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[Extramammary Paget's disease interpreted as psoriasis]
M L Friis1, T Johansen, E Dahland
1Hjørring/Brønderslev Sygehus, organkirurgisk afdeling.
Ugeskrift for Laeger
|March 20, 1999
Summary
Extramammary Paget's disease (EMPD) can mimic psoriasis on the breast. This case highlights EMPD with underlying infiltrating ductal carcinoma, emphasizing the need for accurate breast cancer diagnosis.
Area of Science:
- Oncology
- Dermatology
- Pathology
Background:
- Extramammary Paget's disease (EMPD) is a rare intraepithelial adenocarcinoma.
- EMPD can present as eczematous changes on the breast, potentially mimicking other dermatological conditions.
- Psoriasis is a common inflammatory skin condition that can affect the breast area.
Observation:
- A patient with known psoriasis presented with eczematous changes on the lateral breast.
- The breast lesion was initially treated as psoriasis for three years.
- Nodular swellings beneath the eczematous area indicated an underlying malignancy.
Findings:
- Histopathological examination revealed extramammary Paget's disease (EMPD) pattern in the eczema.
- Infiltrating ductal carcinoma was identified beneath the EMPD.
- Mastectomy confirmed two foci of ductal carcinoma in situ and two foci of Paget's disease in the areola and nipple.
- No malignancy was found in the fourteen examined axillary lymph nodes.
Implications:
- This case underscores the importance of considering EMPD in breast lesions with eczematous features, even in patients with pre-existing psoriasis.
- Delayed diagnosis of EMPD can lead to advanced underlying breast cancer.
- Accurate histopathological evaluation is crucial for differentiating EMPD from benign dermatoses and guiding appropriate treatment strategies.