A 100-year-old Japanese woman presented with a genital erosive skin lesion that she had noticed 3 years earlier. On physical examination, a 50 × 30-mm whitish-pink velvety lesion was observed on the right vulva (Figure 1). The indurated lesion showed a small central erosion measuring 10 × 10 mm. Inguinal lymph nodules were not palpable. A skin biopsy specimen was obtained from the center of the eroded lesion (Figure 2), and an initial diagnosis of genital Paget disease was made.
Suda T, Kakinuma H. Erosive Velvety Lesion on the Vulva—Quiz Case. Arch Dermatol. 2006;142(3):385-390. doi:10.1001/archderm.142.3.385-c