ʻOki kino Mohs

ʻO ke kahakaha micrographic Mohs kahi ala e mālama a hoʻōla i kekahi mau maʻi ʻili ʻili. ʻO nā kauka i hoʻomaʻamaʻa ʻia i ke kaʻina hana Mohs hiki ke hana i kēia ʻoki. ʻAe ʻia e lawe ʻia i ka maʻi ʻaʻai ʻili me ka hōʻemi iki ʻana o ka ʻili olakino a puni.

Hana pinepine ʻo Mohs i ke keʻena o ke kauka. Hoʻomaka ke ʻōpala i ke kakahiaka nui a hana ʻia i hoʻokahi lā. I kekahi manawa inā nui ka tumo a i ʻole pono ʻoe i ke kūkulu hou ʻana, ʻelua paha kipa ʻana.

I ka wā o ke kaʻina hana, lawe ka lāʻau lapaʻau i ka maʻi ʻaʻai i nā papa a hiki i ka lawe ʻia ʻana o ka maʻi ʻaʻai. E hana ke kauka.

• Pōpō i kou ʻili kahi o ka maʻi ʻaʻai no laila ʻaʻole ʻoe e ʻeha. Noho ala ʻoe no ke kaʻina hana.
• Wehe i ka ʻōpuʻu i ʻike ʻia me kahi ʻāpana lahilahi o ka ʻaoʻao kokoke i ka tumo.
• E nānā i ka mea kiko ma lalo o ka microscope.
• E hōʻoia no ka maʻi ʻaʻai. Inā loaʻa ka maʻi ʻaʻai i kēlā papa, e lawe ke kauka i kahi papa ʻē aʻe a nānā i kēlā ma lalo o ka microscope.
• E hoʻomau hou i kēia hana a hiki i ka loaʻa ʻole o kahi maʻi ʻaʻai i kahi papa. Kēlā me kēia puni ma kahi o 1 hola. Lawe ke ʻōpala i 20 a 30 mau minuke a ke nānā nei i ka papa ma lalo o ka microscope he 30 mau minuke.
• Hana ma kahi o 2 a 3 mau puni e loaʻa ai ka maʻi ʻaʻai. Pono i nā tumors hohonu nā papa hou.
• Kāohi i ke kahe ʻana o ke kahe ma ka hoʻopili ʻana i kahi kaomi kaomi, ka hoʻohana ʻana i kahi probe liʻiliʻi e wela ai ka ʻili (electrocautery), a i ʻole ke hāʻawi ʻana iā ʻoe i kahi humuhumu

Hiki ke hoʻohana ʻia ke kahakaha Mohs no ka nui o nā maʻi ʻili ʻili, e like me ka cell basal a i ʻole nā ​​maʻi ʻili squamous cell. No nā maʻi ʻili ʻili he nui, hiki ke hoʻohana i nā kaʻina hana maʻalahi ʻē aʻe.

ʻOi aku paha ke koho ʻia ʻana o ke kaha ʻana ʻo Mohs ke kū ka maʻi ʻaʻai ʻili ma kahi kahi:

• He mea nui e hemo e like me ka liʻiliʻi e like me ka maka, e like me nā lihilihi, ihu, pepeiao, lehelehe, a lima paha
• Pono e ʻike i kāu kauka ka hemo ʻana o ka tumo holoʻokoʻa ma mua o ke humuhumu ʻana iā ʻoe
• Aia kahi maʻi ʻōkuhi a i ʻole ma mua i hoʻohana ʻia ai ka hana radiation
• Aia kahi manawa kiʻekiʻe aʻe e hoʻi mai ka tumo, e like me nā pepeiao, nā lehelehe, ka ihu, nā kuʻemaka, a i ʻole nā ​​luakini

ʻOi aku ke koho ʻia ʻo ke kahakaha ʻo Mohs ke:

• Ua mālama mua ʻia ka maʻi ʻaʻai ʻili, a ʻaʻole i wehe loa ʻia, a i ʻole hoʻi mai ia
• Nui ka maʻi ʻaʻai o ka ʻili, a i ʻole maopopo ʻole nā ​​kihi o ka maʻi ʻaʻai
• ʻAʻole holo maikaʻi kāu ʻōnaehana pale maʻi ma muli o ke kanesa, ka maʻi ʻaʻai, a i ʻole nā ​​lāʻau āu e lawe nei
• ʻOi aku ka hohonu o ka tumo

Palekana ʻo Mohs i kahi palekana. Me ke kahakaha ʻana o Mohs, ʻaʻole pono ʻoe e hiamoe (anesthesia āpau) e like me kāu hana me nā ʻoki lāʻau ʻē aʻe.

