Ua ʻike anei ʻoe i kahi ʻāpana ʻulaʻula, unahi, i kekahi manawa ʻōpala ma kou ʻili, ʻoi aku hoʻi ma ka ʻūhā, nā armpits, a i ʻole ka wahi genital? Me he mea lā e ulu mālie ana ia, a i kekahi manawa he maneʻo, ʻeā? ʻAe, no laila i kēia lā e kamaʻilio mākou e pili ana i kahi maʻi ʻili kūikawā e like me ia. Ua kapa ʻia e nā kauka ʻo Extramammary Paget's Disease , a i ʻole EMPD no ka pōkole. He mea kakaikahi iki ia, akā he mea nui e makaʻala.
He aha ka maʻi ʻo Paget Extramammary (EMPD)?
I ka ʻōlelo maʻalahi, he maʻi ʻili kakaikahi ka EMPD. I kekahi manawa hiki ke pili pū me nā ʻano maʻi ʻē aʻe. Akā, ʻaʻole ia ka hihia mau. He maʻi ia e lilo ai kou ʻili i ʻulaʻula, unahi, a ʻōpala paha a ulu nui. I kekahi manawa hiki ke ʻike ʻole ʻia no nā makahiki ma hope o ka hoʻomaka ʻana o ka maʻi.
Ua kapa ʻia ʻo "Paget's Disease" ma hope o Sir James Paget, he kauka Pelekane akamai o ke kenekulia 19. Ua hoʻopili ʻia kona inoa i kekahi mau ʻano maʻi kanesa ʻē aʻe ma muli o kāna mau haʻawina i ke kahua o ka pathology. ʻO ke ʻano o ka huaʻōlelo "extramammary" ʻo ia hoʻi "ma waho o ka umauma." ʻAʻole pono e huikau kēia me ka maʻi o Paget o ka umauma.
Ua manaʻo ʻia aia ma waena o 7% a me 40% o ka poʻe me ka maʻi Extramammary Paget e loaʻa paha kahi maʻi kanesa . Eia naʻe, e like me kaʻu i ʻōlelo ai ma mua, ʻaʻole mau ka EMPD he hōʻailona o kahi maʻi ʻē aʻe. Hiki i ka mālama mua ke kōkua i ka hōʻemi ʻana i kāu mau hōʻailona a kōkua i ka ʻike ʻana i ke kanesa.
He aha nā ʻano nui o nā EMPD?
ʻElua ʻano nui o nā EMPD:
1. EMPD Mua: He ʻano ʻili kēia e kū koke mai ana. Hoʻomaka ia ma ka ʻili me ke kumu ʻole.
2. EMPD Lua: Hoʻokumu ʻia kēia e kahi maʻi kanesa ma kahi ʻē aʻe o ke kino.
ʻO wai ka mea i ʻoi aku ka paʻakikī e hoʻomohala i ka EMPD?
Hiki i kekahi ke hoʻomohala i ka EMPD, akā ʻoi aku ka maʻamau i nā hui aʻe:
- ʻO nā kānaka ma waena o 50 a me 80 mau makahiki.
- ʻO ka mea maʻamau i waena o nā wāhine .
- Hiki ke ʻike ʻia i waena o nā kāne ʻĀsia .
- Poʻe keʻokeʻo .
Akā, he mea nui e hoʻomanaʻo he mea laha ʻole kēia.
No ke aha e hana ʻia ai kēia EMPD?
He aha ke kumu o ka EMPD mua?
ʻO kaʻoiaʻiʻo, ʻaʻole maopopo loa i nā kauka ke kumu o ka EMPD mua. Manaʻo lākou e hoʻomaka paha ia i loko o kekahi mau ʻano o nā cell i loko o ko kākou kino. ʻO kēia mau ʻano cell:
- Nā pūnaewele duct apocrine gland: He mau kelepa hou kēia a aia ma kahi kokoke i nā follicle lauoho.
- Nā pūnaewele kumu Keratinocyte: ʻO kēia nā pūnaewele e kōkua i ka hoʻoponopono ʻana i ka ʻili.
- Nā pūnaewele Toker: ʻO kēia nā pūnaewele i loaʻa i loko o ka ʻili ('ʻiʻo vulvar') a puni ka nipple a me ka puka o ka vagina.
