PMC3663178_01
Clinical aspect of extensive extramammary invasive Pagetaes disease with involvement of groins scrotum and perineum
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F1
On examination we observed an extensive erythematous lesion of groins, perineum and proximal parts of scrotal skin with peripheral scaling and central oozing [Figure 1].
Surgical situs after Mohs surgery
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F2
Treatment and course: We performed complete surgical excision with delayed Mohs techniques [Figure 2].
The excised tumor
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F3
The histopathological work-up revealed a Paget carcinoma (apocrine adenocarcinoma) surrounded by intraepidermal Paget's disease [Figure 3].
Histopathology of the tumor with pagetoid cell proliferations and invasive growth (H and E, x4)
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F4
The resulting defect was closed by split-skin mesh-graft and the scrotum was partially reconstructed by extension of scrotal skin [Figure 4].
Mesh-graft split skin transplantation after induction of granulation by topical CO2
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F5
The healing was uneventful and the outcome was functionally and esthetical very good [Figure 5].