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Related Experiment Video

Updated: May 28, 2026

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
13:35

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction

Published on: May 17, 2024

Extramammary Paget disease.

Rachael Hartman1, Julie Chu, Rishi Patel

  • 1Department of Dermatology, New York University, New York, New York, USA.

Dermatology Online Journal
|October 28, 2011
PubMed
Summary

Topical imiquimod cream offers a non-surgical option for penile-scrotal extramammary Paget disease (EMPD) when surgery has positive margins. This approach aids in tumor reduction and margin definition, addressing challenges in EMPD management.

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Last Updated: May 28, 2026

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
13:35

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction

Published on: May 17, 2024

Area of Science:

  • Dermatology
  • Oncology

Background:

  • Extramammary Paget disease (EMPD) is a rare condition affecting the skin outside the breast.
  • Penile-scrotal EMPD presents unique management challenges due to potential functional and cosmetic concerns with extensive surgery.

Observation:

  • A 60-year-old male patient with penile-scrotal EMPD had positive margins after Mohs surgery and multiple biopsies.
  • Wide local excision was avoided due to concerns about functional impairment and cosmesis.

Findings:

  • Topical 5% imiquimod cream was utilized as a cytoreductive and margin-defining treatment for penile-scrotal EMPD.
  • This non-surgical approach was chosen to manage positive surgical margins and avoid extensive excision.

Implications:

  • Topical imiquimod represents a viable alternative treatment for EMPD, particularly in sensitive areas like the genitals.
  • Thorough metastatic evaluation is crucial for penile-scrotal EMPD to rule out underlying malignancies.
  • Long-term follow-up is essential due to the high recurrence rates associated with EMPD, irrespective of treatment modality.