Paget eczeem van de tepel - Symptomen, Oorzaken en Behandeling

Epidemiology

Paget disease is usually seen in individuals older than 50 years of age. Around the world, it is reported that the prevalence of the disease has decreased during the past 2 decades, currently estimated between 1.5% to 8.3%.[8] It is common in Caucasians of northern European descent.[9] Paget disease is equally common in males and females. In the US, it is said to affect 1 to 3 million people, but most of the patients are asymptomatic. The disorder is slightly more common in white males. The disorder usually presents in the fourth to fifth decade of life, but the diagnosis is often made a decade later.

Paget disease of the bone occurs with an increase in bone resorption, leading to a decrease in bone mass and lytic structures. This process gives rise to osteoblasts from the bone utilizing a sensing system that allows them to increase their activity.

Paget disease's pathological process occurs in 4 stages. It begins with osteoclastic activity, followed by a hybrid osteoclastic/osteoblastic process. In the third stage, osteoblastic activity is observed and culminates in the final stage, where malignant degeneration is seen.

The disease occurs in isolated pockets but is usually progressive. There is often erythema and warmth over the involved bone due to hypervascularity, which can lead to high-output heart failure.

The disease can affect almost every bone in the skeleton but has an affinity for the long bones, axial skeleton, and the skull. Involvement of the feet and hands is rare.

Symptoms of Paget's disease of the nipple

Paget's disease of the nipple always starts in the nipple and may extend to the areola. It appears as a red, scaly rash on the skin of the nipple and areola.

The affected skin is often sore and inflamed, and it can be itchy or cause a burning sensation. The nipple can sometimes be ulcerated.

The rash is often similar in appearance to other skin conditions, such as eczema or psoriasis. If you scratch it, or if it's left untreated, it can bleed, become ulcerated or scab over.

If you're experiencing itchiness, burning or bleeding but the nipple looks normal and is not red or scaly, it's unlikely to be Paget's disease of the nipple. However, you should still have it checked by a doctor.

Around half of all women diagnosed with Paget's disease of the nipple have a lump behind the nipple. In 9 out of 10 cases this is an invasive breast cancer.

Invasive cancer is where cancerous cells invade the surrounding breast tissue. Some women with Paget's disease have invasive breast cancer but do not have a lump.

However, most women with Paget's disease who do not have a lump have non-invasive cancer.

This is where the cancerous cells are contained in 1 or more areas of the breast and have not spread.

textuur

De huid op de tepel is normaal gesproken glad. De tepelhof heeft kleine bultjes die Montgomery-klieren worden genoemd.

Normale wijzigingen

Vaak is een verandering in de textuur van de tepelhof te wijten aan eczeem. Dat is een behandelbare, jeukende huiduitslag. Eczeem is waarschijnlijk als het ook andere delen van het lichaam aantast.

Abnormale veranderingen

Meer over tepelhoftextuurveranderingen zijn onder meer:

• Verdikkende huid
• Zichtbare zwelling of ontsteking
• Een “sinaasappelschil” textuur
• Merkbaar warmere huidtemperatuur

Dit kunnen symptomen zijn van inflammatoire borstkanker (IBC). Dat is een zeldzame ziekte die zwelling en roodheid van de borst veroorzaakt.

Een andere zeldzame vorm van kanker is de tepelziekte van Paget. Het begint op de tepel en breidt zich uit naar de tepelhof. Het kan na verloop van tijd borstknobbels of tumoren veroorzaken. De tepel kan rood en glanzend worden, of dik, ruw en schilferig.

Let op veranderingen in de grootte, kleur of textuur van je tepels en tepelhof. Deze kunnen te wijten zijn aan normale hormonale schommelingen. Of het kunnen tekenen zijn van een ernstig probleem.

Eenzijdige veranderingen zijn vaak zorgwekkender. Zeldzame borstkankers kunnen een sinaasappelschil of ruwe en schilferige tepels veroorzaken.