Kua kite koe i tētahi wāhi whero, unahi, he kiripaka i ētahi wā i runga i tō kiri, inā koa i te paparinga, i ngā kēkē, i te wāhi ira tangata rānei? Te āhua nei ka tipu haere, ā, i ētahi wā ka mākūkū, tika? Āe, i tēnei rā ka kōrero tātou mō tētahi mate kiri motuhake pērā. Ka tapaina e ngā tākuta ko te Mate Paget Extramammary , ko te EMPD rānei hei whakarapopototanga. He ahua onge, engari he mea nui kia mōhio koe.
He aha te Mate a Paget i waho o te Maama (EMPD)?
He māmā noa iho, he mate kiri onge te EMPD. I ētahi wā ka hono atu ki ētahi atu momo mate pukupuku. Engari ehara i te mea koinei tonu te āhua. He mate ka whero, ka unahi, ka kirikiri rānei tō kiri, ā, ka nui haere. I ētahi wā, kāore e kitea mō ngā tau i muri i te tīmatanga o te mate.
Ko te ingoa o tēnei mate ko "Paget's Disease" i muri i a Tā James Paget, he rata rongonui nō Peretānia i te rautau 19. Kua whakamahia tōna ingoa ki ētahi atu momo mate pukupuku nā āna takoha ki te mara o te pathology. Ko te tikanga o te kupu "extramammary" ko "waho i te ū." Kaua tēnei e whakapoauautia ki te mate a Paget o te ū.
E ai ki te whakatau tata, kei waenganui i te 7% me te 40% o te hunga whai mate pukupuku Extramammary Paget te mate pukupuku kei a rātou . Heoi, e ai ki taku kōrero i mua ake nei, ehara te EMPD i te tohu o tētahi atu mate. Mā te maimoatanga wawe ka āwhina i te whakaiti i ō tohu me te ārai i te mate pukupuku kei roto.
He aha ngā momo matua o ngā EMPD?
E rua ngā momo matua o ngā EMPD:
1. EMPD Matua: He mate kiri tēnei ka puta noa mai. Ka tīmata ki te kiri, kāore he take kē atu.
2. EMPD Tuarua: Ka puta mai tēnei i tētahi mate pukupuku kei roto i tētahi atu wāhanga o te tinana.
Ko wai te mea ka nui ake te tūponotanga ka pāngia e te EMPD?
Ka taea e te tangata katoa te pāngia e te EMPD, engari he nui ake te kitea i roto i ēnei rōpū:
- Ngā tāngata i waenga i te 50 me te 80 tau te pakeke.
- He mea noa i waenga i ngā wāhine .
- Ka kitea anō hoki i roto i ngā tāne Āhia .
- Ngā tāngata Pākehā .
Engari he mea nui kia mahara he tino onge tēnei mate.
He aha i puta ai tēnei EMPD?
He aha ngā take o te EMPD tuatahi?
Ki te pono, kāore anō kia tino mōhio ngā tākuta he aha te take o te EMPD tuatahi. E whakapae ana rātou ka tīmata pea i roto i ētahi momo pūtau o ō tātou tinana. Ko ēnei momo pūtau ko:
- Ngā pūtau awaawa o te repe apocrine: He repe werawera ēnei, ā, kei te taha o ngā pūtake makawe.
- Ngā pūtau take keratinocyte: Ko ēnei ngā pūtau e āwhina ana ki te whakatika i te kiri.
- Ngā pūtau Toker: Ko ēnei ngā pūtau kei roto i te kiri ('kiko vulvar') huri noa i te uma me te pūaha o te tara.
He aha ngā take o te EMPD tuarua?
Ko te EMPD tuarua ka puta mai i te mate pukupuku i ētahi atu wāhi o te tinana. E kiia ana ko te mate pukupuku rectum te take o te tata ki te hautoru o ngā take EMPD. Hei tāpiri, tera atu momo mate pukupuku ka taea te whakaputa i te EMPD tuarua:
- Matepukupuku ā-ira
- Matepukupuku tōngāmimi
- Matepukupuku kōpū
- Matepukupuku ovarian
- Matepukupuku prostate
- Matepukupuku kōpū
He aha ngā tohu o te EMPD?
Ko te tohu matua o te EMPD he ponana kiri e rite ana ki te ekisema . Kua whakaatuhia e ngā rangahau, tata ki te 65% o ngā tūroro EMPD, ka puta i te taha o te vulva , ā, tata ki te 20%, ka puta i te taha o te nono .
