text: Yo, listen up, I got a tale to share,
  'Bout perianal Paget's disease, beware!
  From '74 to '85, eleven years in the game,
  Ten patients battled, ain't it a shame?
  
  Average age, 64, half of 'em male,
  Two found it by chance, post-hemorrhoidectomy, without fail.
  The rest had a rash, itchiness and moisture,
  Two years of struggle, no time for composure.
  
  Physical exam showed lesions, so clear,
  Some erythematous, ulcers appear.
  Whitish gray patches, all around,
  One had a papillary lesion, profound.
  
  Three patients faced invasive carcinomas,
  Despite treatment, metastasis caused traumas.
  Two had excisions, with minimal margins tight,
  Four and ten years later, invasive cancers took flight.
  
  The other five were treated, wide excision in sight,
  Skin grafts applied, to bring back the light.
  As of now, they're disease-free, the battle's won,
  But this lesion's appearance ain't no fun.
  
  If you see it, don't delay, take a biopsy,
  Confirm the diagnosis, don't let it slip by.
  Wide local excision, that's the key,
  But stay vigilant, 'cause other malignancies may be.
  
  So, listen up, docs, don't be blind,
  Catch this disease, it's one of a kind.
  Give it your all, from start to end,
  And keep an eye out for the cancers that may descend.