Osiiwa ng’olina ekifo ekyewuunyisa ku lususu lwo? Kiyinza okuba obulwadde bwa Extramammary Paget (EMPD)!

Wali olabye ku lususu lwo ekimyufu, ekikuta, oluusi nga kirimu ebikuta naddala mu kisambi, mu nnyindo oba mu bitundu by’ekyama? Kirabika kikula mpolampola, ate oluusi ne kisiiwa, nedda? Okay, kale leero tugenda kwogera ku mbeera y'olususu ey'enjawulo nga eyo. Abasawo bagiyita Extramammary Paget’s Disease , oba EMPD mu bufunze. Kiba kya bulijjo katono, naye kikulu okukimanya.

Obulwadde bwa Extramammary Paget (EMPD) kye ki?

Mu ngeri ennyangu, EMPD mbeera ya lususu etali ya bulijjo. Oluusi kiyinza okukwatagana n’ebika bya kookolo ebirala. Naye ekyo si bwe kiri bulijjo. Embeera olususu lwo mwe lumyufu, nga lufuuse ebikuta oba ebikuta ne lukula. Oluusi kiyinza okumala emyaka nga tekizuuliddwa ng’obulwadde butandise.

Kituumiddwa "Obulwadde bwa Paget" erinnya lya Sir James Paget, omusawo Omuzungu omugezi ennyo mu kyasa eky'ekkumi n'omwenda. Erinnya lye libadde likozesebwa ku bika bya kookolo ebirala ebiwerako olw’ebintu by’akola mu by’obulwadde. Ekigambo "extramammary" kitegeeza "ebweru w'amabeere." Kino tekirina kutabulwa na bulwadde bwa Paget obw’amabeere.

Kiteeberezebwa nti wakati w’ebitundu 7% ne 40% ku bantu abalina obulwadde bwa Extramammary Paget’s Disease bayinza okuba ne kookolo omuzira . Wabula nga bwe nnagambye emabegako, EMPD si bulijjo kabonero ka bulwadde bulala. Obujjanjabi nga bukyali busobola okukuyamba okukendeeza ku bubonero bwo n’okuyamba okuzuula kookolo akuli mu mbeera.

Bika ki ebikulu ebya EMPDs?

Waliwo ebika bya EMPD bibiri ebikulu:

1. Primary EMPD: Eno mbeera ya lususu ebaawo mu ngeri eyeetongodde. Butandikira ku lususu awatali nsonga ndala yonna.

2. Secondary EMPD: Kino kiva ku kookolo ali wansi awalala mu mubiri.

Ani asinga okulwala EMPD?

Omuntu yenna asobola okufuna EMPD, naye esinga kubeera mu bibinja bino wammanga:

• Abantu abali wakati w'emyaka 50 ne 80 .
• Ya bulijjo mu bakyala .
• Era kiyinza okulabibwa mu basajja b'omu Asia .
• Abantu abazungu .

Naye kikulu okujjukira nti eno mbeera ya bbula nnyo.

Lwaki EMPD eno ebaawo?

Kiki ekivaako EMPD eyasooka?

Mu butuufu, abasawo n’okutuusa kati tebamanyi bulungi kiki ekivaako EMPD eyasooka. Bateebereza nti kiyinza okutandikira mu bika by’obutoffaali ebimu mu mibiri gyaffe. Ebika by’obutoffaali bino mulimu:

• Obutoffaali bw’endwadde z’omubiri (apocrine gland duct cells): Zino ntuuyo era zisangibwa okumpi n’enkwaso z’enviiri.
• Keratinocyte stem cells: Buno butoffaali obuyamba okuddaabiriza olususu.
• Obutoffaali bwa Toker: Buno butoffaali obusangibwa mu lususu (`vulvar tissue`) okwetooloola enfuli n’ekisenge ky’obukyala.

Kiki ekivaako EMPD ey’okubiri?

Secondary EMPD ereetebwa kookolo awalala wonna mu mubiri. Kigambibwa nti kookolo w’omumwa gwa nnabaana y’avaako abantu nga kimu kya kusatu ku balwadde ba EMPD. Okugatta ku ekyo, waliwo ebika bya kookolo ebirala ebiyinza okuleeta EMPD ey’okubiri:

• Kookolo w’omumwa gwa nnabaana
• Kookolo w’ekibumba
• Kookolo w’omumwa gwa nnabaana
• Kookolo w’enkwaso
• Kookolo w’enseke
• Kookolo wa nnabaana

Bubonero ki obulaga EMPD?

Akabonero akakulu aka EMPD kwe kuzimba olususu nga kulinga eczema . Okunoonyereza kulaga nti mu balwadde nga 65% ku balwadde ba EMPD, kibeerawo okwetooloola enseke , ate mu bitundu nga 20%, kibeerawo okwetooloola enseke .