Tērā pea ka kite koe i ngā wāhi o tō kiri kei a rātou ēnei āhuatanga:
- Pērā i te kirinuku (`Pakarukaru`)
- Kua whero (`Whero`)
- Unahi
Ka nui haere ngā ira, ā, tera pea he taha koretake. I te haere whakamua o te EMPD, ka puta pea he puku hohonu, he pona rānei. Ko ētahi atu tohu ko:
- Te mura o te tinana
- He whero te kiri, ā, he ahua riri .
- Mākūkū
- Mamae, ngawari rānei
- Kiri pupuhi (edema)
Ko te EMPD te mea e kitea nuitia ana i ngā wāhi kei reira ō repe werawera (ina koa ko ngā repe kiri apocrine). Ka kitea whānuitia i te taha o te pūaha o te tara. Ka taea hoki te puta i ēnei wāhi:
- Huri noa i te nono (`Nono`)
- Ure
- Perineum
- Te kiriuhi
He tino onge te kitea o te EMPD i ētahi atu wāhanga o te tinana, pēnei i:
- Puku
- Keke
- Puku
- papa
- Taringa, kamo, mata, tumuaki rānei
- Uma o raro
- Turi, huha rānei
He mea nui kia mōhio koe tata ki te 10% o te hunga whai mate a Paget i waho o te ū, kāore he tohu e pā ana ki a rātou .
Me pēhea te tātaritanga o tēnei mate EMPD?
Tuatahi, ka pātai atu te tākuta ki a koe mō ō tohumate, ā, ka tirotirohia e ia tō tinana. Mēnā kei te whakapae rātou kei a koe te EMPD, ka penei rātou:Ka mahia he koiora kiri. Ko te koiora he tango i tētahi tauira iti o tō kiri ka tirotirohia i raro i tētahi karuārai.
Ina tirohia i raro i te karuārai, ka rapu te tohunga mate i ngā pūtau motuhake, nui, rerekē e kiia nei ko ngā "pūtau Paget." Ka tautuhia hoki e rātou ēnei pūtau mā te titiro ki te āhua o tā rātou tauhohenga ki ngā momo matū (immunohistochemistry).
Me pēhea te mōhio mēnā he mate pukupuku tōu me te EMPD?
I muri i te tātaritanga o tō mate EMPD, ka whakahaerehia e tō tākuta ētahi atu whakamātautau hei tirotiro mō te mate pukupuku kei raro. Kei roto i ēnei whakamātautau ko:
- Matawai Ultrasound (`Ultrasound`)
- Te whakamātautau ū (mammogram)
- Pap smear
- Ko te koroni, ko te proctoscopy rānei
- Matawai CT
- Cystoscopy (tirotiro i te pūkahukahu)
- Whakamātautau prostate
- Pyelogram retrograde (tirotiro i ngā whatukuhu me te ara mimi)
- Te tango i te ngira, te tango rānei i te ngira i roto i te ultrasound o ngā kōpuku lymph
- Te tirotiro i te korokoro, te esophagus, me te puku (endoscopy o runga)
He aha ngā maimoatanga mō te EMPD?
Ko te tikanga ka rongoatia e ngā tākuta te mate a Paget i waho o te uma mā te pokanga.
- Pokanga Mohs: I roto i tēnei tikanga, ka tangohia e te taote pokanga te kiri kua pāngia, he paparanga ia paparanga, kia tiakina ai te kiri hauora e karapoti ana.
- Te tango whānui ā-rohe: I tēnei tikanga, ka tangohia e te taote pokanga te wāhi o te EMPD me ētahi kiko hauora e karapoti ana. Kātahi ka tuia ngā taha o te patunga.
I ētahi wā, me tango e ngā taote pokanga he wāhi nui o te kiri me ētahi atu kiko. Ko ētahi tāngata whai EMPD huri noa i te vulva, me tango pea tetahi wāhanga, te katoa rānei o te vulva (he 'vulvectomy').
Whakaarohia tēnei: Mena kāore e taea e koe te mahi pokanga nā tētahi atu mate hauora, nā te ngoikore rānei o te hauora, ka tūtohu pea tō tākuta i ētahi atu maimoatanga pēnei i:
- Te rongoā ārai mate
- Te whakahou kiri i te laser
- Te rongoā whakaahua-ā-tinana (PDT)
- Te rongoā irahiko
- Ngā rongoā ā-waha e whakamahia ana hei rongoā i te mate pukupuku (ngā rongoā cytotoxic)
Ko te mea nui, mēnā he mate pukupuku kei raro i te mate, me rongoā motuhake anō hoki.
