10.5826/dpc.1204a222
text/xml
2160-9381
2373
en
Zeinab Aryanian
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Paget’s cells
Clinicopathological and demographic characteristics of Paget disease: A 4-year study showing a male predominance in extramammary paget
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Research Letter
2022-10-31
2022-02-06
2022-10-31
2022-12-05
e2022222
Dermatol Pract Concept
Zeinab Aryanian
2022/10/31
10.5826/dpc.1204a222
e2022222
Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran  2.  Department of Dermatology, Babol University of Medical Sciences, Babol, Iran
2160-9381
Paget’s cells
en
e2022222
Elbendary A, Xue R, Valdebran M, Torres KMT, Parikh K, Elattar I, Kwon EJ, Elston DM. Diagnostic Criteria in Intraepithelial Pagetoid Neoplasms: A Histopathologic Study and Evaluation of Select Features in Paget Disease, Bowen Disease, and Melanoma In Situ. Am J Dermatopathol. 2017 Jun;39(6):419-427. doi: 10.1097/DAD.0000000000000704. PMID: 28525420
Clinicopathological and demographic characteristics of Paget disease: A 4-year study showing a male predominance in extramammary paget
https://dpcj.org/index.php/dpc/article/download/2373/1825
              Clinicopathological and Demographic
            Characteristics of Paget’s Disease: a 4-year
             Study Showing a Male Predominance in
                      Extra-mammary Paget
      Kamran Balighi1,2, Yasamin Kalantari1,2, Kambiz Kamyab Hesari3, Vahide Lajevardi2,
                             Hamidreza Kheiri2, Zeinab Aryanian1,4


1 Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
2 Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
3 Department of Dermatopathology, School of Medicine, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
4 Department of Dermatology, Babol University of Medical Sciences, Babol, Iran



Key words: paget, extramammary paget, mammary paget, Paget cells
Citation: Balighi K, Kalantari Y, Kamyab Hesari K, Lajevardi V, Kheiri H, Aryanian Z. Clinicopathological and demographic characteristics
of Paget’s disease: A 4-year study showing a male predominance in extra-mammary paget. Dermatol Pract Concept. 2022;12(4):e2022222.
DOI: https://doi.org/10.5826/dpc.1204a222
Accepted: March 31, 2022; Published: October 2022
Copyright: ©2022 Balighi et al. This is an open-access article distributed under the terms of the Creative Commons
Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted
noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Zeinab Aryanian, Assistant Professor of Dermatology, Autoimmune Bullous Diseases Research Center, Tehran
University of Medical Sciences, Tehran; Department of Dermatology, Babol University of Medical Sciences, Babol, Iran, 1445613131,
Iran. tel. 021-55630223. E-mail: z_aryanian@yahoo.com




Introduction                                                             (range 34-78) were included in our study. All patients gave
                                                                         informed consent for participating in our study. The ma-
Paget disease is a rare skin neoplasm and is categorized into            jority of our patients 26/32 (81.25%) had MPD, and 6/32
mammary (MPD) and extra-mammary (EMPD) [1,2]. To date,                   (8.75%) had EMPD. All cases had a history of scaly and
its detailed histopathological features along with patients de-          erythematous prolonged lesions. Out of the 26 MPD cases,
mographic characteristics have not been investigated in Iran.            25/26 (96.1%) were female and 1/26 (3.9%) were male.
In this study, we performed a clinic-pathological analysis of            The mean age of the MPD cases was 51.03 ± 8.80 (range
Paget cases in a single tertiary center between 2016 and 2020.           34-78). Out of the 6 EMPD cases, 5/6 (83.3%) were male
                                                                         and 1/6 (16.7%) were female. The mean age of the EMPD

Cases Presentation                                                       cases was 61.5 ± 10.98 (range 42-74). Of note, all EMPD pa-
                                                                         tients had ano-genital involvement. 2/6 (33.33%) cases had
A total of 32 cases including 26 (81.25%) females and 6                  scrotum EMPD, 1/6 (16.66%) patient had penis and scro-
(18.75%) males with the mean age of 53 ±9 .96 years                      tum EMPD, 2/6 (33.3%) had peri-anal involvements, and



Research Letter | Dermatol Pract Concept. 2022;12(4):e2022222                                                                          1
                             Table 1. The results of immunohistochemistry staining.
                               Number of patients that were assessed              Number of patients that were positive
                                  for the presence of this antigen                               N (%)
 CK7                                                6                                                6 (100%)
 CK AE1/AE3                                         6                                                6 (100%)
 S100                                               3                                              2 (66.66%)
 CEA                                                6                                               5 (83.4%)
 Melan A                                            4                                                3 (75%)
 Ki-67                                              2                                                2 (100%)
 HMB-45                                             2                                                1 (50%)


1/6 (16.66%) patient had labia major EMPD. Histopatho-               Our study confirms that MPD is more prevalent than
logical examination revealed the presence of cells with pale     EMPD. Based on our study, there is a female predominance
cytoplasm in addition to prominent nuclei along with a high      in MPD cases at younger ages in comparison to other re-
nuclei cytoplasm ratio (N/C) in all 32 cases. Moreover, 10/32    ports, and penis and scrotal involvements of EMPD are
(31.25%) had lymphocyte infiltration. IHC was performed          highly probable locations.
for 6 EMPD patients and all of them were positive for CK7
and (CK AE3/AE1) (Table 1).                                      Acknowledgment: The authors would like to thank the Au-
                                                                 toimmune Bullous Diseases Research Center, Tehran Univer-
                                                                 sity of Medical Sciences, Tehran, Iran for its technical and
Conclusions                                                      editorial assists

It is believed that Paget disease is more prevalent among
older female patients [1-5]. The peak incidence of MPD is
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