{"id":8122,"date":"2020-04-27T06:31:56","date_gmt":"2020-04-27T09:31:56","guid":{"rendered":"https:\/\/doctorhoogstra.com\/es\/enfermedad-de-paget-extramamaria-de-la-piel\/"},"modified":"2020-04-27T14:40:06","modified_gmt":"2020-04-27T17:40:06","slug":"doenca-extramamaria-da-pele","status":"publish","type":"wiki","link":"https:\/\/doctorhoogstra.com\/pt\/wiki\/enfermedad-de-paget-extramamaria-de-la-piel\/","title":{"rendered":"Doen\u00e7a extramam\u00e1ria da pele de Paget"},"content":{"rendered":"<p><\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_89 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Conte\u00fado<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Alternar tabela de conte\u00fado\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Alternar<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/doctorhoogstra.com\/pt\/wiki\/enfermedad-de-paget-extramamaria-de-la-piel\/#%C2%BFQue-es-la-enfermedad-de-Paget-extramamaria-de-la-piel\" >O que \u00e9 a doen\u00e7a de Paget extramam\u00e1ria da pele?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/doctorhoogstra.com\/pt\/wiki\/enfermedad-de-paget-extramamaria-de-la-piel\/#%C2%BFQuien-contrae-la-enfermedad-de-Paget-extramamaria\" >Quem recebe a doen\u00e7a de Paget extramam\u00e1ria?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/doctorhoogstra.com\/pt\/wiki\/enfermedad-de-paget-extramamaria-de-la-piel\/#%C2%BFComo-se-clasifica-la-enfermedad-de-Paget-extramamaria\" >Como \u00e9 classificada a doen\u00e7a de Paget extramam\u00e1ria?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/doctorhoogstra.com\/pt\/wiki\/enfermedad-de-paget-extramamaria-de-la-piel\/#%C2%BFCuales-son-las-caracteristicas-clinicas-de-la-enfermedad-de-Paget-extramamaria\" >Quais s\u00e3o as caracter\u00edsticas cl\u00ednicas da doen\u00e7a de Paget extramam\u00e1ria?<\/a><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/doctorhoogstra.com\/pt\/wiki\/enfermedad-de-paget-extramamaria-de-la-piel\/#Enfermedad-de-Paget-extramamaria\" >Doen\u00e7a de Paget extramam\u00e1ria<\/a><\/li><\/ul><\/li><\/ul><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/doctorhoogstra.com\/pt\/wiki\/enfermedad-de-paget-extramamaria-de-la-piel\/#%C2%BFQue-sitios-estan-afectados\" >Quais sites s\u00e3o afetados?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/doctorhoogstra.com\/pt\/wiki\/enfermedad-de-paget-extramamaria-de-la-piel\/#%C2%BFComo-se-diagnostica-la-enfermedad-de-Paget-extramamaria\" >Como \u00e9 diagnosticada a doen\u00e7a de Paget extramam\u00e1ria?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/doctorhoogstra.com\/pt\/wiki\/enfermedad-de-paget-extramamaria-de-la-piel\/#%C2%BFCual-es-el-tratamiento-de-la-enfermedad-de-Paget-extramamaria\" >Qual \u00e9 o tratamento da doen\u00e7a de Paget extramam\u00e1ria?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/doctorhoogstra.com\/pt\/wiki\/enfermedad-de-paget-extramamaria-de-la-piel\/#%C2%BFCual-es-el-pronostico-para-la-enfermedad-de-Paget-extramamaria\" >Qual \u00e9 o progn\u00f3stico da doen\u00e7a de Paget extramam\u00e1ria?<\/a><\/li><\/ul><\/nav><\/div>\n\n<section class=\"textBlock\">\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFQue-es-la-enfermedad-de-Paget-extramamaria-de-la-piel\"><\/span>O que \u00e9 a doen\u00e7a de Paget extramam\u00e1ria da pele?