Kei te mākūkū koe me te putaputa rerekē i tō kiri? Tērā pea he Mate a Paget i waho o te uma (EMPD)!

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.

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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.