Role of preoperative topical 5-fluorouracil in preparation for Mohs micrographic surgery of extramammary Paget's disease.
The true extent of the skin affected in extramammary Paget's disease is frequently well beyond its clinical borders. A case of extramammary Paget's disease of the scrotum was treated with Mohs micrographic surgery. Prior to surgery, 5-fluorouracil was applied topically for 10 days. This resulted in a sharply delineated, erythematous patch of biopsy-proved extramammary Paget's disease well beyond the original clinical borders. This increased the visible area of disease by 60%. Mohs micrographic surgery detected microscopic extramammary Paget's disease approximately 1 cm beyond the erythematous borders. The location of disease farthest from the margins was in the direction toward which this erythema was most advanced when the application of 5-fluorouracil was discontinued. At the time of writing, 3.5 years after treatment, the patient was free of disease. Topical 5-fluorouracil may have a role as an adjunct to surgery by highlighting subclinical areas of extramammary Paget's disease. It may also be useful postoperatively to detect early disease recurrence.
Eliezri
Y D
YD
Department of Dermatology, Columbia Presbyterian Medical Center, New York, NY.
Silvers
D N
DN
Horan
D B
DB
D000368:Aged; D001706:Biopsy; D005472:Fluorouracil / Q000008:administration & dosage* / Q000627:therapeutic use; D005834:Genital Neoplasms, Male / Q000601:surgery*; D006801:Humans; D008297:Male; D010145:Paget Disease, Extramammary / Q000473:pathology / Q000601:surgery*; D011300:Preoperative Care; D012611:Scrotum; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*
D005472:Fluorouracil