Extramammary Paget's disease: what do we know and how do we treat?

Introduction: Extramammary Paget's disease (EMPD) is a rare and complex condition, for which no established guidelines exist regarding diagnosis and management. There have been recent improvements in the diagnosis and management in EMPD, largely due to an enhanced understanding of its underlying pathogenesis. Materials and methods: A literature search on PubMed including articles that describe pathogenesis, clinical diagnosis, treatment modalities, and future treatment were selected and included to build this review. Results: Recent studies would suggest the expression of HER2 and androgen receptors which could be useful targets for future treatment strategies. Carcinoembryonic antigen as a biomarker for EMPD has shown the potential to aid in the detection of metastatic EMPD and assessment of treatment response. Studies have also demonstrated the initial site of EMPD can be predictive of secondary malignancies, which helps guide initial work up and evaluation. Conclusions: Significant developments in understanding the pathogenesis of EMPD have been made, especially of the genomic aberrations associated with EMPD. This has allowed for the development and use of therapeutic options which may improve outcomes for patients with EMPD.