So wo honam ani yɛ wo yaw a ɛyɛ nwonwa wɔ wo honam ani? Ebetumi ayɛ Extramammary Paget Yare (EMPD)!

So woahu sɛ wo honam ani yɛ kɔkɔɔ, ɛyɛ nsensanee, na ɛtɔ mmere bi a ɛyɛ kurukuruwa, titiriw wɔ wo honam ani, wo asen, anaa wo honam ani fã a ɛwɔ wo honam ani? Ɛte sɛ nea enyin nkakrankakra, na ɛtɔ mmere bi a ɛyɛ yaw, ɛnte saa? Okay, enti ɛnnɛ yɛbɛka honam ani tebea soronko bi a ɛte saa ho asɛm. Nnuruyɛfo frɛ no Extramammary Paget’s Disease , anaa EMPD tiawa. Ɛho yɛ na kakra, nanso ɛho hia sɛ wohu.

Dɛn ne Extramammary Paget Yare (EMPD)?

Sɛ yɛbɛka no tiawa a, EMPD yɛ honam ani yare a ɛntaa nsi. Ɛtɔ mmere bi a, wobetumi de abata kokoram ahorow afoforo ho. Nanso ɛnyɛ bere nyinaa na ɛte saa. Ɛyɛ tebea a wo honam ani yɛ kɔkɔɔ, ɛyɛ mmerɛw, anaasɛ ɛyɛ kurukuruwa na ɛyɛ kɛse. Ɛtɔ mmere bi a, ebetumi akɔ so mfe pii a yare no afi ase akyi a wontumi nhu.

Wɔde Sir James Paget, afeha a ɛto so 19 Britania oduruyɛfo a ne ho akokwaw din too so "Paget Yare". Wɔde ne din no ato kokoram ahorow afoforo pii ho esiane mmoa a ɔde ama wɔ ɔyare ho adesua mu nti. Asɛmfua "extramammary" kyerɛ "nufu no akyi." Ɛnsɛ sɛ wɔde eyi toto Paget yare a ɛwɔ nufu mu no ho.

Wobu akontaa sɛ ebia nnipa a wɔwɔ Extramammary Paget Yare no mu 7% kosi 40% na wɔwɔ kokoram a ɛda adi . Nanso, sɛnea madi kan aka no, ɛnyɛ bere nyinaa na EMPD yɛ yare foforo ho sɛnkyerɛnne. Ayaresa a wodi ntɛm betumi aboa ma wo yare no ho sɛnkyerɛnne so atew na aboa ma woahu kokoram a ɛda adi no.

Dɛn ne EMPD ahorow titiriw?

EMPD ahorow titiriw abien na ɛwɔ hɔ:

1. Primary EMPD: Eyi yɛ honam ani yare a ɛba ara kwa. Efi ase wɔ honam ani a biribiara nni hɔ a ɛde ba.

2. EMPD a ɛto so abien: Kokoram bi a ɛda adi wɔ nipadua no mu baabi foforo na ɛde eyi ba.

Hena na ɛda adi kɛse sɛ obenya EMPD?

Obiara betumi anya EMPD, nanso ɛtaa ba akuw a edidi so yi mu:

• Nnipa a wɔadi fi mfe 50 kosi 80 .
• Ɛtaa ba mmea mu .
• Wobetumi ahu no nso wɔ Asia mmarima mu .
• Aborɔfo a wɔyɛ aborɔfo .

Nanso ɛho hia sɛ yɛkae sɛ eyi yɛ tebea a ɛntaa nsi koraa.

Dɛn nti na EMPD yi ba?

Dɛn na ɛde EMPD titiriw ba?

Sɛ yɛbɛka nokware a, nnuruyɛfo da so ara nnim nea ɛde EMPD titiriw ba ankasa. Wosusuw sɛ ebia ebefi ase wɔ nkwammoaa ahorow bi a ɛwɔ yɛn nipadua mu no mu. Nkwammoaa ahorow yi bi ne:

• Apocrine gland duct cells: Eyinom yɛ fifiri ntini na ɛbɛn nhwi ntini.
• Keratinocyte stem cells: Eyinom yɛ nkwammoaa a ɛboa ma wosiesie honam ani.
• Toker nkwammoaa: Eyinom yɛ nkwammoaa a wohu wɔ honam ani (`vulvar tissue`) a atwa nufusu ne ɔbea awotwaa mu abue ho ahyia.