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>A doen\u00e7a extramam\u00e1ria da pele de Paget \u00e9 uma doen\u00e7a intra-epitelial rara. <span class=\"term\" data-term-id=\"30\">C\u00e2ncer<\/span> caracterizado por um <span class=\"term\" data-term-id=\"319\">cr\u00f4nica<\/span> <span class=\"term\" data-term-id=\"491\">eczema<\/span>-eu gosto <span class=\"term\" data-term-id=\"255\">erup\u00e7\u00e3o<\/span> ao redor de <span class=\"term\" data-term-id=\"629\">axilas<\/span> ou <span class=\"term\" data-term-id=\"825\">anogenital<\/span> regi\u00f5es masculina e feminina. Sob o microsc\u00f3pio, a doen\u00e7a de Paget extramam\u00e1ria \u00e9 muito semelhante \u00e0 doen\u00e7a de Paget mais comum da mama que ocorre na mama.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFQuien-contrae-la-enfermedad-de-Paget-extramamaria\"><\/span>Quem recebe a doen\u00e7a de Paget extramam\u00e1ria?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>A doen\u00e7a extra-mam\u00e1ria de Paget ocorre com mais freq\u00fc\u00eancia no <span class=\"term\" data-term-id=\"1004\">vulva<\/span> de mulheres entre 50 e 60 anos. Tamb\u00e9m pode afetar o <span class=\"term\" data-term-id=\"572\">axila<\/span> e a \u00e1rea anogenital em homens de idade semelhante. Verificou-se ser mais comum em asi\u00e1ticos do que europeus e muito raro em afro-americanos.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFComo-se-clasifica-la-enfermedad-de-Paget-extramamaria\"><\/span>Como \u00e9 classificada a doen\u00e7a de Paget extramam\u00e1ria?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>A doen\u00e7a extramam\u00e1ria de Paget da pele foi classificada em v\u00e1rios subtipos.<\/p>\n<ul>\n<li>Tipo 1a <span class=\"term\" data-term-id=\"949\">prim\u00e1rio<\/span> <span class=\"term\" data-term-id=\"47\">cut\u00e2neo<\/span> doen\u00e7a de Paget extramam\u00e1ria surge de <span class=\"term\" data-term-id=\"12\">gl\u00e2ndulas ap\u00f3crinas<\/span> Dentro de <span class=\"term\" data-term-id=\"85\">epiderme<\/span> (<span class=\"term\" data-term-id=\"863\">no lugar<\/span>) ou pele subjacente <span class=\"term\" data-term-id=\"14\">ap\u00eandices<\/span>.<\/li>\n<li>A doen\u00e7a cut\u00e2nea extramam\u00e1ria prim\u00e1ria de Paget tipo 1b (15-25%) est\u00e1 associada a <span class=\"term\" data-term-id=\"612\">invasor<\/span> Doen\u00e7a de Paget ou adenocarcinoma in situ.<\/li>\n<li>A doen\u00e7a de Paget extramam\u00e1ria do tipo 2 resulta de adenocarcinoma anal ou retal subjacente.<\/li>\n<li>A doen\u00e7a extramam\u00e1ria de Paget tipo 3 \u00e9 origin\u00e1ria do adenocarcinoma da bexiga.<\/li>\n<\/ul>\n<p>\u00c0s vezes, a doen\u00e7a extra-mam\u00e1ria de Paget est\u00e1 presente por 10 a 15 anos antes de evid\u00eancias de c\u00e2ncer ou <span class=\"term\" data-term-id=\"383\">met\u00e1stase<\/span> parece.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCuales-son-las-caracteristicas-clinicas-de-la-enfermedad-de-Paget-extramamaria\"><\/span>Quais s\u00e3o as caracter\u00edsticas cl\u00ednicas da doen\u00e7a de Paget extramam\u00e1ria?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>O mais comum <span class=\"term\" data-term-id=\"902\">sintoma<\/span> A doen\u00e7a de Paget extramam\u00e1ria da pele \u00e9 uma coceira leve a grave de um <span class=\"term\" data-term-id=\"164\">ferimentos<\/span> encontrado ao redor da virilha, \u00f3rg\u00e3os genitais, <span class=\"term\" data-term-id=\"889\">per\u00edneo<\/span> ou <span class=\"term\" data-term-id=\"1192\">perianal<\/span> zona. Dor e sangramento podem ocorrer devido a arranh\u00f5es e les\u00f5es que existem h\u00e1 muito tempo. Espessado <span class=\"term\" data-term-id=\"368\">pratos<\/span> pode formar e ficar vermelho, <span class=\"term\" data-term-id=\"385\">escamoso<\/span> e crocante <\/p>\n<section class=\"textBlock imageLinkBlockTitle\">\n<h5 class=\"colour--primary\"><span class=\"ez-toc-section\" id=\"Enfermedad-de-Paget-extramamaria\"><\/span>Doen\u00e7a de Paget extramam\u00e1ria<span class=\"ez-toc-section-end\"><\/span><\/h5>\n<\/section>\n<section class=\"imageLinkBlock\">\n<div class=\"flex\">\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='extra-paget3__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisinkildfd-7017465-1129650' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/extra-paget3__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsInkiLDFd-7017465.jpg'>\n<\/div>\n<p class=\"p-small\">Axila<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='extra-paget5__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisinkildg1xq-5600810-4289280' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/extra-paget5__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsInkiLDg1XQ-5600810.jpg'>\n<\/div>\n<p class=\"p-small\">Vulva<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='extra-paget-24__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-7579895-2882563' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/extra-paget-24__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-7579895.jpg'>\n<\/div>\n<p class=\"p-small\">Escroto<\/p>\n<\/p><\/div>\n<\/section>\n<div class=\"clearfix imageLinkBlock\"><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFQue-sitios-estan-afectados\"><\/span>Quais sites s\u00e3o afetados?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Nas mulheres, a \u00e1rea mais comum envolvida \u00e9 a vulva. Os primeiros sintomas s\u00e3o geralmente prurido e queima\u00e7\u00e3o em uma ou mais placas persistentes. Estes podem se espalhar para os l\u00e1bios, p\u00fabis, vagina e coxas. As les\u00f5es perianais podem se estender para o canal anal.<\/p>\n<p>Nos homens, a \u00e1rea mais comum \u00e9 o escroto, seguido de doen\u00e7a perianal, p\u00eanis e virilha.<\/p>\n<p>A axila \u00e9 um local raro para a doen\u00e7a de Paget extramam\u00e1ria da pele.<\/p>\n<p>A localiza\u00e7\u00e3o da doen\u00e7a de Paget extramam\u00e1ria \u00e9 \u00fatil na previs\u00e3o do risco de c\u00e2ncer associado. Por exemplo, 25\u201335% da doen\u00e7a extra-mam\u00e1ria de Paget que surge perto do \u00e2nus est\u00e1 associada ao c\u00e2ncer colorretal subjacente.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFComo-se-diagnostica-la-enfermedad-de-Paget-extramamaria\"><\/span>Como \u00e9 diagnosticada a doen\u00e7a de Paget extramam\u00e1ria?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Pele <span class=\"term\" data-term-id=\"24\">bi\u00f3psia<\/span> A les\u00e3o \u00e9 realizada para obter um diagn\u00f3stico preciso da doen\u00e7a de Paget extramam\u00e1ria, pois existem v\u00e1rias outras condi\u00e7\u00f5es genitais da pele que podem parecer semelhantes. Abaixo <span class=\"term\" data-term-id=\"867\">microscopia<\/span>, a presen\u00e7a de c\u00e9lulas de Paget juntamente com outras <span class=\"term\" data-term-id=\"474\">histol\u00f3gico<\/span> Os resultados confirmam o diagn\u00f3stico. Pontos especiais podem ser necess\u00e1rios para distinguir a doen\u00e7a de Paget dos primeiros <span class=\"term\" data-term-id=\"1670\">melanoma<\/span> (melanoma in situ). Ver doen\u00e7a de Paget extramam\u00e1ria <span class=\"term\" data-term-id=\"223\">patologia<\/span>.