The treatment of anogenital extramammary Paget's disease as part of a multidisciplinary approach: The use of Mohs surgery moat method with CK7
- PMID: 34435670
- DOI: 10.1111/ijd.15847
The treatment of anogenital extramammary Paget's disease as part of a multidisciplinary approach: The use of Mohs surgery moat method with CK7
Abstract
Although most cases of extramammary Paget's disease (EMPD) are localized to the intraepidermal, the extensive subclinical extension can lead to high rates of marginal recurrence with wide local excisions and topically destructive treatments. Recurrence rates of EMPD treated with Mohs micrographic surgery (MMS) without immunohistochemical staining are better but variable. Here, we describe our multidisciplinary approach for treating large EMPD tumors of the anogenital region involving critical anatomy using MMS for peripheral margin clearance (moat method) and intraoperative CK7 immunostaining. Our clinical pearls for the management of anogenital EMPD are based on 53 multidisciplinary cases treated at the author's institution between 2014 and 2020.
© 2021 the International Society of Dermatology.
References
-
- Lloyd J, Flanagan AM. Mammary and Extramammary Paget's disease. J Clin Pathol 2000; 53: 742-749. https://doi.org/10.1136/jcp.53.10.742
-
- Morris CR, Hurst EA. Extramammary Paget disease: a review of the literature-part I: history, epidemiology, pathogenesis, presentation, histopathology, and diagnostic work-up. Dermatol Surg 2020; 46: 151-158. https://doi.org/10.1097/DSS.0000000000002064
-
- Morris CR, Hurst EA. Extramammary Paget's disease: a review of the literature part II: treatment and prognosis. Dermatol Surg 2020; 46: 305-311. https://doi.org/10.1097/DSS.0000000000002240
-
- Merritt BG, Degesys CA, Brodland DG. Extramammary Paget disease. Dermatol Clin 2019; 37: 261-267. https://doi.org/10.1016/j.det.2019.02.002
-
- Kim SJ, Thompson AK, Zubair AS, et al. Surgical treatment and outcomes of patients with Extramammary Paget disease: a cohort study. Dermatol Surg 2017; 43: 708-714. https://doi.org/10.1097/DSS.0000000000001051
MeSH terms
LinkOut - more resources
Full Text Sources
Research Materials