Dɛn na ɛde EMPD a ɛto so abien ba?

Kokoram a ɛwɔ nipadua no mu mmeae afoforo na ɛde EMPD a ɛto so abien ba. Wɔkyerɛ sɛ kokoram a ɛwɔ akyi berɛmo mu na ɛde EMPD a ɛba no bɛyɛ nkyem abiɛsa mu biako ba. Nea ɛka ho no, kokoram ahorow afoforo wɔ hɔ a ebetumi de EMPD a ɛto so abien aba:

• Kokoram a ɛwɔ akyi berɛmo mu
• Kokoram a ɛwɔ akisikuru mu
• Awotwaa mu kokoram
• Kokoram a ɛwɔ awotwaa mu
• Prostate kokoram
• Awotwaa mu kokoram

Dɛn ne EMPD ho sɛnkyerɛnne ahorow?

EMPD ho sɛnkyerɛnne titiriw ne honam ani akisikuru a ɛte sɛ eczema . Nhwehwɛmu ada no adi sɛ wɔ EMPD ayarefo bɛyɛ 65% mu no, ɛba wɔ awotwaa no ho , na bɛyɛ 20% mu no, ɛba wɔ akyi berɛmo no ho .

Ebia wubehu mmeae bi wɔ wo honam ani a ɛwɔ saa su ahorow yi:

• Te sɛ akutu (`Crusty`) .
• Wɔadan no kɔkɔɔ (`Kɔkɔbɔ`) .
• Scaly a ɛyɛ mmerɛw

Nsonsonoe no trɛw nkakrankakra, na ebetumi ayɛ n’afã horow a ɛnyɛ pɛpɛɛpɛ. Bere a EMPD kɔ so no, akuru anaa ntini a emu dɔ betumi aba. Nsɛnkyerɛnne afoforo bi ne:

• Ɔhyew a ɛyɛ hyew
• Wora no yɛ kɔkɔɔ na ɛte nka sɛ ɛyɛ abufuw .
• Ɛyɛ akisikuru
• Ɛyɛ yaw anaasɛ ɛyɛ mmerɛw
• Wora a ɛho ahonhon (edema).

EMPD taa ba wɔ mmeae a wo fifiri ntini (titiriw apocrine honam ani ntini) wɔ. Wɔtaa hu no wɔ ɔbea no awotwaa no ano a ɛbue no ho. Ebetumi aba wɔ mmeae yi nso:

• Atwa akyi berɛmo (`Anus`) ho ahyia .
• Penis a ɛwɔ ɔbarima no akyi
• Perineum a ɛwɔ nipadua no mu
• Nkwammoaa a wɔfrɛ no Scrotum

Ɛntaa mma koraa sɛ wobetumi ahu EMPD nso wɔ nipadua no afã afoforo te sɛ:

• Yafunu mu
• Armpit
• Yafunu mu aduru
• Nsuo a ɛwɔ akyi
• Aso, aniwa, anim anaa ti nhwi
• Koko a ɛwɔ fam
• Kotodwe anaa asen

Ɛho hia sɛ yehu sɛ nnipa a wɔwɔ extramammary Paget yare no mu bɛyɛ 10% nhu sɛnkyerɛnne biara .

Ɔkwan bɛn so na wohu EMPD tebea yi?

Nea edi kan no, oduruyɛfo bi bebisa wo wo yare no ho sɛnkyerɛnne na wayɛ wo nipadua mu nhwehwɛmu. Sɛ wosusuw sɛ wowɔ EMPD a, wɔbɛyɛ:Wɔyɛ honam ani nipadua mu nhwehwɛmu. Nea ɛka biopsy ho ne sɛ wobegye wo honam ani fã ketewaa bi na wɔde afiri a wɔde hwɛ nneɛma nketenkete ahwɛ mu.

Sɛ ɔyare ho ɔbenfo de afiri a wɔde hwɛ nneɛma nketenkete rehwɛ a, ɔhwehwɛ nkwammoaa soronko, akɛse, a ɛnyɛ ne kwan so a wɔfrɛ no "Paget nkwammoaa." Wɔsan nso hu saa nkwammoaa yi denam sɛnea wɔyɛ wɔn ade wɔ nnuru ahorow ho (immunohistochemistry) a wɔhwɛ so.