<\/p>\n<p>Outros testes podem incluir:<\/p>\n<ul>\n<li>Avalia\u00e7\u00e3o <span class=\"term\" data-term-id=\"1775\">g\u00e2nglios linf\u00e1ticos<\/span> de <span class=\"term\" data-term-id=\"1378\">ultrassom<\/span> digitaliza\u00e7\u00e3o ou agulha fina <span class=\"term\" data-term-id=\"1869\">Aspirar<\/span>\n<\/li>\n<li>Procure outras neoplasias, incluindo exame de Papanicolaou, imagem p\u00e9lvica para detectar c\u00e2ncer subjacente, <span class=\"term\" data-term-id=\"1553\">colonoscopia<\/span>mamografia<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCual-es-el-tratamiento-de-la-enfermedad-de-Paget-extramamaria\"><\/span>Qual \u00e9 o tratamento da doen\u00e7a de Paget extramam\u00e1ria?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Local amplo <span class=\"term\" data-term-id=\"848\">excis\u00e3o<\/span>, vulvectomia ou, se dispon\u00edvel, excis\u00e3o cir\u00fargica controlada por margem (cirurgia microgr\u00e1fica de Mohs) \u00e9 o tratamento padr\u00e3o para a doen\u00e7a de Paget extramam\u00e1ria. As se\u00e7\u00f5es de parafina s\u00e3o preferidas \u00e0s se\u00e7\u00f5es congeladas. \u00c0s vezes, \u00e9 dif\u00edcil definir a margem quando as les\u00f5es se espalham esporadicamente por toda a regi\u00e3o anogenital. A reconstru\u00e7\u00e3o pode exigir enxerto de pele ou reparo de retalho.<\/p>\n<p><span class=\"term\" data-term-id=\"1074\">Reaparecimento<\/span> Como \u00e9 comum (30\u201350%), os pacientes devem ser reexaminados a cada tr\u00eas meses ap\u00f3s a cirurgia pelos pr\u00f3ximos dois anos, ap\u00f3s o que se recomenda o acompanhamento anual. A recorr\u00eancia geralmente leva a cirurgia adicional.<\/p>\n<p>Tratamentos n\u00e3o cir\u00fargicos para <span class=\"term\" data-term-id=\"805\">recorrente<\/span> a doen\u00e7a pode incluir:<\/p>\n<ul>\n<li><span class=\"term\" data-term-id=\"1325\">Radioterapia<\/span><\/li>\n<li>\n<span class=\"term\" data-term-id=\"1617\">Ser estar<\/span> <span class=\"term\" data-term-id=\"1754\">abla\u00e7\u00e3o<\/span>\n<\/li>\n<li><span class=\"term\" data-term-id=\"1571\">Fotodin\u00e2mica<\/span> terapia<\/li>\n<li>5-fluorouracil <span class=\"term\" data-term-id=\"1121\">creme<\/span><\/li>\n<li>\n<p>Creme de imiquimod.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCual-es-el-pronostico-para-la-enfermedad-de-Paget-extramamaria\"><\/span>Qual \u00e9 o progn\u00f3stico da doen\u00e7a de Paget extramam\u00e1ria?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>A doen\u00e7a de Paget tem baixa mortalidade. <span class=\"term\" data-term-id=\"241\">Previs\u00e3o<\/span> \u00e9 pior se houver c\u00e2ncer subjacente, o paciente tiver mais de 70 anos e a doen\u00e7a de Paget estiver na regi\u00e3o anal.<\/p>\n<\/section>","protected":false},"excerpt":{"rendered":"<p>\u00bfQu\u00e9 es la enfermedad de Paget extramamaria de la piel? La enfermedad de Paget extramamaria de la piel es una intraepitelial rara c\u00e1ncer caracterizado por un cr\u00f3nico eczema-me gusta erupci\u00f3n&#8230;<\/p>","protected":false},"author":8,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"categories":[204],"tags":[],"class_list":["post-8122","wiki","type-wiki","status-publish","format-standard","category-glosario-definiciones"],"_links":{"self":[{"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/wiki\/8122","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/comments?post=8122"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/wiki\/8122\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/media?parent=8122"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/categories?post=8122"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/tags?post=8122"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}