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August 1991

Two Cases of Genital Paget's Disease With Bilateral Axillary Involvement: Mutability of Axillary Lesions

Author Affiliations

Department of Dermatology Toranomon Hospital 2-2-2 Toranomon, Minato-ku Tokyo 105, Japan

Arch Dermatol. 1991;127(8):1243. doi:10.1001/archderm.1991.01680070145029

To the Editor.—  The combination of genital and axillary Paget's disease seems to be extremely rare. We recently experienced two cases of genital Paget's disease with bilateral axillary involvement, and observed that the appearances of their axillary lesions changed daily.

Report of Cases.—Case 1.—  A 77-year-old man had itchy erythema on his penile foreskin and scrotum for about 4 years. Physical examination revealed several erythematous and depigmented macules measuring approximately 1 to 2 cm in diameter on his penis and scrotum. We also noted an ill-defined fingertip-sized irregular erythema on each axilla (Fig 1). After admission, we noticed that the clinical appearances of his axillary lesions changed daily: on our first examination the apparent erythematous lesions of his axillae became fainter and obscure.

Case 2.—  A 72-year-old man had a gradually enlarging erythema on his pubic skin for about 2 years. Physical examination revealed a 23 × 18-mm erythematous plaque on the pubic area and reticular hypopigmented macules around it. There also was an egg-sized illdefined faintly erythematous macule on each axilla (Fig 2, left). After admission, we also found that the clinical appearances of his axillary lesions changed day by day from erythematous plaques to

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