He huarahi hei whakaiti i te mōrearea o te whakawhanaketanga o te EMPD?
Engari, kāore he mea e taea e tātou te mahi hei whakaiti i te mōrearea o te whakawhanaketanga o te EMPD.
He aha te momo āpōpō ka taea e te tangata whai EMPD te tumanako atu?
I muri i te maimoatanga mō te EMPD, me toro atu koe ki tō tākuta mō ētahi atu tirotiro. Ka whakawhirinaki tēnei ki te wāhi i puta ai te EMPD. He mea noa te puta anō o te EMPD i roto, i te wāhi rānei i rongoatia ai i mua. Nō reira, he mea tino nui kia whai tonu koe i ngā tohutohu a tō tākuta.
He tino onge te mate Paget i waho o te uma, ka horapa (metastasizes) ki ētahi atu wāhanga o te tinana. Heoi, i ētahi wā ka horapa ki ngā kōpū lymph, ki ētahi atu okana rānei. Ka taea e tō tākuta te whakamārama pai i ngā mea ka taea mō tō keehi.
Ka taea e te EMPD te hoki mai i muri i tōna oranga?
Ae, he mate te EMPD ka hoki anō ahakoa kua rongoatia, kua ora anō hoki, ahakoa he maha ngā tau kua pahure. I ētahi wā ka hoki anō i muri i te neke atu i te 15 tau. Koia te take e taunaki ana ngā tākuta kia aroturukitia mō te wā roa me te tirotiro auau.
Mena kei a au te EMPD, me pēhea taku tiaki i a au anō?
Ko te mea pai rawa atu ka taea e koe ko te haere tonu ki tō tākuta mō ngā wā tirotiro auau. Mēnā ka kite tō tākuta i ngā tohu o te hokinga mai o te EMPD, ka taea e ia te tīmata tonu i te maimoatanga.
Āhea ahau me toro atu ki te tākuta?
Ki te kite koe i ētahi tohu hou, i ētahi āhuatanga rānei o te EMPD, me toro atu ki te tākuta tonu.
He mea noa te mataku, te whakama, me te pouri ina kite koe i te kiri ponana, i te puku rānei i tētahi wāhi tairongo o tō tinana, pērā i ō ira tāne. Ka taea te whakapoauau i tēnei mate, e kiia nei ko te Mate a Paget o Extramammary (EMPD), ki ētahi atu mate kiri, nō reira ka roa pea te wā ki te tautuhi tika. Mēnā he mate pukupuku kei raro, ka nui ake te kino o te EMPD.
Heoi, ko te rongo pai ko te nuinga o te hunga whai EMPD ka ora noa, ka ora tonu i muri i te maimoatanga. Ko te tikanga ka rongoatia te EMPD mā te pokanga. Mena he mate pukupuku kei raro, me rongoatia hoki. I te mea ka taea te hoki mai o te Mate Paget Extramammary, ka taea e ngā tirotiro auau me tō tākuta te āwhina ki te kite wawe mena ka hoki mai.
Ngā mea tino nui hei maumahara māu (Karere hei tango ki te kāinga)
- He mate kiri onge te EMPD e hono ana pea ki te mate pukupuku.
- Kia tūpato ki ngā wāhi kiri whero, unahi, kiripaka, piki rānei, inā koa ki te taha o ngā ira tangata, ngā kēkē, te nono rānei. Tērā pea ko te mākati, te wera, me te mamae ngā tohu.
- Ki te kite koe i tētahi tohu pēnei , kaua e whakama, kaua e mataku, engari me toro atu ki te tākuta tonu.
- Ka tātaritatia te EMPD mā te kopa kiri.
- Ko te pokanga te maimoatanga tino noa.
- He mea nui kia haere tonu ngā tirotiro hauora, i te mea ka taea e te EMPD te hoki mai anō.
- Kaua e manukanuka, ko te nuinga o te hunga whai EMPD ka ora pai i muri i te maimoatanga. Ko te mea nui ko te tautuhi wawe i te mate me te whiwhi i te maimoatanga tika.
Mēnā he pātai anō āu mō tēnei, kōrero ki tō tākuta. Ka taea e ia te tuku tohutohu e tika ana māu.
` Te Mate a Paget i waho o te Umu, EMPD, ngā mate kiri, te mate pukupuku kiri, ngā pūtau Paget, ngā ira kiri, te mākūkū, te vulva, te rohe perianal, ngā mate kiri, te pokanga Mohs
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