He aha ke kumu o ka EMPD lua?
ʻO ka lua o ka EMPD ke kumu o ke kanesa ma nā wahi ʻē aʻe o ke kino. Ua ʻōlelo ʻia ʻo ke kanesa rectal ke kumu o kahi hapakolu o nā hihia EMPD. Eia kekahi, aia kekahi mau ʻano kanesa ʻē aʻe e hiki ai ke hoʻoulu i ka lua o ka EMPD:
- Ka maʻi ʻaʻai anal
- Ka maʻi ʻōpū
- Ka maʻi ʻaʻai o ka ʻōpū
- Ka maʻi ʻōpū
- Ka maʻi ʻaʻai prostate
- Ka maʻi ʻōpū
He aha nā hōʻailona o ka EMPD?
ʻO ka hōʻailona nui o ka EMPD he ʻulaʻula ʻili e like me ka eczema . Ua hōʻike ʻia e ka noiʻi ma kahi o 65% o nā maʻi EMPD, kū ia a puni ka vulva , a ma kahi o 20%, kū ia a puni ka anus .
Hiki paha iā ʻoe ke ʻike i nā wahi ma kou ʻili me kēia mau ʻano:
- E like me ka ʻili (ʻO ka ʻili paʻa)
- Ua ʻulaʻula (`ʻUlaʻula`)
- Unahi
Hoʻonui mālie nā kiko, a loaʻa paha nā lihi ʻano ʻē. I ka holomua ʻana o ka EMPD, hiki ke ulu aʻe nā ʻeha hohonu a i ʻole nā nodules. ʻO nā hōʻailona ʻē aʻe:
- Manaʻo wela
- ʻUlaʻula ka ʻili a huhū hoʻi .
- ʻĀnai
- ʻEha a palupalu paha
- ʻIli pehu (edema)
ʻIke pinepine ʻia ka EMPD ma nā wahi i loaʻa ai kou mau kelepa hou (ʻoi aku hoʻi nā kelepa ʻili apocrine). ʻIke pinepine ʻia ia a puni ka puka o ka vagina. Hiki nō hoʻi ke hana ma kēia mau wahi:
- A puni ka anus (`Anus`)
- Penis
- ʻO ka Perineum
- ʻO ka ʻōpū
ʻAʻole pinepine loa, hiki ke ʻike ʻia ʻo EMPD ma nā wahi ʻē aʻe o ke kino, e like me:
- ʻōpū
- ʻĀʻī
- ʻŌpū
- nā puʻupuʻu
- Pepeiao, lihilihi maka, maka a i ʻole ke poʻo
- Umauma lalo
- Kuli a ʻūhā paha
He mea nui e ʻike he 10% o ka poʻe me ka maʻi ʻo Paget ma waho o ka maʻi maʻi ʻaʻole i ʻike i kekahi mau hōʻailona .
Pehea e ʻike ʻia ai kēia maʻi EMPD?
ʻO ka mea mua, e nīnau ke kauka iā ʻoe e pili ana i kāu mau hōʻailona a hana i kahi hoʻokolokolo kino. Inā manaʻo lākou he EMPD kou, e hana lākou:Hana ʻia kahi biopsy ʻili. Pili ka biopsy i ka lawe ʻana i kahi hāpana liʻiliʻi o kou ʻili a nānā iā ia ma lalo o kahi microscope.
Ke nānā ʻana ma lalo o kahi microscope, ʻimi ke kauka pathology i nā pūnaewele kūikawā, nui, a ʻano ʻē i kapa ʻia ʻo "nā pūnaewele Paget." Hoʻomaopopo pū lākou i kēia mau pūnaewele ma ka nānā ʻana i ke ʻano o kā lākou pane ʻana i nā kemika like ʻole (immunohistochemistry).
Pehea ʻoe e ʻike ai inā loaʻa iā ʻoe ka maʻi kanesa me EMPD?
