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Extramammary Paget Disease. Presented by John T. McCarthy, MD.
A 56-year-old white woman developed pruritus and burning of the left labium majus two years ago. Culture revealed Monilia albicans, and topical therapy with Mycolog Ointment and Vioform HC cream produced partial healing.Examination revealed a 4 x 3-cm oval area of superficial erosion of the left labium majus. There was no enlargement of the inguinal or femoral nodes.Pathologic findings included a focally disrupted surface epidermis that was largely devoid of stratum corneum. Many atypical cells were noted throughout the epithelium, in some areas in nests. The cells generally had somewhat hyperchromatic nuclei and relatively pale-staining cytoplasm. PAS staining following digestion with diastase and mucicarmine stain revealed mucin within the cytoplasm of some of the cells.
Dr. D. Torre: I agree with the diagnosis. One of the problems with Paget disease is extension below the skin, and any treatment
Atkinson SC. NEW YORK DERMATOLOGICAL SOCIETY. Arch Dermatol. 1973;108(4):588. doi:10.1001/archderm.1973.01620250066032