Extramammary Paget's disease of the unilateral axilla: a review of seven cases in a 20-year experience.
BACKGROUND
Extramammary Paget's disease (EMPD) is an uncommon malignancy that occurs on apocrine-rich skin. EMPD of the axillary region is extremely rare and is not well documented. Objectives  The aim of the study is to review our experience with axillary EMPD with regard to initial examination, treatment, and long-term outcome.


METHODS
A retrospective study of inpatient files with the diagnosis of axillary EMPD was made. The data were collected regarding patient demographics, symptoms, surgical treatments, and time to recurrence. Follow-up information was obtained as well.


RESULTS
Seven patients with a median age of 67.6 years were diagnosed with axillary EMPD during a 20-year period from 1989 to 2008. The male-female ratio was 1 : 1.3. All patients had a unilateral axillary occurrence, with three in the left and four in the right side. Patients typically presented with a chronic erythematous to brownish plaque with or without pruritus. All patients were treated with wide excision with margins up to 2-3 cm. There were no recurrences after surgery during the follow-up period.


CONCLUSIONS
Extramammary Paget's disease of the axillary region is a rare finding even in a large medical center. The disease process is generally a prolonged one without remarkable symptoms. The prognosis of axillary EMPD is relatively good, and long-term follow-up is recommended.
Department of Dermatology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Cheng-Sheng
CS
Chiu
Chih-Hsun
CH
Yang
Chien-Hsun
CH
Chen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D010145:Paget Disease, Extramammary / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome