Treatment of Extramammary Paget Disease and the Role of Reflectance Confocal Microscopy: A Prospective Study

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dc.contributor.authorNavarrete-Dechent, Cristian
dc.contributor.authorAleissa, Saud
dc.contributor.authorCordova, Miguel
dc.contributor.authorHibler, Brian P.
dc.contributor.authorErlendsson, Andres M.
dc.contributor.authorPolansky, Max
dc.contributor.authorCordova, Frank
dc.contributor.authorLee, Erica H.
dc.contributor.authorBusam, Klaus J.
dc.contributor.authorHollmann, Travis
dc.contributor.authorLezcano, Cecilia
dc.contributor.authorMoy, Andrea
dc.contributor.authorPulitzer, Melissa
dc.contributor.authorLeitao, Mario M., Jr.
dc.contributor.authorRossi, Anthony M.
dc.date.accessioned2025-01-20T22:19:37Z
dc.date.available2025-01-20T22:19:37Z
dc.date.issued2021
dc.description.abstractBACKGROUND Extramammary Paget disease (EMPD) poses treatment challenges. Invasive and noninvasive treatment modalities exist with variable success reported. Reflectance confocal microscopy (RCM) is emerging as an adjuvant diagnostic tool. OBJECTIVE To evaluate the treatment of EMPD patients and the role of RCM. METHODS Prospective study. Demographic and tumor characteristics were recorded. Handheld-RCM was performed and correlated with histology. Treatment, clearance, pathology, and follow-up were all recorded. RESULTS Thirty-six EMPD lesions in 33 patients were included. Mean age was 71.7 years, and 23 were men. Mean number of surgical stages needed to clear margins was 1.9 (SD, 0.9; 1.0-3.0 stages), and mean margin needed to clear was 1.8 cm. Reflectance confocal microscopy correlated well with scouting punch biopsies (kappa, 0.93; p < .001). Disruption of the dermoepidermal junction was associated with invasive EMPD versus in situ (83.3% vs 25.9%) on histology (p = .01). Limitations Relatively small sample size. CONCLUSION Extramammary Paget disease is challenging, and lesion demarcation is of the utmost importance. Using a staged surgical excision approach, the mean margins needed were 1.8 cm, less than previously reported. Nonsurgical modalities, including radiation therapy, imiquimod, or photodynamic therapy can be considered if surgery is not pursued. Reflectance confocal microscopy is a valuable noninvasive imaging modality for the management of EMPD.
dc.fuente.origenWOS
dc.identifier.doi10.1097/DSS.0000000000002934
dc.identifier.eissn1524-4725
dc.identifier.issn1076-0512
dc.identifier.urihttps://doi.org/10.1097/DSS.0000000000002934
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/94601
dc.identifier.wosidWOS:000658825800014
dc.issue.numero4
dc.language.isoen
dc.pagina.final479
dc.pagina.inicio473
dc.revistaDermatologic surgery
dc.rightsacceso restringido
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleTreatment of Extramammary Paget Disease and the Role of Reflectance Confocal Microscopy: A Prospective Study
dc.typeartículo
dc.volumen47
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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