Peripheral Mohs micrographic surgery for the treatment of extramammary Paget's disease

Objective\r\nTo evaluate effectiveness of peripheral Mohs micrographic surgery for the treatment of extramammary Paget\u0027s disease (EMPD).\r\n\r\n\r\nMethods\r\nA total of 28 patients with EMPD were treated with peripheral Mohs micrographic surgery. The depth and extent of tumor infiltration were evaluated before the surgery. One day before the surgery, 20% aminolevulinic acid hydrochloride was topically applied to determine and label surgical margins under a Wood\u0027s lamp. After fluorescence-based localization, peritumoral skin tissues were resected and underwent frozen-section examination according to the protocol for Mohs micrographic surgery. Meanwhile, the tumor was resected. After surgery, patients were followed up every 3 - 6 months to detect local recurrence and metastasis.\r\n\r\n\r\nResults\r\nOf the 28 patients, 25 were male and 3 were female. Six patients each underwent 3 sessions of frozen-section examination, and 12 patients each received 2 sessions, with an average of 1.86 sessions for each patient. During the follow-up for 5-72 months, local recurrence occurred in 3 cases, and 1 patient died of tumor metastasis and uremia after 2 years of follow-up.\r\n\r\n\r\nConclusion\r\nPeripheral Mohs micrographic surgery is a time-saving and effective treatment for EMPD.\r\n\r\n\r\nKey words: \r\nMohs surgery; Paget disease, extramammary; Treatment outcome; Recurrence