Intensive Care Unit, Wesley Hospital, Brisbane, Queensland, Australia.
Australas J Dermatol. 2013 Feb;54(1):9-21. doi: 10.1111/j.1440-0960.2012.00898.x. Epub 2012 Jun 4.
Extramammary Paget's disease is a rare and unusual neoplastic entity that presents mainly on apocrine gland-bearing skin. The vulva is the most common site of involvement but any area of the anogenital skin can be affected. Due to its rarity, variable clinical course and deceptive histological appearance it has a high misdiagnosis rate and both gynaecologists and dermatologists have limited experience in its management. The significance of the disease lies in its association with underlying malignancy as well as its inherent ability to invade the dermis and metastasise. The management is notoriously complicated and recurrence rates are high despite aggressive surgeries. Several alternative modalities are being explored, with results that are often variable and unpredictable. This review summarises the histopathological, clinical and therapeutic features of extramammary Paget's disease of the vulva reported in recent years.
派杰氏病(Extramammary Paget's disease)是一种罕见且不常见的肿瘤性疾病,主要发生在顶泌汗腺分布的皮肤。外阴是最常见的受累部位,但任何会阴部皮肤区域都可能受到影响。由于其罕见性、多变的临床病程和具有欺骗性的组织学表现,它的误诊率很高,妇科医生和皮肤科医生对此病的诊治经验都有限。该疾病的重要性在于其与潜在恶性肿瘤的相关性,以及其固有侵袭真皮和转移的能力。尽管采用了积极的手术治疗,但该疾病的管理仍极具挑战性,复发率很高。目前正在探索几种替代方法,但结果往往各不相同且不可预测。本文总结了近年来报道的外阴派杰氏病的组织病理学、临床和治疗特征。