PMC9807350_01
Erythema of labia majora.
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An 80-year-old woman with a history of UC presented with painful erythema of the labia majora that began approximately 3 months earlier (Fig. 1).
Biopsy specimen of erythematous skin. (a) The epidermis shows intense thickening owing to the proliferation of atypical cells in Paget's disease (H&E staining, magnification: 40x). (b) Pagetoid migration of atypical epithelial cells is observed near the granular layer. Some cells have clear cytoplasm (H&E staining, magnification: 400x). (c) Immunohistochemistry using anti-CK20 antibodies reveals CK20-positive cells, indicating EMPD.
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The diagnosis was confirmed via immunostaining (CK20-positive and GCDFP-15) (Fig. 2).
Biopsy specimen of erythematous skin. (a) H&E staining reveals Paget's cells. (b) Cells are positive for CK7, indicating secondary EMPD. (c) Cells are also positive for CK20, confirming secondary EMPD. (d) Cells are positive for GATA-binding protein-3, indicating urothelial cellular features.
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Immunostaining of the vulvar specimen was positive for CK20, CK-7, and GATA-binding protein 3, suggesting EMPD secondary to UC (Fig. 3).