ʻOiai he kakaikahi, eia kekahi mau pilikia no kēia ʻoki kino:

• Maʻi kīnā.
• Hoʻopilikia ke aʻalolo i kumu o ka helu a i ʻole ka ʻā ʻana o ke ahi. Hele maʻamau kēia.
• Hoʻonui ʻia a me nā ʻulaʻula nunui, i kapa ʻia he keloids.
• Kahena.

E wehewehe kāu kauka i ka mea āu e hana ai e hoʻomākaukau ai no kāu ʻoki ʻana. E noi ʻia ʻoe e:

• Hoʻoki i ka lawe ʻana i kekahi mau lāʻau, e like me ka aspirin a i ʻole nā ​​mea ʻokiʻoki koko. Mai hōʻoki i ka lawe ʻana i nā lāʻau i kuhikuhi ʻia ke ʻole ke kauka e haʻi iā ʻoe e kū.
• Uoki ka puhipaka.
• E hoʻonohonoho e lawe kekahi iā ʻoe i ka home ma hope o kāu ʻoki ʻana.

ʻO ka mālama pono ʻana i kou ʻeha ma hope o ke kaha ʻana e kōkua ai i kou ʻili ke nānā aku. E kamaʻilio pū kāu kauka me ʻoe e pili ana i kāu koho:

• E hoʻōla kahi ʻeha liʻiliʻi iā ia iho. ʻO ka hapa nui o nā ʻeha liʻiliʻi e hoʻōla maikaʻi iā lākou iho.
• E hoʻohana i nā humuhumu e pani i ka ʻeha.
• E hoʻohana i nā paʻa o ka ʻili. Uhi ke kauka i ka ʻeha me ka hoʻohana ʻana i ka ʻili mai kahi ʻē aʻe o kou kino.
• E hoʻohana i nā paʻa o ka ʻili. Uhi ke kauka i ka ʻeha me ka ʻili e pili ana i kou ʻeha. Pili ka ʻili ma kahi o kou ʻeha i ke kala a me ke ʻano.

He 99% ka lōi o ka hana ʻana o Mohs i ka mālama ʻana i ka maʻi ʻaʻai ʻili.

Me kēia ʻoki ʻana, hoʻoneʻe ʻia ka liʻiliʻi o nā kiko i hiki ke lawe ʻia. E loaʻa iā ʻoe kahi welu liʻiliʻi ma mua o kāu me nā koho lapaʻau ʻē aʻe.

Ka maʻi ʻaʻai o ka ʻili - ʻoki kino Mohs; Ka maʻi ʻaʻai o ka ʻili basal - maʻi ʻo Mohs; ʻO ka maʻi ʻaʻai ʻāpepa squamous - ʻōpala ʻo Mohs

ʻO Ad Hoc Task Force, Connolly SM, Baker DR, et al. AAD / ACMS / ASDSA / ASMS 2012 hoʻohana kūpono kūpono no ke kahakaha micropograpical Mohs: kahi hōʻike o ka American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery Association, a me ka American Society for Mohs Surgery. ʻO J Am Acad Dermatol. 2012; 67 (4): 531-550. PMID: 22959232 www.ncbi.nlm.nih.gov/pubmed/22959232.

Pūnaewele ʻoki kino ʻo American College of Mohs. Ke kaʻina hana i kēlā me kēia kaʻina Mohs. www.skincancermohssurgery.org/about-mohs-surgery/the-mohs-step-by-step-process. Hoʻohou ʻia Malaki 2, 2017. Loaʻa ʻia iā Kēkēmapa 7, 2018.

Lam C, Vidimos AT. ʻOki kino Mohs I: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. ʻEhā ed. Piladelapia, PA: Elsevier Saunders; 2018: chap 150.