ArticleDermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]2021
Treatment of Extramammary Paget Disease and the Role of Reflectance Confocal Microscopy: A Prospective Study.
Article in Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Review
- Anal adenocarcinoma with perianal Paget's disease: A case report.World journal of gastrointestinal surgery · 2025Article
- Cause-specific survival of mohs micrographic surgery versus wide local excision in extramammary Paget disease: a retrospective cohort study.Archives of dermatological research · 2025Article
- Case Report: A case study of perianal paget's disease in a patient receiving adjuvant photodynamic therapy post-surgery.Frontiers in surgery · 2025Article
- Topical Imiquimod in Primary Cutaneous Extramammary Paget's Disease: A Systematic Review.Cancers · 2023Review
- In vivo reflectance confocal microscopy can detect the invasive component of lentigo maligna melanoma: Prospective analysis and case-control study.Journal of the European Academy of Dermatology and Venereology : JEADV · 2023Article
- Case report: The application of neoadjuvant chemoradiotherapy in anal adenocarcinoma combined with perianal Paget disease involving vulvar skin.Frontiers in oncology · 2023Article
- Network meta-analysis of treatments for perineal extramammary paget's disease: Focusing on performance of recurrence prevention.PloS one · 2023Article
- Nomograms for predicting the prognosis of patients with penoscrotal extramammary Paget's disease: A retrospective study in the SEER database and two medical centers.Frontiers in oncology · 2022Article
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Abstract
backgroundExtramammary Paget disease (EMPD) poses treatment challenges. Invasive and noninvasive treatment modalities exist with variable success reported. Reflectance confocal microscopy (RCM) is emerging as an adjuvant diagnostic tool.
objectiveTo evaluate the treatment of EMPD patients and the role of RCM.
methodsProspective study. Demographic and tumor characteristics were recorded. Handheld-RCM was performed and correlated with histology. Treatment, clearance, pathology, and follow-up were all recorded.
resultsThirty-six EMPD lesions in 33 patients were included. Mean age was 71.7 years, and 23 were men. Mean number of surgical stages needed to clear margins was 1.9 (SD, 0.9; 1.0-3.0 stages), and mean margin needed to clear was 1.8 cm. Reflectance confocal microscopy correlated well with scouting punch biopsies (kappa, 0.93; p < .001). Disruption of the dermoepidermal junction was associated with invasive EMPD versus in situ (83.3% vs 25.9%) on histology (p = .01). LIMITATIONS: Relatively small sample size.
conclusionExtramammary Paget disease is challenging, and lesion demarcation is of the utmost importance. Using a staged surgical excision approach, the mean margins needed were 1.8 cm, less than previously reported. Nonsurgical modalities, including radiation therapy, imiquimod, or photodynamic therapy can be considered if surgery is not pursued. Reflectance confocal microscopy is a valuable noninvasive imaging modality for the management of EMPD.
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