News
Occasionally a news story, blog or feature is written about extramammary Paget's disease (EMPD). EMPD articles appear here.
Even though I was not a stranger to chronic illness, cancer was a whole different ballgame.
It all started with some itching. I thought I had a rash that was transient, and I couldn’t make an appointment quick enough to catch it because it would be gone in a day or two. My 2023 well-woman visit finally lined up to a day I had the issue occurring. I mentioned to my gynecologist that I had felt some itching off and on for a few months, and that I was itching that day.
Extramammary Paget's Disease (EMPD) is a rare malignancy of the skin, primarily affecting the genital and perianal regions in older adults, often linked to underlying internal malignancies. Recent advancements in research emphasize improved diagnostic methods, including multiple biopsies and immunohistochemical markers like TRPS1, which aid in distinguishing EMPD from similar conditions. Evidence-based clinical guidelines recommend surgical resection, particularly Mohs micrographic surgery (MMS), as the preferred treatment due to its lower recurrence rates compared to wide local excision (WLE). Non-invasive EMPD may benefit from therapies like imiquimod, a topical immune response modifier, which has shown promise in achieving remission despite side effects such as fatigue and headaches. These developments underscore the importance of personalized treatment strategies and ongoing evaluation of patient outcomes to improve the management of EMPD.
The Extramammary Paget’s disease (EMPD) was associated with underlying internal adenocarcinoma, known as secondary EMPD, though differences by an anatomic subtype and screening implications remained unclear.
Researchers conducted a retrospective study to determine the rates of secondary EMPD and the types of adenocarcinomas associated with EMPD anatomic subtype and to propose a screening algorithm for underlying the adenocarcinoma.
Investigators concluded that screening for underlying the adenocarcinoma in EMPD should be guided by an anatomic location.
Barry Humphries fought a secret battle with inoperable cancer for years before his death last week.
The Australian actor and comic, known for his alter ego Dame Edna Everage, died aged 89 on April 22 following complications from a recent hip replacement surgery.
“Close family sources” confirmed to the The Saturday Telegraph he had been diagnosed with Extramammary Paget’s disease, a rare form of skin cancer, in 2021 after noticing “something unusual” on one of his testicles when he was in the shower.
Genital extramammary Paget disease (gEMPD) is a rare skin cancer that affects the genital area. Surgery is the standard treatment for gEMPD. For a study, researchers sought to investigate whether the treatment and outcomes of gEMPD differ by sex and US region. The researchers found that women were more frequently offered total skinning procedures for gEMPD, while men were more frequently offered MMS.
For a study, researchers sought to assess the local recurrence rates and patient-reported outcomes when extramammary Paget’s disease (EMPD) is treated with Mohs micrographic surgery with cytokeratin-7 immunostains (MMS-CK7).
In-depth internal malignancy screening, low local recurrence rates, and high patient satisfaction were all characteristics of interdisciplinary teams that successfully treat EMPD.
After noticing “something weird” in the shower, Barry Humphries was diagnosed with a rare malignancy.
After detecting something weird with his testicles in the shower, BARRY HUMPHRIES realized he had a rare form of skin cancer.
Barry Humphries, better known as Dame Edna Everage, has revealed that he was diagnosed with Paget’s Disease, a type of skin cancer. Following the finding, the Australian actor revealed that he had surgery.
In 2013, Sandy Fontan was a 53-year-old marathon runner in tip-top shape. She maintained a healthy diet and ran between 25 and 30 miles a week. Then, one day, she noticed a little bump on her anus. It didn’t hurt or bleed, so she thought it was a hemorrhoid. She watched it for more than a year before mentioning it to her gynecologist.
Today, Sandy wishes she’d mentioned it sooner. Because that little bump turned out to be something more serious: an extremely rare type of cancer called extra-mammary Paget’s disease, which usually appears on the skin of the breast.
Researchers from the University of California, Irvine, in collaboration with their colleagues from Beijing, China, have gained new insights into the development of poorly understood malignant skin cancers collectively known as Paget's disease. The team identified new biomarker genes that highly correlate with Paget's disease. The group then used a Food and Drug Administration (FDA) approved drug to target one of the newly identified molecular features of Paget's disease, leading to prominently improved clinical symptoms in a small cohort of Chinese patients. Their results have been published online in Cell Research.
I always include extramammary Paget disease (EMPD) and Bowen disease in my differential diagnosis of anogenital rashes for fear of missing them. It is good form to biopsy such lesions should they not respond to standard therapies for the more likely diagnoses in this region (tinea, Candida, seborrheic dermatitis, or psoriasis). Even with this prudent approach, I have diagnosed EMPD only a few times in four decades of practice.
Up until the late spring of 2019, I figured that for a relatively old codger, I was in pretty good health.
I took no medications, my blood pressure and weight were fine, I very seldom had a cold and hadn’t had the flu in many years.
But as an example of how one’s health can take an unexpected turn, I developed a groin rash (the crude term is “jock itch”) that defied the prescription cream that my doctor, Joseph Zeno, seemed to believe would cure the problem.
After some months of using this cream during which I also experienced a general feeling of malaise, Dr. Zeno said, “We have to get to the bottom of this… I’m going to send you to a dermatologist.”
Stephen Schroeder figured he had little to lose, his growing sense of desperation fueled by the loneliness of his unusual diagnosis.
