Interesting Case Series An Important Differential: Extramammary Paget’s Disease

A 70-year-old man presented with a slow growing painless lesion on his right scrotum and base of penis for 2 years. It caused considerable irritation and discomfort and required wound dressings. He had tried numerous treatments without response. QUESTIONS 1. What are some differential diagnoses for this lesion? 2. What is the best way to diagnose this lesion? 3. Are other malignancies linked with this lesion? 4. What are the surgical and nonsurgical treatment modalities? DISCUSSION Middle-aged male patients presenting with nonspecific genital or perianal lesions often provide a diagnostic challenge. These lesions are often misdiagnosed as penoscrotal eczema, intertrigo, chronic dermatitis, tinea cruris, candida, or psoriasis. Nonresolution with active treatment should alert physicians for the need for biopsy. Extramammary Paget’s disease (EMPD) is a rare disease that is part of a spectrum of intraepithelial adenocarcinomata and accounts for 6.5 % of all cutaneous Paget’s disease.1,2 Those between the ages of 50 to 8