Case for diagnosis
An 83 year-old man with a history of total bilateral amaurosis, of unknown cause, and\nwith no other relevant known diseases, was observed for an 8 yearlong pruritic\npolycyclic erythematous plaque of the left axilla (). He had been continuously medicated with topical antifungals and steroids,\nwith disease progression. No lymphadenopathies were found. Histology of skin biopsy\nrevealed an intraepidermal proliferation of large cells with clear cytoplasm and\npleomorphic nuclei, either loosely scattered or in small nests (). Immunohistochemistry was CK7 positive and negative for\nCK20 and Melan A (). After diagnosis of\nExtramammary Paget's Disease, total excision with 2cm margins was performed, with a\nposterior brachial cutaneo-fascial flap and a graft from the right thigh. Mammography,\nbreast ultrasound and thoraco-abdomino-pelvic computerized tomography detected no\nchanges. 24 months after surgery the patient remains without evidence of local or\nunderlying internal malignancy.