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EMPD

Extramammary Paget’s Disease (EMPD) is a cancer that is related to the Paget’s disease of the breast, but it is found around the anus and genitals of both males and females.

HOW TO DIAGNOSE?

EMPD is slow and it may even be present for 10 - 15 years before it becomes noticed. The most common symptom of EMPD is a chronic rash that is like eczema, except that topical steroid creams are unable to treat it.

If you also find that you have

  • itching or burning sensation with pain and bleeding when scratching, 

  • thickened lesions that can become red, scaly and crusty

It is best to get a professional to check it out.

The doctor may order further tests such as ultrasound, biopsies, pap smear, colonoscopy, or a mammography to understand and confirm that diagnosis.

WHAT CAUSES IT TO OCCUR?

Its cause remains unknown. There is an approximate 1 in 4 cases of EMPD that are associated with an underlying tumour.

NEXT STEPS

If you suspect that you may have EMPD, seek medical advice from your doctor who can order diagnostic tests for you. If your diagnosis is confirmed, your doctor may refer you to either a surgical oncologist or a medical oncologist to discuss your treatment plans.

HOW CAN YOU PREVENT IT/ IS IT PREVENTABLE?

As its cause remains unknown, it is difficult to prevent. However, early detection can help to improve its prognosis.

IS IT COMMON?

It is more common in females than in males, and it usually occurs when one is between 60 to 80 years old. However, it is worth noting that there is a male predominance of EMPD that exists in Asia.

TREATMENT

Treatment for EMPD can be either a surgical intervention, or a topical therapy with medications such as radiation therapy or photodynamic therapy.

For surgeries, depending on the extent of the EMPD, Mohs micrographic surgery (MMS) , vulvectomy, or excision biopsy may be performed. 

EMPD can also come back after it has been cleared, so your doctor will also schedule regular checkups to monitor your condition.