Oyinza okulaba ebitundu ku lususu lwo ebirina engeri zino:

• Nga ekikuta (`Crusty`) .
• Yafuuka emmyufu (`Emmyuufu`) .
• Ensigo

Ebitundu bigenda bikula mpolampola, era biyinza okuba n’empenda ezitali za bulijjo. EMPD bw’egenda egenda mu maaso, amabwa amawanvu oba ebizimba biyinza okuvaamu. Obubonero obulala kuliko:

• Okwokya
• Olususu lumyufu era owulira nga lunyiize .
• Okusiiwa
• Okuluma oba okunyirira
• Olususu oluzimba (edema).

EMPD esinga kubeera mu bitundu awali endwadde zo ez’entuuyo (naddala endwadde z’olususu eziyitibwa apocrine skin glands). Kisinga kulabibwa okwetoloola ekifo ekigguka obukyala. Era kiyinza okubaawo mu bitundu bino:

• Okwetoloola enseke (`Anus`) .
• Obusajja
• Ekitundu ky’omubiri ekiyitibwa Perineum
• Ensigo z’omu lubuto

Tekitera nnyo, EMPD era esobola okulabibwa mu bitundu by’omubiri ebirala, gamba nga:

• Olubuto
• Enkwaso
• Olubuto lw’omu lubuto
• Ensigo
• Okutu, ekibikka, ffeesi oba olususu lw’oku mutwe
• Ekifuba ekya wansi
• Okugulu oba ekisambi

Kikulu okumanya nti abantu nga 10% abalina obulwadde bwa Paget obw’ebweru w’amabeere tebafuna bubonero bwonna .

Embeera eno eya EMPD ezuulibwa etya?

Okusooka omusawo ajja kukubuuza ku bubonero bwo era akukebere omubiri. Singa bateebereza nti olina EMPD, bajja:Okukebera olususu kukolebwa. Okukebera olususu lwo kizingiramu okuggya akatundu akatono ku lususu lwo n’olukebera ng’okozesa microscope.

Omusawo w'endwadde bw'atunuulira wansi wa microscope, anoonya obutoffaali obw'enjawulo, obunene, obutali bwa bulijjo obuyitibwa "Paget cells." Era bazuula obutoffaali buno nga batunuulira engeri gye bukwatamu eddagala ery’enjawulo (immunohistochemistry).

Omanya otya oba olina kookolo ne EMPD?

Oluvannyuma lw’okuzuulibwa nti olina EMPD, omusawo wo ajja kukola ebigezo ebirala ebiwerako okukebera kookolo alina obulwadde buno. Ebigezo bino biyinza okuli:

• Sikaani ya Ultrasound (`Eddoboozi ery'amaanyi`) .
• Okukebera amabeere (mammogram) .
• Okusiiga eddagala lya Pap smear
• Okukebera colonoscopy oba okukebera proctoscopy
• Okukebera CT
• Cystoscopy (okukebera ekibumba) .
• Okukebera enseke
• Retrograde pyelogram (okukebera ensigo n’omusulo) .
• Ultrasound oba needle biopsy ku nnywanto z’omusaayi
• Upper endoscopy (okukebera emimiro, omumwa gwa nnabaana n’olubuto) .

Bujjanjabi ki obuweebwa EMPD?

Abasawo batera okujjanjaba obulwadde bwa Paget obw’ebweru w’amabeere nga balongoosebwa.

• Mohs surgery: Mu nkola eno, omusawo alongoosa aggyawo olususu olukoseddwa layeri ku layeri, n’akuuma olususu olulamu olubeetoolodde.
• Wide local excision: Mu nkola eno, omusawo alongoosa aggyawo ekitundu kya EMPD wamu n’ebitundu ebimu ebiramu ebikyetoolodde. Olwo empenda z’ekiwundu ne zitungibwa.

Oluusi abasawo abalongoosa balina okuggyawo ekitundu ekinene eky’olususu n’ebitundu ebirala. Abantu abamu abalina EMPD okwetoloola ekibumba bayinza okwetaaga okuggyibwako ekitundu oba kyonna eky’obukyala (a `vulvectomy`).

Lowooza ku kino: Bw’oba ​​tosobola kulongoosebwa olw’embeera endala ey’obulamu oba obulamu obubi, omusawo ayinza okukuwa amagezi ku bujjanjabi obulala nga:

• Obujjanjabi bw’abaserikale b’omubiri
• Okuddamu okukola olususu lwa layisi
• Obujjanjabi bw’ekitangaala (PDT) .
• Obujjanjabi bw’amasannyalaze (radiation therapy).
• Eddagala eriweebwa ku mubiri erikozesebwa okujjanjaba kookolo (cytotoxic drugs) .

Ekisinga obukulu nti singa wabaawo kookolo alina obulwadde buno, naye alina okujjanjabibwa okwawukana.

