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Perianal Paget's disease.

D E Beck, V W Fazio

    Diseases of the Colon and Rectum
    |April 1, 1987
    PubMed
    Summary
    This summary is machine-generated.

    Perianal Paget's disease, a rare skin condition, requires biopsy for diagnosis. Wide local excision with skin grafts offers a successful treatment, achieving disease-free outcomes for patients.

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    Area of Science:

    • Dermatology
    • Surgical Oncology

    Background:

    • Perianal Paget's disease is a rare intraepithelial adenocarcinoma.
    • It often presents as a chronic, symptomatic rash, frequently misdiagnosed.
    • Diagnosis can be delayed due to non-specific symptoms like itching and moisture.

    Purpose of the Study:

    • To review treatment outcomes for patients with perianal Paget's disease.
    • To evaluate the efficacy of different surgical approaches.
    • To emphasize diagnostic and follow-up strategies.

    Main Methods:

    • Retrospective review of ten patients treated between 1974 and 1985.
    • Analysis of patient demographics, clinical presentation, and treatment modalities.
    • Comparison of outcomes based on surgical technique: local excision vs. wide local excision with skin grafts.

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    Main Results:

    • Five patients treated with wide local excision and skin grafts remain disease-free.
    • Three patients with invasive carcinoma developed metastatic disease despite aggressive therapy.
    • Two patients with local excision and minimal margins developed recurrent invasive cancers.

    Conclusions:

    • Biopsy is essential for diagnosing perianal Paget's disease due to its characteristic appearance and resistance to conventional therapy.
    • Wide local excision is an adequate and effective treatment modality.
    • Thorough initial evaluation and close follow-up are crucial for detecting associated malignancies.