Vulvar Paget's disease and sweat gland carcinoma--report of a case and review of the literature.

A report of a 79-year-old woman with vulvar Paget's disease and underlying sweat gland carcinoma is given. Itching and oozing are the major symptoms. The clinical manifestations are diffuse erythematous, thickened and irregular scaling vulvar skin lesions that are similar to eczematous change. The Paget's cells appear large and round with abundant cytoplasm stained faintly with hematoxylin and eosin in the acanthotic epidermis. Wide local excision and reconstruction with myocutaneous gracilis flaps were carried out. No local recurrence was found after 1 year of follow-up. Skinning vulvectomy should be excluded as an option for treatment, as Paget's cells or underlying malignancy may exist in the adnexal structures of the skin which may be located in the subcutaneous tissue.