Waliwo engeri y’okukendeeza ku bulabe bw’okulwala EMPD?

Ebyembi, tewali kye tuyinza kukola okukendeeza ku bulabe bw’okufuna EMPD.

Ebiseera eby’omu maaso eby’engeri ki omuntu alina EMPD by’ayinza okusuubira?

Oluvannyuma lw’okujjanjabibwa EMPD, ojja kwetaaga okukyalira omusawo wo okugoberera. Kino kijja kusinziira ku EMPD gye yali. Kitera okubaawo EMPD okuddamu mu kitundu kye kimu oba okwetoloola ekitundu kye kimu we yajjanjabirwa emabegako. N’olwekyo, kikulu nnyo okugenda mu maaso n’okugoberera ebiragiro by’omusawo.

Obulwadde bwa Paget obw’ebweru w’amabeere tebutera kubaawo nnyo nga busaasaana (busaasaana) mu bitundu by’omubiri ebirala. Kyokka oluusi kiyinza okusaasaana mu nnywanto oba ebitundu ebirala. Omusawo wo asobola bulungi okunnyonnyola ekisoboka mu mbeera yo.

EMPD esobola okudda nga emaze okuwona?

Yee, EMPD mbeera esobola okuddamu ne bwe yamala okujjanjabwa n’okuwona, ne bwe wabaawo emyaka mingi. Oluusi kiyinza okuddamu oluvannyuma lw’emyaka egisukka mu 15. Eno y’ensonga lwaki abasawo bawa amagezi okulondoola okumala ebbanga eddene n’okukeberebwa buli kiseera.

Bwemba nnina EMPD, nneerabirira ntya?

Ekisinga obulungi ky’oyinza okukola kwe kusigala ng’ogenda ew’omusawo wo okugenda okugoberera buli kiseera. Singa omusawo alaba obubonero obulaga nti EMPD ekomawo, asobola okutandika obujjanjabi amangu ago.

Ddi lwe nnina okulaba omusawo?

Bw’olaba obubonero obupya obwa EMPD, oba bw’ofuna obubonero obupya, laba omusawo mu bwangu.

Kya bulijjo okuwulira ng’otya, ng’oswadde n’okunyiiga ng’olaba olususu olusiiyibwa oba ekizimba mu kitundu ekizibu eky’omubiri gwo, gamba ng’ebitundu byo eby’ekyama. Embeera eno eyitibwa Extramammary Paget’s Disease (EMPD), oluusi esobola okutabulwa n’embeera endala ez’olususu, n’olwekyo kiyinza okutwala akaseera okuzuula ekituufu. Singa wabaawo kookolo asirikidde, EMPD eyinza okuba ey’amaanyi ennyo.

Wabula amawulire amalungi gali nti abantu abasinga obungi abalina EMPD babeera mu bulamu obwa bulijjo, obujjuvu oluvannyuma lw’okujjanjabibwa. EMPD etera okujjanjabibwa nga balongoosebwa. Bwe wabaawo kookolo alina obulwadde buno, oyo nakyo kijja kwetaagisa okujjanjabibwa. Okuva obulwadde bwa Extramammary Paget bwe busobola okuddamu, okwekebejjebwa buli kiseera n’omusawo kiyinza okukuyamba okubuzuula amangu singa bukomawo.

Ebintu ebikulu by’olina okujjukira (Take-Home Message)

• EMPD mbeera ya lususu etali ya bulijjo eyinza okuba nga yeekuusa ku kookolo.
• Faayo ku bitundu byonna eby’olususu ebimyufu, ebizimba, ebikuta oba ebigulumivu naddala okwetooloola ebitundu by’ekyama, enkwaso oba enseke. Obubonero buyinza okuli okusiiwa, okwokya n’okulumwa.
• Bw’olaba akabonero nga kano , tokwatibwa nsonyi wadde okutya, wabula laba omusawo mu bwangu.
• EMPD ezuulibwa nga bakeberebwa olususu.
• Okulongoosa bwe bujjanjabi obusinga okukozesebwa.
• Kikulu okugenda mu maaso n’okukeberebwa abasawo, kubanga EMPD esobola okuddamu.
• Tofaayo, abantu abasinga abalina EMPD babeera bulungi oluvannyuma lw’okujjanjabwa. Ekikulu kwe kuzuulibwa nga bukyali n’okufuna obujjanjabi obutuufu.

Bw’oba ​​olina ekibuuzo ekirala kyonna ku nsonga eno, yogerako n’omusawo wo. Asobola okukuwa amagezi agakusaanira.

` Obulwadde bwa Paget obw’ebweru w’amabeere, EMPD, endwadde z’olususu, kookolo w’olususu, obutoffaali bwa Paget, amabala g’olususu, okusiiwa, enseke, ekitundu ky’omu lubuto, endwadde z’olususu, okulongoosebwa kwa Mohs