Ingaba urhawuzelelwa yindawo engaqhelekanga eluswini lwakho? Isenokuba sisifo se-Extramammary Paget's Disease (EMPD)!

Ngaba wakha waphawula ibala elibomvu, elinamaxolo, ngamanye amaxesha elirhabaxa eluswini lwakho, ingakumbi kwimiqolo, emakhwapheni, okanye kwindawo yesini? Libonakala likhula kancinci kancinci, kwaye ngamanye amaxesha liyarhawuzelela, akunjalo? Kulungile, ngoko ke namhlanje siza kuthetha ngemeko ekhethekileyo yesikhumba efana naleyo. Oogqirha bayibiza ngokuba yi -Extramammary Paget's Disease , okanye i-EMPD ngamafutshane. Linqabile kancinci, kodwa kubalulekile ukuliqaphela.

Yintoni i-Extramammary Paget's Disease (EMPD)?

Ngamafutshane, i-EMPD yimeko yolusu engaqhelekanga. Ngamanye amaxesha inokunxulunyaniswa nezinye iintlobo zomhlaza. Kodwa oko akusoloko kunjalo. Yimeko apho ulusu lwakho luba bomvu, lube namaxolo, okanye lube namaqhuqhuva kwaye lukhule lube lukhulu. Ngamanye amaxesha lunokungafunyaniswa kangangeminyaka emva kokuba isifo siqalile.

Ibizwa ngokuba yi "Paget's Disease" emva kukaSir James Paget, ugqirha waseBritane owayekrelekrele ngenkulungwane ye-19. Igama lakhe lisetyenziswe kwezinye iintlobo ezininzi zomhlaza ngenxa yegalelo lakhe kwicandelo lezifo. Igama elithi "extramammary" lithetha "ngaphandle kwebele." Oku akufanele kudidaniswe nesifo sikaPaget sebele.

Kuqikelelwa ukuba phakathi kwe-7% kunye ne-40% yabantu abaneSifo se-Extramammary Paget banokuba nomhlaza ongaphantsi komhlaba . Nangona kunjalo, njengoko benditshilo ngaphambili, i-EMPD ayisoloko ingumqondiso wesifo esinye. Unyango lwangethuba lunokunceda ukunciphisa iimpawu zakho kwaye luncede ekufumaneni umhlaza ongaphantsi komhlaba.

Ziziphi iintlobo eziphambili ze-EMPD?

Kukho iintlobo ezimbini eziphambili ze-EMPDs:

1. I-EMPD ePhambili: Le yimeko yesikhumba eyenzeka ngokungacwangciswanga. Iqala eluswini ngaphandle kwesizathu esinye.

2. I-EMPD yesibini: Oku kubangelwa ngumhlaza ongaphantsi kwenye indawo emzimbeni.

Ngubani onokuba nethuba elikhulu lokuphuhlisa i-EMPD?

Nabani na angenza i-EMPD, kodwa ixhaphake kakhulu kumaqela alandelayo:

• Abantu abaphakathi kweminyaka engama -50 nama-80 ubudala.
• Ixhaphakile phakathi kwabasetyhini .
• Ingabonakala nakwamadoda aseAsia .
• Abantu abamhlophe .

Kodwa kubalulekile ukukhumbula ukuba le yimeko engaqhelekanga kakhulu.

Kutheni le nto i-EMPD isenzeka?

Yintoni ebangela i-EMPD eyintloko?

Inyaniso kukuba, oogqirha abakayazi kakuhle into ebangela i-EMPD yokuqala. Bacinga ukuba inokuqala kwiintlobo ezithile zeeseli emizimbeni yethu. Ezi ntlobo zeeseli ziquka:

• Iiseli ze-Apocrine gland duct: Ezi zii-sweat glands kwaye zikufutshane nee-hair follicles.
• Iiseli zeKeratinocyte stem: Ezi ziiseli ezinceda ekulungiseni ulusu.
• Iiseli zeToker: Ezi ziiseli ezifumaneka eluswini (`izicubu ze-vulvar`) ezijikeleze ingono kunye nomnyango welungu lobufazi.

Yintoni ebangela i-EMPD yesibini?

I-EMPD yesibini ibangelwa ngumhlaza kwenye indawo emzimbeni. Kuthiwa umhlaza wamathumbu ngunobangela wesinye kwisithathu seemeko ze-EMPD. Ukongeza, kukho ezinye iintlobo zomhlaza ezinokubangela i-EMPD yesibini:

• Umhlaza wempundu
• Umhlaza wesinyi
• Umhlaza womlomo wesibeleko
• Umhlaza wesibeleko
• Umhlaza weprostate
• Umhlaza wesibeleko

Zithini iimpawu ze-EMPD?

Uphawu oluphambili lwe-EMPD kukuqhambuka kwesikhumba okufana ne-eczema . Uphando lubonise ukuba malunga ne-65% yezigulane ze-EMPD, kwenzeka malunga ne-vulva , kwaye malunga ne-20%, kwenzeka malunga ne-anus .