Ma hope o kou ʻike ʻia ʻana me EMPD, e hana kāu kauka i kekahi mau hoʻokolohua ʻē aʻe e nānā ai i ka maʻi kanesa. Hiki i kēia mau hoʻokolohua ke komo pū me:
- ʻO ke kiʻi ʻana o ka ultrasound (`Ultrasound`)
- Ka nānā ʻana i ka umauma (mammogram)
- Pap smear
- ʻO Colonoscopy a i ʻole proctoscopy
- Nānā CT
- Cystoscopy (ka nānā ʻana i ka ʻōpū mimi)
- Hoʻokolohua prostate
- ʻO ka pyelogram retrograde (ka nānā ʻana i nā puʻupaʻa a me ke ala urinary)
- ʻO ka ultrasound a i ʻole ka biopsy nila o nā lymph nodes
- ʻO ka endoscopy luna (ka nānā ʻana i ka ʻāʻī, esophagus, a me ka ʻōpū)
He aha nā lāʻau lapaʻau no ka EMPD?
Hoʻomaʻamaʻa pinepine nā kauka i ka maʻi o Paget extramammary me ke ʻoki ʻana.
- ʻO ke ʻoki kino Mohs: Ma kēia kaʻina hana, wehe ke kauka ʻoki i ka papa ʻili i hoʻopilikia ʻia ma ka papa, e mālama ana i ka ʻili olakino a puni.
- ʻO ka ʻoki kūloko ākea: Ma kēia kaʻina hana, wehe ke kauka lapaʻau i ka ʻāpana o EMPD me kekahi mau ʻiʻo olakino a puni. A laila humuhumu ʻia nā kihi o ka ʻeha.
I kekahi manawa, pono nā kauka ʻoki e wehe i kahi ʻāpana nui o ka ʻili a me nā ʻiʻo ʻē aʻe. Pono paha kekahi poʻe me EMPD a puni ka vulva e wehe i kahi hapa a i ʻole ka vulva āpau (kahi `vulvectomy`).
E noʻonoʻo i kēia: Inā ʻaʻole hiki iā ʻoe ke hana i ke ʻoki kino ma muli o kekahi maʻi olakino ʻē aʻe a i ʻole ke olakino maikaʻi ʻole, hiki i kāu kauka ke kuhikuhi i nā lāʻau lapaʻau ʻē aʻe e like me:
- Hoʻōla lāʻau pale
- Hoʻoponopono hou ʻana i ka ʻili laser
- Hoʻōla Photodynamic (PDT)
- Hoʻōla radiation
- Nā lāʻau lapaʻau topical i hoʻohana ʻia e mālama i ka maʻi kanesa (nā lāʻau cytotoxic)
ʻO ka mea nui loa, inā he maʻi ʻaʻai kumu, pono e mālama ʻokoʻa ʻia.
Aia kekahi ala e hōʻemi ai i ka pilikia o ka hoʻomohala ʻana i ka EMPD?
ʻO ka mea pōʻino, ʻaʻohe mea hiki iā mākou ke hana e hōʻemi i ka pilikia o ka hoʻomohala ʻana i ka EMPD.
He aha ke ʻano o ka wā e hiki mai ana e hiki i kekahi me EMPD ke manaʻo?
Ma hope o ka mālama ʻana no EMPD, pono ʻoe e hele i kāu kauka e nānā hou. E pili ana kēia i kahi o ka EMPD. He mea maʻamau ka hoʻi hou ʻana o ka EMPD ma kahi like a puni paha kahi i mālama mua ʻia ai. No laila, he mea nui loa ka hoʻomau ʻana i ka hahai ʻana i nā ʻōlelo a kāu kauka.
He mea kākaʻikahi loa ka maʻi ʻo Paget ma waho o ka maʻi maʻi, kahi e laha ai (metastasizes) i nā ʻāpana ʻē aʻe o ke kino. Eia nō naʻe, hiki i kekahi manawa ke laha i nā lymph nodes a i ʻole nā ʻōpū ʻē aʻe. Hiki i kāu kauka ke wehewehe maikaʻi loa i ka mea hiki ke hana ʻia i kou hihia.
Hiki iā EMPD ke hoʻi mai ma hope o kona ho'ōla ʻia ʻana?
