Paget's Disease of the Vulva

Very rare malignancy originating in vulvar apocrine-gland-bearing skin cells (primary disease) or as a manifestation of adjacent primary anal, rectal or bladder adenocarcinoma (secondary disease)

Aetiology

  • Usually only affects post-menopausal women

Pathophysiology

  • Tumour cells in epidermis, contain mucin

Clinical presentation

  • Crusting rash, often sharp demarcation
  • Pruritic/painful

Investigations

  • Biopsy
  • Further imaging may be used to investigate for further malignancy

Management

  • Options include surgery, photodynamic therapy, topical imiquimod, and radiotherapy