Wobɛyɛ dɛn ahu sɛ wowɔ kokoram a ɛwɔ EMPD?

Sɛ wohu sɛ wowɔ EMPD wie a, wo duruyɛfo no bɛyɛ nhwehwɛmu afoforo pii de ahwɛ sɛ kokoram bi wɔ hɔ anaa. Ebia sɔhwɛ ahorow yi bi ne:

• Ultrasound scan (`Nnyigyei kɛse`) .
• Nufu mu nhwehwɛmu (mammogram) .
• Pap a wɔde hyɛ nipadua mu
• Colonoscopy anaa proctoscopy a wɔde hwɛ nipadua no mu
• CT scan a wɔde yɛ adwuma
• Cystoscopy (akisikuru mu nhwehwɛmu) .
• Prostate nhwehwɛmu
• Retrograde pyelogram (asaabo ne nsu a ɛkɔ nsu mu nhwehwɛmu) .
• Ultrasound anaa needle biopsy a wɔde yɛ ntini a ɛma mogya tu no
• Upper endoscopy (menewa, aduannuru, ne yafunu mu nhwehwɛmu) .

Dɛn ne ayaresa ahorow a wɔde sa EMPD?

Nnuruyɛfo taa de oprehyɛn sa Paget yare a ɛwɔ nufu akyi no.

• Mohs oprehyɛn: Wɔ saa oprehyɛn yi mu no, oprehyɛn no yi honam ani honam ani fã biara a ɛka no fi hɔ, na ɔkora honam ani a ɛte apɔw a atwa ho ahyia no so.
• Wide local excision: Wɔ saa adeyɛ yi mu no, oduruyɛfo no yi EMPD no fã no ka ntini bi a ɛte apɔw a atwa ho ahyia no ho. Afei wɔpam kuru no anoano.

Ɛtɔ mmere bi a, ɛsɛ sɛ nnuruyɛfo a wɔyɛ oprehyɛn yi honam ani ne ntini afoforo pii fi hɔ. Ebia ɛho behia sɛ nnipa binom a wɔwɔ EMPD a atwa awotwaa no ho ahyia no yi awotwaa no fã anaa ne nyinaa (`vulvectomy`).

Susuw eyi ho: Sɛ woantumi anyɛ oprehyɛn esiane akwahosan tebea foforo anaa akwahosan a enye nti a, wo duruyɛfo betumi akyerɛ wo ayaresa afoforo te sɛ:

• Nnuru a ɛko tia nyarewa
• Laser honam ani hwɛbea a ɛsan ba bio
• Ayaresa a ɛma hann (PDT) .
• Mframa a wɔde sa yare
• Nnuru a wɔde sa kokoram (nnuru a wɔde sa kokoram) .

Nea ɛho hia sen biara ne sɛ, sɛ kokoram bi wɔ hɔ a, ɛsɛ sɛ wɔsa no nso wɔ ɔkwan soronko so.

So ɔkwan bi wɔ hɔ a wɔbɛfa so atew asiane a ɛwɔ hɔ sɛ wobenya EMPD no so?

Nea ɛyɛ awerɛhow no, biribiara nni hɔ a yebetumi ayɛ de atew asiane a ɛwɔ hɔ sɛ yebenya EMPD no so.

Daakye bɛn na obi a ɔwɔ EMPD betumi ahwɛ kwan?

Sɛ wosa EMPD yare wie a, ɛho behia sɛ wo ne wo duruyɛfo kɔsra wo di akyi. Eyi begyina baabi a na EMPD no wɔ so. Ɛtaa ba sɛ EMPD san ba wɔ beae koro no ara a na wɔadi kan ayɛ no yare no anaa ne mpɔtam. Enti, ɛho hia paa sɛ wobɛkɔ so adi wo duruyɛfo akwankyerɛ akyi.

Extramammary Paget yare no ho yɛ na koraa a ɛtrɛw (ɛtrɛw) kɔ nipadua no afã afoforo. Nanso, ɛtɔ mmere bi a ebetumi atrɛw akɔ ntini a ɛma mogya tu anaa akwaa afoforo mu. Wo duruyɛfo betumi akyerɛkyerɛ nea ebetumi aba wɔ w’asɛm no mu yiye.

So EMPD betumi asan aba bere a asa awie no?

