Bilateral axillary and genital Paget's disease occurred in a 77-year-old man. All three lesions were histologically confirmed. Both axillary lesions were surgically excised and the genital lesion was subjected to topical chemotherapy with 5% fluorouracil cream under occlusion. The therapy was only partially successful because the reepithelializing follicular or apocrine duct epithelium contained the Paget's cells. The remaining lesion was treated with radiation. Simultaneous occurrence of Paget's disease in more than two separate regions appears quite exceptional.
Kawatsu T, Miki Y. Triple Extramammary Paget's Disease. Arch Dermatol. 1971;104(3):316-319. doi:10.1001/archderm.1971.04000210090018