Extramammary Paget’s Disease Concurrent with Basal Cell Carcinoma in a Filipino Female Patient

Abstract

We present a rare case of a 71-year-old Filipino female with the presence of two skin cancers occurring synchronously in two different regions of the body. The patient noted symmetrical, erythematous, pruritic, eczematous patches and plaques on her inguinal areas that are unresponsive to topical medication 5 years before consultation. The patient also had a 2-year history of multiple pigmented papules and plaques on the head and sternal area associated with occasional bleeding. Skin examination showed symmetrical, irregularly shaped, bright red moist plaques with finger-like projections on the vulva, inguinal areas, and intergluteal areas. The patient also had multiple pigmented papules and plaques with rolled borders located on the right forehead, lateral canthus of the left eye, right cheek, left jaw, and sternal area. Skin punch biopsy was done on the vulvar skin and signed out as extramammary Paget’s disease with positive immunohistochemical stain for Cytokeratin-7. A skin punch biopsy on the pigmented plaque on the right forehead was signed out as nodular and pigmented basal cell carcinoma. We speculate that the two tumors in our patient may have developed independently with no causal relationship, but we are attributing the occurrence of the patient’s carcinomas to her old age, prolonged sun exposure, and immunosuppression due to underlying comorbidities. This case is uncommon among Filipinos and highlights the value of pursuing further evaluations on chronic eczematous skin lesions that are unresponsive to medications in elderly individuals.