title: Comparison of mohs micrographic surgery and wide excision for extramammary Paget's disease.
abstract: BACKGROUND
  Extramammary Paget's disease is a rare cutaneous adenocarcinoma that occurs in an apocrine gland distribution mainly in the anogenital region.
  
  
  OBJECTIVE
  To formulate treatment recommendations for this rare disease, we examined clinical and follow-up data of patients with it.
  
  
  METHODS
  A retrospective review is given about the treatment and outcome for 95 patients at Mayo Clinic, Rochester, Minnesota, and Scottsdale, Arizona, between 1976 and 2001. The literature regarding diagnosis and treatment of this disease is also reviewed.
  
  
  RESULTS
  Of the 95 patients, 86 had primary disease and 9 had recurrent disease. At mean follow-up (wide excision, 65 months; Mohs surgery, 24 months), disease had recurred in 18 of 83 (22%) who underwent standard wide excision, compared with recurrence in 1 of 12 (8%) who had the Mohs micrographic excision.
  
  
  CONCLUSIONS
  Mohs micrographic surgery compares favorably with wide excision. Intraoperative immunostaining with cytokeratin 7 is helpful in delineating disease, as are preoperative scouting biopsies and photodynamic diagnosis.
authors.affiliation: Department of Dermatology, Mayo Clinic, Scottsdale, Arizona Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: O'Connor
authors.forename: Katherine K
authors.initials: KK
authors.lastname: Lim
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Zalla
authors.forename: Maureen
authors.initials: M
authors.lastname: Gagnot
authors.forename: Clark C
authors.initials: CC
authors.lastname: Otley
authors.forename: Tri H
authors.initials: TH
authors.lastname: Nguyen
authors.forename: Randall K
authors.initials: RK
authors.lastname: Roenigk
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001005:Anus Neoplasms / Q000601:surgery; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D005834:Genital Neoplasms, Male / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D009364:Neoplasm Recurrence, Local; D010145:Paget Disease, Extramammary / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome