What is paget's disease? Ask for help.

Paget's disease, also known as eczema-like cancer, is a cancer disease that mainly occurs in women's breasts and resembles eczema-like changes, and is called paget's disease of breast. But it also occurs in other skin parts besides the breast, which is called extramammary paget's disease.

diagnose

1. Clinical manifestations

(1) paget's disease of breast is common in middle-aged and elderly women, mostly in one nipple or areola and its surroundings, and it can also occur in some men.

⑵ Extramammary paget's disease mainly occurs in vulva, perianal region, umbilical region, armpit and other sweat gland distribution areas, mostly unilateral.

⑶ The skin lesions are reddish patches with clear boundaries, a small amount of exudation and yellow scab, and different degrees of itching, which is very similar to subacute eczema-like changes. However, unlike eczema, skin lesions have obvious infiltration, asymmetric distribution, clear boundaries, long-term non-healing, and corticosteroids and other drugs are ineffective.

⑷ Half of extramammary Paget's disease is accompanied by breast cancer, and a few extramammary Paget's disease may be accompanied by rectal cancer and cervical cancer.

2. Histopathology

The characteristic change is that the epidermis has Paget cells, which are large and round, without spinous process, with rich cytoplasm, light staining like vacuoles, large nucleus and filamentary division.

differential diagnosis

1. Eczema: It often occurs symmetrically with unclear boundary, and the infiltration is not as obvious as paget's disease.

2. Bowman's disease: there is no specific predilection site, which can be identified by histopathology.

treat cordially

1. Surgical treatment: Once the diagnosis is made, surgical treatment should be performed as soon as possible, unilateral mastectomy should be performed for paget's disease of breast, and radical mastectomy should be performed for those complicated with breast cancer. The excision scope of extramammary paget's disease should include the normal skin outside the lesion margin 1 ~ 2 cm, and the depth should reach the subcutaneous fat layer. The excised tissue should undergo pathological examination, and the operation should be expanded again if necessary.

2. Radiotherapy: It is generally believed that the radiotherapy effect of this disease is poor, but the skin lesion is large and it is not suitable for surgical resection. X-ray radiotherapy can be used.

prognosis

If paget's disease is complicated with breast cancer, it is easy to metastasize and the prognosis is poor.