Ten genital skin specimens, biopsy proven to be Paget's disease, were examined by human papillomavirus (HPV) in situ hybridization in an effort to detect DNA of HPV types 6, 11, 16, 18, 31, 33, and 35. All ten specimens showed no evidence of DNA of these HPV types. Extramammary Paget's disease is probably not a result of infection with HPV types 6,11,16,18, 31,33, or 35. Cancer 1992; 69:249-251.
Extramammary Paget's disease (EMPD) is a disease of unknown cause and usually presents as a pruritic, welldemarcated, enlarging erythematous patch. Oozing and crusting are variable features. Although the most common site of involvement is the vulva, EMPD also may affect male genitalia.' Surgical excision of the affected skin by Mohs micrographic surgery is usually the preferred treatment because it offers the best chance of complete excision with conservation of normal tissue.
The histologic picture of Paget's disease of the breast and EMPD is characterized by large, rounded cells with large nuclei and abundant pale-staining cytoplasm in the epidermis. These cells, called Paget cells, are devoid of intercellular bridges. They may appear in the epidermis as scattered single cells or may be found in groups or clusters.
In addition, EMPD differs from Paget's disease of the breast because invasion of the dermis from the overlying epidermis may occur in EMPD.' Moreover, in contrast to Paget's disease of the breast, EMPD can arise multifocally and involve normal-appearing skim3 Furthermore, Paget's disease of the breast is associated with an underlying ductal adenocarcinoma of the b r e a ~t . ~ Conversely, 24% percent of patients with