Eliezri Y D, Silvers D N, Horan D B
Department of Dermatology, Columbia Presbyterian Medical Center, New York, NY.
J Am Acad Dermatol. 1987 Sep;17(3):497-505. doi: 10.1016/s0190-9622(87)70236-9.
The true extent of the skin affected in extramammary Paget's disease is frequently well beyond its clinical borders. A case of extramammary Paget's disease of the scrotum was treated with Mohs micrographic surgery. Prior to surgery, 5-fluorouracil was applied topically for 10 days. This resulted in a sharply delineated, erythematous patch of biopsy-proved extramammary Paget's disease well beyond the original clinical borders. This increased the visible area of disease by 60%. Mohs micrographic surgery detected microscopic extramammary Paget's disease approximately 1 cm beyond the erythematous borders. The location of disease farthest from the margins was in the direction toward which this erythema was most advanced when the application of 5-fluorouracil was discontinued. At the time of writing, 3.5 years after treatment, the patient was free of disease. Topical 5-fluorouracil may have a role as an adjunct to surgery by highlighting subclinical areas of extramammary Paget's disease. It may also be useful postoperatively to detect early disease recurrence.
乳腺外佩吉特病累及皮肤的实际范围通常远远超出其临床边界。一例阴囊乳腺外佩吉特病患者接受了莫氏显微外科手术治疗。手术前，局部应用5-氟尿嘧啶10天。这导致了一块经活检证实的乳腺外佩吉特病的边界清晰的红斑，其范围远远超出了原来的临床边界。这使可见的病变面积增加了60%。莫氏显微外科手术在红斑边界外约1厘米处检测到了微小的乳腺外佩吉特病病变。病变距离边缘最远的位置是在停用5-氟尿嘧啶时红斑最严重的方向。在撰写本文时，治疗后3.5年，患者无疾病复发。局部应用5-氟尿嘧啶可能通过突出乳腺外佩吉特病的亚临床区域而作为手术的辅助手段。它在术后检测早期疾病复发方面可能也有用。