Yiw, EMPD yɛ tebea a ebetumi asan aba bio bere a wɔasa no yare na ne ho atɔ no mpo akyi, wɔ mfe pii akyi mpo. Ɛtɔ mmere bi a, ebetumi asan aba wɔ bɛboro mfe 15 akyi. Ɛno nti na nnuruyɛfo kamfo kyerɛ sɛ wɔnhwɛ wɔn so bere tenten na wɔnkɔhwɛ wɔn daa no.

Sɛ mewɔ EMPD a, mɛyɛ dɛn ahwɛ me ho?

Ade a eye sen biara a wubetumi ayɛ ne sɛ wobɛkɔ so akɔ wo duruyɛfo nkyɛn akɔhwɛ wo daa. Sɛ wo duruyɛfo hu sɛnkyerɛnne ahorow a ɛkyerɛ sɛ EMPD asan aba a, wobetumi afi ase sa yare no ntɛm ara.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wuhu EMPD ho sɛnkyerɛnne anaa sɛnkyerɛnne foforo biara a, kɔ oduruyɛfo nkyɛn ntɛm ara.

Ɛyɛ ade a ɛfata sɛ wobɛte ehu nka, w’ani awu, na w’abam abu bere a wuhu sɛ honam ani akisikuru anaa akisikuru bi ayɛ wo nipadua no fã bi a ɛyɛ mmerɛw te sɛ w’akyi akwaa no. Ɛtɔ mmere bi a wobetumi de saa tebea yi a wɔfrɛ no Extramammary Paget’s Disease (EMPD) afrafra honam ani yare afoforo, enti ebetumi agye bere kakra ansa na wɔahu yare no pɛpɛɛpɛ. Sɛ kokoram bi wɔ hɔ a, EMPD betumi ayɛ nea emu yɛ den kɛse mpo.

Nanso, asɛmpa no ne sɛ nnipa dodow no ara a wɔwɔ EMPD no tra ase sɛnea ɛsɛ, na ɛyɛ pɛ wɔ ayaresa akyi. Wɔtaa de oprehyɛn na ɛsa EMPD. Sɛ kokoram bi wɔ hɔ a, ɛho behia sɛ wɔsa ɛno nso. Esiane sɛ Extramammary Paget Yare no betumi asan aba bio nti, sɛ wosan kɔ wo duruyɛfo nkyɛn daa a, ebetumi aboa ma woahu ntɛm sɛ ɛsan ba a.

Nneɛma a ɛho hia paa sɛ wobɛkae (Take-Home Message) .

• EMPD yɛ honam ani yare a ɛntaa nsi a ebia ɛne kokoram wɔ abusuabɔ.
• Hwɛ yiye wɔ honam ani fã biara a ɛyɛ kɔkɔɔ, ɛyɛ mmerɛw, ɛyɛ kurukuruwa, anaa ɛkɔ soro, titiriw wɔ ɔbarima ne ɔbea nna, abasa, anaa akyi berɛmo ho. Ebia sɛnkyerɛnne ahorow no bi ne ɛyaw, ɔhyew, ne ɛyaw.
• Sɛ wuhu sɛnkyerɛnne bi te sɛ eyi a , nfɛre anaasɛ nsuro, na mmom kɔ oduruyɛfo nkyɛn ntɛm ara.
• Wɔde honam ani nipadua mu nhwehwɛmu na ehu sɛ EMPD.
• Oprehyɛn ne ayaresa a wɔtaa yɛ.
• Ɛho hia sɛ wɔtoa so yɛ aduruyɛ mu nhwehwɛmu, efisɛ EMPD betumi asan aba bio.
• Mma ɛnhaw wo, nnipa dodow no ara a wɔwɔ EMPD no tra ase yiye wɔ ayaresa akyi. Nea ɛho hia ne sɛ wobehu yare no ntɛm na wɔanya ayaresa a ɛfata.

Sɛ wowɔ nsɛmmisa foforo bi fa eyi ho a, wo ne wo duruyɛfo nkasa. Obetumi ama wo afotu a ɛfata wo.

` Extramammary Paget's Disease, EMPD, honam ani nyarewa, honam ani kokoram, Paget nkwammoaa, honam ani nsensanee, ɛyaw, vulva, perianal area, honam ani nyarewa, Mohs oprehyɛn