Center for Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, NJ, USA.
Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
J Cutan Pathol. 2020 Dec;47(12):1170-1174. doi: 10.1111/cup.13804. Epub 2020 Sep 7.
Pigmented extramammary Paget disease (PEMPD) is a rare intraepithelial carcinoma which can clinically resemble other pigmented neoplasms. Similarities to melanoma on dermoscopy, histopathology, and reflectance confocal microscopy (RCM) increase the risk of misdiagnosis and, consequently, mismanagement. Here, we describe a case of a 67-year-old African American woman with a large, pigmented axillary patch that exhibited features of melanoma on RCM, guiding the clinician to perform an excisional biopsy. While traditional histopathology resembled melanoma, immunohistochemistry staining was performed and revealed PEMPD. We highlight an uncommon clinical presentation of PEMPD disease and identify morphologic mimickers of melanoma on RCM-as well as differentiating features.
色素性外阴派杰病（PEMPD）是一种罕见的上皮内癌，临床上可类似于其他色素性肿瘤。在皮肤镜检查、组织病理学和反射共聚焦显微镜（RCM）上与黑色素瘤的相似性增加了误诊的风险，进而导致治疗不当。在这里，我们描述了一例 67 岁非裔美国女性的病例，她的腋窝有一个大的色素斑，在 RCM 上表现出黑色素瘤的特征，这指导了临床医生进行切除活检。虽然传统的组织病理学类似于黑色素瘤，但进行了免疫组织化学染色，结果显示为 PEMPD。我们强调了 PEMPD 疾病的一种不常见临床表现，并确定了 RCM 上黑色素瘤的形态模拟物以及有区别的特征。
