Chronic macerated plaques over the genitalia in an elderly female: A diagnostic challenge

Extramammary Paget's disease (EMPD) is a rare dermatosis occurring in sites rich in apocrine glands, such as the vulva, anogenital region, and axilla. It can be subdivided into primary and secondary disease. An 84-year-old female presented with itchy, whitish, oozy raised lesions over the genit...

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Main Authors: S Suvarna, Jacintha Martis, B Nandakishore, Ganesh H Kamath, Reshma G Kini
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2017-01-01
Series:Clinical Dermatology Review
Subjects:
Online Access:http://www.cdriadvlkn.org/article.asp?issn=2542-551X;year=2017;volume=1;issue=2;spage=73;epage=75;aulast=Suvarna
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author S Suvarna
Jacintha Martis
B Nandakishore
Ganesh H Kamath
Reshma G Kini
author_facet S Suvarna
Jacintha Martis
B Nandakishore
Ganesh H Kamath
Reshma G Kini
author_sort S Suvarna
collection DOAJ
description Extramammary Paget's disease (EMPD) is a rare dermatosis occurring in sites rich in apocrine glands, such as the vulva, anogenital region, and axilla. It can be subdivided into primary and secondary disease. An 84-year-old female presented with itchy, whitish, oozy raised lesions over the genitalia and groin since 2 years, associated with burning sensation. Examination revealed erythema, maceration and white oozy plaques over bilateral groin folds, perineum, and labia majora. She was treated as candidal intertrigo with secondary infection, with antibiotics and antifungals with minimal improvement. Routine blood investigations were within normal limits. Skin biopsy done from the vulva showed Paget cells in the lower two-thirds of the epidermis. She was diagnosed to have EMPD and referred to the oncosurgeon for further management. We present this case due to the rarity of its occurrence and to emphasize the high index of clinical suspicion required for chronic, macerated, erythematous plaques over the perineum, which do not respond to conventional treatment, in an elderly patient.
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spelling doaj.art-e2db4b0ce7d1461599d6a9fcc1a16c3a2022-12-21T22:30:43ZengWolters Kluwer Medknow PublicationsClinical Dermatology Review2542-551X2542-55282017-01-0112737510.4103/CDR.CDR_7_17Chronic macerated plaques over the genitalia in an elderly female: A diagnostic challengeS SuvarnaJacintha MartisB NandakishoreGanesh H KamathReshma G KiniExtramammary Paget's disease (EMPD) is a rare dermatosis occurring in sites rich in apocrine glands, such as the vulva, anogenital region, and axilla. It can be subdivided into primary and secondary disease. An 84-year-old female presented with itchy, whitish, oozy raised lesions over the genitalia and groin since 2 years, associated with burning sensation. Examination revealed erythema, maceration and white oozy plaques over bilateral groin folds, perineum, and labia majora. She was treated as candidal intertrigo with secondary infection, with antibiotics and antifungals with minimal improvement. Routine blood investigations were within normal limits. Skin biopsy done from the vulva showed Paget cells in the lower two-thirds of the epidermis. She was diagnosed to have EMPD and referred to the oncosurgeon for further management. We present this case due to the rarity of its occurrence and to emphasize the high index of clinical suspicion required for chronic, macerated, erythematous plaques over the perineum, which do not respond to conventional treatment, in an elderly patient.http://www.cdriadvlkn.org/article.asp?issn=2542-551X;year=2017;volume=1;issue=2;spage=73;epage=75;aulast=Suvarnaextramammarypaget'svulva
spellingShingle S Suvarna
Jacintha Martis
B Nandakishore
Ganesh H Kamath
Reshma G Kini
Chronic macerated plaques over the genitalia in an elderly female: A diagnostic challenge
Clinical Dermatology Review
extramammary
paget's
vulva
title Chronic macerated plaques over the genitalia in an elderly female: A diagnostic challenge
title_full Chronic macerated plaques over the genitalia in an elderly female: A diagnostic challenge
title_fullStr Chronic macerated plaques over the genitalia in an elderly female: A diagnostic challenge
title_full_unstemmed Chronic macerated plaques over the genitalia in an elderly female: A diagnostic challenge
title_short Chronic macerated plaques over the genitalia in an elderly female: A diagnostic challenge
title_sort chronic macerated plaques over the genitalia in an elderly female a diagnostic challenge
topic extramammary
paget's
vulva
url http://www.cdriadvlkn.org/article.asp?issn=2542-551X;year=2017;volume=1;issue=2;spage=73;epage=75;aulast=Suvarna
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AT bnandakishore chronicmaceratedplaquesoverthegenitaliainanelderlyfemaleadiagnosticchallenge
AT ganeshhkamath chronicmaceratedplaquesoverthegenitaliainanelderlyfemaleadiagnosticchallenge
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