Ungabona iindawo eluswini lwakho ezinezi mpawu zilandelayo:

• Njengeqokobhe (`Crusty`)
• Ijike yaba bomvu (`Bomvu`)
• I-Scaly

Amabala akhula kancinci kancinci, kwaye anokuba nemiphetho engacwangciswanga. Njengoko i-EMPD iqhubeka, izilonda ezinzulu okanye amaqhuqhuva anokuvela. Ezinye iimpawu ziquka:

• Imvakalelo yokutsha
• Ulusu lubomvu kwaye luvakala lucaphukile .
• Ukurhawuzelela
• Ibuhlungu okanye ithambile
• Ulusu oludumbileyo (edema)

I-EMPD idla ngokuvela kwiindawo apho kukho khona amadlala akho okubila (ingakumbi amadlala esikhumba e-apocrine). Ihlala ibonakala ijikeleze umngxuma welungu lobufazi. Inokwenzeka nakwezi ndawo:

• Ejikeleze i-anus (`Anus`)
• Ipenisi
• I-Perineum
• I-Scrotum

Kunqabile kakhulu, i-EMPD inokubonwa nakwezinye iindawo zomzimba, ezinje:

• Isisu
• Ikhwapha
• Icici lesibhono
• Amaqakala
• Indlebe, ijwabu, ubuso okanye isikhumba sentloko
• Isifuba esisezantsi
• Idolo okanye ithanga

Kubalulekile ukwazi ukuba malunga ne-10% yabantu abanesifo sePaget esingaphandle kwamabele abanazo naziphi na iimpawu .

Ifunyanwa njani le meko ye-EMPD?

Okokuqala, ugqirha uza kukubuza ngeempawu zakho aze akuhlole ngokwasemzimbeni. Ukuba bacinga ukuba une-EMPD, baza ku:Kwenziwa i-biopsy yolusu. I-biopsy ibandakanya ukuthatha isampuli encinci yolusu lwakho uze uyihlolisise phantsi kwe-microscope.

Xa ejonga phantsi kwe-microscope, ingcali yezifo ikhangela iiseli ezikhethekileyo, ezinkulu, ezingaqhelekanga ezibizwa ngokuba yi- "Paget cells." Zikwachonga ezi seli ngokujonga indlela ezisabela ngayo kwiikhemikhali ezahlukeneyo (immunohistochemistry).

Ufumanisa njani ukuba unomhlaza one-EMPD?

Emva kokuba ufunyaniswe une-EMPD, ugqirha wakho uza kwenza ezinye iimvavanyo ezininzi ukujonga umhlaza ongaphantsi. Ezi mvavanyo zingabandakanya:

• Iskeni ye-ultrasound (`i-Ultrasound`)
• Uvavanyo lwebele (i-mammogram)
• I-Pap smear
• I-Colonoscopy okanye i-proctoscopy
• Iskeni ye-CT
• I-Cystoscopy (uvavanyo lwesinyi)
• Uvavanyo lweprostate
• I-retrograde pyelogram (uvavanyo lwezintso kunye nomgudu womchamo)
• I-ultrasound okanye i-biopsy yenaliti ye-lymph nodes
• I-endoscopy ephezulu (uvavanyo lomphimbo, umphimbo, kunye nesisu)

Ziziphi iindlela zonyango ze-EMPD?

Oogqirha badla ngokunyanga isifo sikaPaget esingaphandle kwebele ngotyando.

• Utyando lweMohs: Kule nkqubo, ugqirha otyandayo ususa umaleko wolusu oluchaphazelekayo ngomaleko, egcina ulusu olujikelezileyo lusempilweni.
• Ukususwa kwenxeba kwindawo ebanzi: Kule nkqubo, ugqirha ususa indawo ye-EMPD kunye nezicwili eziphilileyo ezijikelezileyo. Emva koko imiphetho yenxeba iyathungwa.

Ngamanye amaxesha oogqirha kufuneka basuse indawo enkulu yolusu kunye nezinye izicwili. Abanye abantu abane-EMPD ejikeleze i-vulva banokufuna ukuba inxalenye okanye yonke i-vulva isuswe (i-'vulvectomy').

Cinga ngoku: Ukuba awukwazi ukwenza utyando ngenxa yesinye isimo sempilo okanye impilo embi, ugqirha wakho unokucebisa ezinye iindlela zonyango ezifana nezi:

• Unyango lwe-immunotherapy
• Ukulungiswa kolusu nge-laser
• Unyango lwe-Photodynamic (PDT)
• Unyango ngemitha
• Amayeza asetyenziswa kunyango lomhlaza (amayeza abangela ubuthi)

Eyona nto ibalulekileyo kukuba ukuba kukho umhlaza ongaphantsi, kufuneka unyangwe ngokwahlukileyo.

Ngaba ikho indlela yokunciphisa umngcipheko wokufumana i-EMPD?

Ngelishwa, akukho nto sinokuyenza ukunciphisa umngcipheko wokufumana i-EMPD.

Luhlobo luni lwekamva umntu one-EMPD anokulilindela?

Emva konyango lwe-EMPD, kuya kufuneka ukuba undwendwele ugqirha wakho kwakhona. Oku kuya kuxhomekeka ekubeni i-EMPD ikuphi. Kuqhelekile ukuba i-EMPD iphinde ivele kwindawo enye okanye ejikeleze indawo eyayinyangwa kuyo ngaphambili. Ngoko ke, kubaluleke kakhulu ukuqhubeka nokulandela imiyalelo kagqirha wakho.

Isifo sika-Extramammary Paget sinqabile kakhulu apho sisasazeka khona (sisasazeka) kwezinye iindawo zomzimba. Nangona kunjalo, ngamanye amaxesha sinokusasazeka kwi-lymph nodes okanye kwezinye izitho zomzimba. Ugqirha wakho unokukuchazela ngcono ukuba yintoni enokwenzeka kwimeko yakho.

Ngaba i-EMPD ingabuya emva kokuba ipholile?

Ewe, i-EMPD yimeko enokuphinda ivele nasemva konyango nokuchacha, nasemva kweminyaka emininzi. Ngamanye amaxesha inokubuya emva kweminyaka engaphezu kwe-15. Yiyo loo nto oogqirha becebisa ukuba umntu abekwe esweni ixesha elide kwaye ahlolwe rhoqo.

Ukuba ndine-EMPD, ndingazinyamekela njani?

Eyona nto ingcono onokuyenza kukuhlala usiya kugqirha wakho rhoqo ukuze ufumane amadinga okulandela. Ukuba ugqirha wakho ubona iimpawu ze-EMPD zibuya, unokuqala unyango ngoko nangoko.

Ndifanele ndimbone nini ugqirha?

Ukuba ubona naziphi na iimpawu ezintsha ze-EMPD, okanye ukuba ubonakalisa naziphi na iimpawu ezintsha, bonana nogqirha ngoko nangoko.

Kuqhelekile ukuziva usoyika, uneentloni, kwaye ucaphukile xa ubona irhashalala okanye iqhuma kwindawo ebuthathaka yomzimba wakho, njengeenxalenye zangasese. Le meko, ebizwa ngokuba yi-Extramammary Paget's Disease (EMPD), ngamanye amaxesha inokubhidaniswa nezinye iimeko zesikhumba, ngoko ke kungathatha ixesha ukufumana uxilongo oluchanekileyo. Ukuba kukho umhlaza okhoyo, i-EMPD inokuba yingozi nangakumbi.

Nangona kunjalo, iindaba ezimnandi zezokuba uninzi lwabantu abane-EMPD baphila ubomi obuqhelekileyo nobupheleleyo emva konyango. I-EMPD idla ngonyango ngotyando. Ukuba kukho umhlaza ongaphantsi, oko kuya kufuneka kunyangwe. Ekubeni isifo se-Extramammary Paget sinokuphinda sibuye, ukuhlolwa rhoqo ngugqirha wakho kunokunceda ukusifumanisa kwangethuba ukuba sibuya.

Izinto ezibaluleke kakhulu ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

• I-EMPD yimeko yesikhumba engaqhelekanga enokunxulunyaniswa nomhlaza.
• Nika ingqalelo kuyo nayiphi na indawo ebomvu, enamaxolo, enamaxolo, okanye ephakanyisiweyo yesikhumba, ingakumbi ejikeleze amalungu esini, amakhwapha, okanye i-anus. Iimpawu zingabandakanya ukurhawuzelela, ukutsha, kunye nentlungu.
• Ukuba ubona uphawu olufana nolu , musa ukuba neentloni okanye ukoyika, kodwa bonana nogqirha ngokukhawuleza.
• I-EMPD ifunyaniswa nge-biopsy yolusu.
• Utyando lolona nyango luqhelekileyo.
• Kubalulekile ukuqhubeka nokuhlolwa kwezonyango, njengoko i-EMPD inokuphinda ivele.
• Ungakhathazeki, uninzi lwabantu abane-EMPD baphila kakuhle emva konyango. Eyona nto ibalulekileyo kukuxilongwa kwangethuba kwaye ufumane unyango olufanelekileyo.

Ukuba unemibuzo engaphezulu malunga noku, thetha nogqirha wakho. Angakunika iingcebiso ezifanelekileyo kuwe.

Isifo sePaget esingaphandle kwebele, i - EMPD, izifo zesikhumba, umhlaza wesikhumba, iiseli zePaget, amabala esikhumba, ukurhawuzelela, i-vulva, indawo ye-perianal, izifo zesikhumba, utyando lwe-Mohs