PMC3129957_01
Extramammary Paget's disease. (A) Before treatment. Large hyperpigmented to pink plaque extending through the pubic area and left great labia. (B) After 25 weeks of treatment. Some biopsy scars are visible but there is no residual Paget's disease.
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She presented with a large hyper-pigmented to pink plaque extending through the pubic area and left great labia (Figure 1A). At the end of 25 weeks of treatment we performed other multiple biopsies, which showed no residual disease (Figure 1B).
Histological presentation of the vulvar skin showing pleomorphic large cells, isolated or in groups, among normal keratinocytes (left). These cells stained for cytokeratin 7 (middle) and were negative for Melan-A (right), allowing the diagnosis of extramammary Pagets disease.
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Biopsy resulted in a diagnosis of Paget's disease based on hematoxylin-eosin staining and the immunohistochemical profile (negative Melan-A and positive cytokeratin 7) (Figure 2).