Reflectance Confocal Microscopy-Targeted Extramammary Paget Disease Before Mohs Micrographic Surgery.

In more recent years, reflectance confocal microscopy (RCM) has been used successfully to diagnose and map EMPD.[1] The standard treatment of EMPD is surgery with either wide local excision (WLE) or Mohs micrographic surgery (MMS); however, both are associated with high recurrence rates.[2] We present a case of EMPD diagnosed and mapped with the aid of RCM and subsequently treated successfully with MMS. We report a novel approach to optimize the management of EMPD, which combines RCM tumor mapping, followed by MMS. Extramammary Paget disease (EMPD) is a rare intraepithelial adenocarcinoma of pluripotent keratinocyte stem cells that typically affects the genital region. [Extracted from the article]