For more than two years, Schroeder had been coping with an extremely rare, invasive cancer called extramammary Paget’s disease (EMPD), which had invaded his scrotum, requiring multiple surgeries. Women account for roughly half of EMPD cases; the cancer, often misdiagnosed as eczema or contact dermatitis, attacks the sweat-producing apocrine glands, including those in the genital and anal areas.
The slow-growing cancer, which in men is frequently misdiagnosed as “jock itch” — slang for a fungal infection — can be fatal. And while treatment is often grueling, for Schroeder the worst part was his sense of isolation: He had never spoken to anyone who shared his diagnosis.
But in time Schroeder would engineer a solution to his isolation, reaping its benefits by connecting with others in similar circumstances. The richness of that experience, he said, has exceeded anything he could have imagined.
台灣一名壯年男子出現胯下痕癢，但由於患處位於生殖器附近，男子怕尷尬不敢求醫，1年後做檢查始發現患上皮膚癌，而男子因延誤治療導致癌細胞擴散，3分之1的脊椎骨被侵蝕。有臨床腫瘤科專科醫生表示，此皮膚癌病徵與濕疹相似，難靠肉眼分辨，若搽類固醇藥膏仍未有改善，宜盡快做檢查。
胯下出疹羞求醫 一年後揭患癌
據台媒報道，當地一名年約50歲男子運動後出現胯下痕癢、破皮、紅疹等症狀，但由於患處位於生殖器附近，事主因不好意思求醫遂自行擦藥膏，1年後情況未見好轉，到醫院檢查始發現患上乳房外柏哲德氏病（Extramammary Paget's Disease），但因延誤治療，汗腺細胞已突變為癌細胞，並順淋巴擴散附在器官與骨頭上，影像檢查發現有3分1脊椎骨都被侵蝕。
症狀與濕疹相似
主治的皮膚科醫生江建平表示，乳房外柏哲德氏病屬皮膚癌的一種，可分為原發型及繼發型，前者源自皮膚大汗腺細胞病變；後者則是因病患患有其他器官癌症之皮膚轉移。疾病好發於汗腺較發達部位，如腋下、胯下、生殖器肛門口周圍皮膚，外觀似濕疹、股癬，初期會出現局部搔癢、疼痛症狀，之後患處會漸漸擴大，甚至出現隆起、組織液滲出、潰瘍等狀況。若患者延誤治療，可導致淋巴結或遠端器官轉移。
Today at 3 p.m. we'll talk to a man whose pesky rash was actually a form of cancer. Watch it on Facebook Live.
Late Friday afternoon on Dec. 4, 2014, Stephen Schroeder was waiting to board his packed flight from Philadelphia to Las Vegas for a much anticipated long weekend with his son when his cellphone rang. On the line was an unexpected caller: his doctor, reporting test results sooner than Schroeder had expected.
Listening intently, Schroeder was flooded with disbelief as he struggled to comprehend what he was hearing. Using the lip of a trash can as a writing surface, he scribbled notes on the back of his boarding pass, making the doctor spell out each unfamiliar word. Then he sent a terse text to his wife, who was at their home in the Philadelphia suburbs, and got on the plane.
Onboard, Schroeder, then 55, fired up the balky in-flight Internet, desperate for information.
What he read over the next five hours left him alternately terrified, stunned and then, as denial took over, skeptical. “I kept thinking this must be some kind of really stupid mistake,” he recalled. “The diagnosis had to be wrong.”
It all started with a small purple pimple on my scrotum. I was pretty sure it was an ingrown hair, so it was easy to ignore. Then it turned into a dime-sized rash that looked and felt a lot like jock itch. I wasn’t overly concerned.
When I finally showed the rash to my family doctor, nine months later, she concurred with my self-diagnosis and suggested trying a different antifungal cream. When the rash didn’t go away I went back to my doctor and she invited one of her colleagues to also take a look. They both agreed it was jock itch but I just needed a stronger treatment. By this time the dime-sized rash had grown to the size of a quarter.
After a year, when the rash remained, I decided to ask my dermatologist to take a look. (As someone with a past history of malignant melanoma – diagnosed more than two decades ago – I visit a dermatologist annually.) The dermatologist continued down the same path of treating a fungal problem. On the second visit he decided I must have an allergic reaction from either shampoo, soap or fabric softener. After five more months of chasing the problem, I requested a biopsy.
臺北市立聯合醫院和平婦幼院區皮膚科醫師李孟穗表示，胯下癢是皮膚科門診中常見的求診症狀，常見的發作部位包括大腿內側或股溝處，或是女性私密處、男性陰囊等。
「胯下癢發作時會搔癢無比，讓人坐立難安，不抓難受，抓了又不雅觀，但由於病灶在隱私部位，不少病患不願意就醫，而選擇自行到藥局購買外用藥膏來塗抹，結果常因擦了不適當的藥膏，造成病情惡化時，才向醫師求助，」李孟穗指出。
李孟穗表示，很多皮膚病都會出現胯下癢的情形，可能是黴菌或細菌、病原蟲感染造成的，也可能因皮膚受到持續摩擦刺激，再加上衣褲包覆悶熱導致，包括：股癬、念珠菌感染、紅癬、疥瘡、陰蝨、濕疹、對磨疹或少見的乳房外柏杰氏病(Extramammary Paget’s disease, EMPD)等疾病。
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