title: Primary extramammary Paget's disease with extensive skeletal metastases.
abstract: Extramammary Paget's disease (EMPD) is an uncommon malignancy that is most commonly seen in the vulval area in postmenopausal women. Pruritus is the predominant symptom. The clinical presentation can be so nonspecific that it can be misdiagnosed as an inflammatory or infective condition. We report an elderly male patient with EMPD over the pubic area, which remained asymptomatic for 5 years; he presented with severe low backache of 5 months' duration. Skin biopsy and immunohistochemistry showed the typical epidermal changes and deep dermal invasion. Positron emission tomography scan revealed involvement of regional lymph nodes as well as extensive skeletal metastases.
authors.affiliation: Department of Dermatology, Apollo Hospitals, Hyderabad, India. drreddyis@gmail.com
authors.forename: Indukooru Subrayalu
authors.initials: IS
authors.lastname: Reddy
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Swain
authors.forename: Swarnalata
authors.initials: S
authors.lastname: Gowrishankar
authors.forename: Dronamraju Butchi Narayana
authors.initials: DB
authors.lastname: Murthy
mesh_terms: D005834:Genital Neoplasms, Male; D006801:Humans; D007150:Immunohistochemistry; D016609:Neoplasms, Second Primary; D010145:Paget Disease, Extramammary; D012878:Skin Neoplasms; D014844:Vulva