновременно уживаются один‑три разных штамма вируса.

Симптомы заболевания

Итак, при подошвенных бородавках мы замечаем неладное только после того, как число бородавок увеличивается с трех до пяти и более. Как правило, они располагаются колонией – скученно, на одном определенном участке стопы. Но могут и «рассредоточиться» по всей стопе – это зависит от штамма вируса и особенностей нашей собственной кожи стоп. Бородавки сами по себе не болят. Однако давление на них вызывает боль, как и от сухих мозолей.

Кроме того, от мозолей бородавки отличаются повышенной чувствительностью к трению. Ведь они возникают не для защиты мягких тканей от травм, а просто потому, что вирус папилломы «приписал» свою ДНК к ДНК клетки эпителия и заставил ее мутировать. Поэтому в зависимости от места расположения бородавок они часто подвергаются травмам при ходьбе, кровоточат, болят и мешают ходить вдвое интенсивнее мозолей. Попытки их удаления по типу мозолей лишь вызывают появление других новообразований неподалеку. А место, где располагалась прежняя бородавка, подолгу не хочет заживать, болит и чешется.

В чем опасность подошвенных бородавок?

Мы упомянули это нехорошее во всех отношениях слово в названии раздела и повторили его только что. Повторили потому, что у нас для этого есть все основания. Причиняющие нам столько неудобств папилломы, которые мы перепутали с мозолями, смертельно опасны. А попытки лечения их методами, предназначенными для удаления мозолей, могут привести к тому, что мы сами подпишем себе смертный приговор.

Суть вопроса предельно проста. Мы только что сказали, что рост бородавок вызывается вирусом, изменившим ДНК нормальной клетки кожи. Согласимся, что клетки новообразований такого типа очень мало напоминают нормальные, ведь нормальные клетки эпидермиса бывают черными только у представителей определенных рас. И то у них они черные, а не зеленые, лиловые, пурпурные.

Вирус папилломы вызывает мутацию собственных клеток кожи. Он – один из сильнейших мутагенов на Земле и стоит в этом отношении на одной ступеньке с ионизирующим излучением. А как нам известно, мутация клеток часто приводит к их злокачественному перерождению. И действительно, склонность родинок и бородавок превращаться при определенных условиях в рак обще– известна.

Бородавки являются доброкачественными новообразованиями. Однако нам очень важно понимать, что в основе каждой из них заложено несколько клеток мутировавших, аномальных, весьма склонных к злокачественному перерождению (малигнизации).

Вся бородавка вырастает именно из этих нескольких клеток, расположенных в ее основании. И их злокачественный рост, в принципе, может начаться в любой момент. Но может и не начаться никогда.

От чего зависит появление или, так сказать, непоявление опухоли на месте клеток, имеющих со злокачественными новообразованиями массу общего, никто не знает. Наука только выделила ряд факторов, способных запустить этот процесс и запускающих его чаще прочих. Но опять‑таки среди них нет ни одного, который запускал бы злокачественное деление всегда… Словом, онкология на поверку знает о заболевании, которое должна лечить, так мало, что нас должна удивлять не низкая результативность ее методов. Больше всего удивляет, что в одном случае на 10 тыс пациентов они и впрямь помогают: опухолевые клетки удается уничтожить полностью и ремиссия после лечения наступает устойчивая, более чем на 5 лет. Кажется, такие эпизоды застают врасплох даже самих онкологов. Потому что пациентов, добившихся устойчивой ремиссии на последних стадиях рака, они изучают и наблюдают потом самым внимательным образом, на протяжении всей жизни.

Таким образом, о раке кожи наука не знает почти ничего. Даже несмотря на то, что ей удалось установить возбудителя основы этого рака – доброкачественных папиллом и родинок. Не зря все онкологи мира рекомендуют: если мы замечаем, что одна из наших родинок или бородавок начинает расти, менять цвет или форму, болеть, чесаться, нам немедленно следует обратиться с таким кажущимся пустяком в больницу. Потому что иногда уже через несколько месяцев на месте «пустяка» образуется незаживающая, дурно пахнущая, стремительно растущая язва. А профильное обследование в онкологической клинике выдает еще и картину обширных метастазов по всему телу…

Лечение подошвенных бородавок

Если теперь мы понимаем, в чем состоит опасность этих невинных, хотя и мучительных новообразований, выясним, в чем заключается опасность их лечения. Возможно, нам известно, что бородавку следует удалять вместе с корнем. Но обычно мы думаем, что это делается, дабы она не выросла вновь. На самом же деле, она вряд ли вырастет на том же месте. Но там может вырасти кое‑что другое. Например, опухоль. Корень или основа бородавки – это и есть те самые клетки‑мутанты, которые могут начать делиться в любой момент. До поры до времени они ведут себя тихо, и весь их потенциал к делению выражается в постоянном обновлении тканей уродливого нароста. То есть именно клеткам рака в основе новообразования мы обязаны тем, что вся кожа обновляется, загорает и бледнеет, стареет – а родинка или бородавка остается на прежнем месте, не изменяясь вместе с кожей с течением времени.

Так вот, клетки, склонные делиться быстрее остальных, можно и пробудить от «спячки». Например, создав им необходимость обновлять тело нароста все чаще и интенсивнее. Что и происходит при каждом более или менее массированном повреждении тканей папилломы или родинки. Неважно, обожгли ли мы ее кислотой, солнечными лучами, или срезали, поцарапали, вовсе сорвали ее выступающую головку… Результат может быть одинаковым: клетки начнут делиться, чтобы восстановить структуру тканей нароста и не сумеют вовремя остановиться.

А следует из этого всего то, что мы, перепутав бородавки с мозолями и попытавшись их удалить, повели себя, мягко говоря, неосмотрительно. И можем быть безумно счастливы, что все они зажили без последствий. Вернее, что единственным последствием нашего самолечения стало увеличение количества бородавок. И если впредь мы увидим у себя на ноге «мозоль», которую натирает любая подошва и даже носок, нам непременно следует сообразить, что как раз с мозолями такого не бывает. Мозоли болят, но повредить их до крови и жжения невозможно – на то их даже высверливают сверлами, похожими на стоматологические.

Как такового лечения от вируса папилломы не существует. Есть лишь прививка от вируса генитальных бородавок, да и к той у самих же онкологов и, в особенности, инфекционистов имеется масса претензий. Но удалять особенно часто повреждаемые при ходьбе новообразования разрешено. Разрешено не потому, что онкологи мечтают рекомендовать столь рискованные меры, а потому, что из двух зол здесь приходится выбирать меньшее. Ведь на одной чаше весов у нас ситуация, когда мы травмируем небезопасный нарост каждый день, при ходьбе. А на второй – возможность травмировать его единожды, зато с условием полного удаления.

Поэтому подошвенные бородавки допустимо лечить. Но этого ни в коем случае не следует делать дома, с помощью средств, по определению неспособных проникнуть в глубинные слои кожи и удалить мнимую мозоль вместе со всеми клетками ножки! Никакие «бабушкины рецепты» здесь неприменимы – только лазер, криодеструкция (замораживание) и др.

Особый вид бородавки на ноге

И еще один маленький нюанс. Теперь мы знаем, что при всем внешнем сходстве подошвенные бородавки отличаются от сухих мозолей высокой склонностью к травмам. Однако может статься, что именно на стопах у нас появятся не только похожие на мозоли новообразования. Иногда они и впрямь похожи на бородавки (такие, как на лице), а иногда – на желтоватую бляшку с глянцевой поверхностью. Такие непонятные «детали рельефа» вполне могут сопровождать активное размножение подошвенных бородавок или образовываться самостоятельно. Считается, что они предпочитают лицо и вообще участки кожи, постоянно освещаемые солнцем. Однако сама онкология признает, что у людей с темным цветом кожи опухоли кожи, напротив, склонны избегать солнца и возникать как раз на ладонях, стопах, тыльных поверхностях рук, в паху…

Желтоватая или розовая, чуть вогнутой формы бляшка с гладкой, словно покрытой маслом или лаком поверхностью, называется базальноклеточной карциномой. А если мы видим, что рядом с обычными бородавками выросла еще одна (или не одна, а несколько похожих) разноцветная, крупная, неправильной формы, мы, скорее всего, наблюдаем у себя плоскоклеточную карциному. То, что они выросли на наших и без того пострадавших после «налета» вируса стопах, явление нечастое. Но, как и было сказано, у нас налицо располагающий фактор – инфекция сильным мутагеном.

Оба вида наростов другого типа требуют немедленного обращения к онкологу, хоть сколько раз они похожи на обычные бородавки на лице. Папиллома папилломе, как говорится, рознь. Оба упомянутых новообразования – это не угроза рака. Это – уже рак. Причем есть вероятность, что даже с метастазами. Если базально‑клеточная карцинома не слишком похожа на бородавку, то плоскоклеточная – очень. Просто она выглядит как крупная, безобразная, разноцветная бородавка или группа бородавочек поменьше.

Пытаться устранять нечто подобное своими силами или в салоне красоты – решение из серии «хуже не придумаешь».

Их можно удалить только в онкологической клинике, под присмотром врача. А затем придется еще пройти химио– и радиотерапию. К самим подошвенным бородавкам обе опухоли имеют отношение, но только косвенное. Речь идет об уже свершившемся факте злокачественного перерождения, и поступать с ним следует только соответственно серьезности случая.

ИСТОЧНИК : «Самое важное о болезнях ног. / Е. М. Савельева»: Вектор; Санкт‑Петербург; 2013

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