ʻAe, he kūlana ka EMPD e hiki ke hoʻi hou mai ma hope o ka mālama ʻana a me ka hoʻōla ʻana, ʻoiai ma hope o nā makahiki he nui. I kekahi manawa hiki ke hoʻi hou mai ma hope o nā makahiki he 15. ʻO ia ke kumu e paipai ai nā kauka i ka nānā lōʻihi a me nā nānā mau ʻana.
Inā loaʻa iaʻu ka EMPD, pehea wau e mālama ai iaʻu iho?
ʻO ka mea maikaʻi loa hiki iā ʻoe ke hana, ʻo ia ke hele mau i kāu kauka no nā manawa hoʻopaʻa maʻamau. Inā ʻike kāu kauka i nā hōʻailona o ka EMPD e hoʻi mai ana, hiki iā lākou ke hoʻomaka koke i ka mālama ʻana.
Āhea wau e ʻike ai i ke kauka?
Inā ʻike ʻoe i kekahi mau hōʻailona hou o EMPD, a inā paha e loaʻa iā ʻoe kekahi mau hōʻailona hou, e ʻike koke i ke kauka.
He mea maʻamau ka makaʻu, ka hilahila, a me ka hoʻonāukiuki ke ʻike ʻoe i kahi ʻulaʻula ʻili a i ʻole ka puʻupuʻu ma kahi ʻāpana koʻikoʻi o kou kino, e like me kou mau ʻōpū. ʻO kēia ʻano, i kapa ʻia ʻo Extramammary Paget's Disease (EMPD), hiki ke huikau ʻia me nā ʻano ʻili ʻē aʻe, no laila hiki ke lōʻihi ka manawa e loaʻa ai kahi hōʻailona pololei. Inā he maʻi kanesa ma lalo, hiki i ka EMPD ke ʻoi aku ka koʻikoʻi.
Eia nō naʻe, ʻo ka nūhou maikaʻi, ʻo ka hapa nui o ka poʻe me EMPD ke ola maʻamau a piha ma hope o ka mālama ʻana. Hoʻōla pinepine ʻia ʻo EMPD me ke ʻoki kino. Inā he maʻi kanesa ma lalo, pono nō hoʻi e mālama ʻia. ʻOiai hiki ke hoʻi hou mai ka maʻi Extramammary Paget, hiki i nā nānā mau ʻana me kāu kauka ke kōkua i ka ʻike ʻana iā ia i ka wā mua inā hoʻi mai.
Nā mea nui loa āu e hoʻomanaʻo ai (Leka Lawe-Home)
- He maʻi ʻili laha ʻole ka EMPD i pili paha i ka maʻi kanesa.
- E makaʻala i nā ʻāpana ʻili ʻulaʻula, unahi, ʻōpala, a i ʻole piʻi aʻe, ʻoiai a puni nā ʻōpū, nā ʻāʻī lima, a i ʻole ka anus. Hiki i nā hōʻailona ke komo pū me ka maneʻo, ka wela, a me ka ʻeha.
- Inā ʻike ʻoe i kahi hōʻailona e like me kēia , mai hilahila a makaʻu paha, akā e ʻike koke i ke kauka.
- Ua ʻike ʻia ka EMPD me ka biopsy ʻili.
- ʻO ke ʻoki kino ke ʻano lapaʻau maʻamau.
- He mea nui e hoʻomau i nā hoʻokolohua lapaʻau, no ka mea, hiki i ka EMPD ke hana hou.
- Mai hopohopo, ʻo ka hapa nui o ka poʻe me EMPD e ola maikaʻi ana ma hope o ka mālama ʻana. ʻO ke kī, ʻo ia ka ʻike koke ʻia a loaʻa ka lāʻau kūpono.
Inā he mau nīnau hou aku kāu e pili ana i kēia, e kamaʻilio me kāu kauka. Hiki iā ia ke hāʻawi iā ʻoe i ka ʻōlelo aʻoaʻo kūpono iā ʻoe.
ʻO ka maʻi ʻili o Paget ma waho o ka umauma, EMPD, nā maʻi ʻili, ka maʻi ʻili, nā pūnaewele Paget, nā kiko ʻili, ka maneʻo, ka vulva, ka ʻāpana perianal, nā maʻi ʻili, ke ʻoki kino Mohs
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