A case of Extramammary Paget's disease with bilateral inguinal lymph node metastases showing purpuric erythema on the lower abdomen and left thigh

Abstract

A 75-year-old man visited our hospital because of bilateral inguinal lymphadenopathy and purpuric erythema on the lower abdomen. He had erythematous plaque on the scrotum. Skin biopsy revealed Paget cells in the epidermis of the scrotum and lymph duct's ectasis containing aggregated Paget cells in the lower abdomen. Radiotherapy was performed with considerable effect. Ten weeks later, however, purpuric erythema recurred on his left buttock. Following oral low-dose Etoposide therapy, the purpuric erythema regressed gradually and disappeared. The serum CEA level decreased concomitantly and normalized. Despite fairly good response to oral low dose Etoposide therapy, the patient died of the disease 16 months after the initial admission. [SkinCancer (Japan) 2002; 17: 161-165]