Two years living with injuries because of thinking it was just dermatitis
The Central Dermatology Hospital received and treated a number of cases of Paget's genital disease after a long period of treatment in the direction of common dermatological diseases but ineffective.
Typically, the case of a male patient over 60 years old who lived with genital damage for two years. Initially, the patient developed red papules in the scrotum, no pain, no itching, so he was not too worried. During examination at many medical facilities, the patient was diagnosed with scrotum dermatitis and used many types of oral and topical medications, but the condition did not improve.
About four months ago, the lesion began to ulcerate, secrete a lot of fluid and spread. When examined at a specialized facility, histology results determined that the patient had Paget genitals in the scrotum - base of the penis, a rare form of gland carcinoma.
Fortunately, imaging explorations showed that the lesion had not invaded the surrounding structures and had not recorded lymph node metastasis. The patient was then operated on by doctors of the Department of Plastic Surgery and Rehabilitation, Central Dermatology Hospital to remove the lesion combined with shaping the missing skin area.
Understand the disease correctly
According to Dr. Nguyen Hong Son, Head of the Department of Plastic Surgery and Rehabilitation, Central Dermatology Hospital, Breast Paget (or genital Paget) is a rare form of gland carcinoma, often appearing in areas of skin rich in sweat glands such as the scrotum, penis, vulva or around the anus.
The disease progresses slowly and initial manifestations are quite similar to common dermatological diseases such as dermatitis, eczema, fungal infections or psoriasis. Therefore, many patients undergo prolonged treatment for many months, even years before being accurately diagnosed.
The disease is common in people over 50 years old and is at risk of being missed if a biopsy is not performed when the injury is prolonged and does not respond to treatment.
To definitively diagnose Paget's genital disease, doctors will perform histology tests combined with immunohistochemistry. After that, patients may be prescribed additional tests and diagnostic imaging to assess the level of invasion as well as screen for related cancers.
Currently, the main treatment method is surgery to widen the lesions combined with plastic surgery to cover the defective skin area. This is considered a priority method with the best disease control effect.
In addition, some other methods can also be applied depending on the case.
According to experts, if the disease is still localized in the epidermis and is completely removed, the prognosis is usually good. However, when it has invaded the lymph nodes or metastasized far away, treatment will be more complicated and the prognosis will be worse.
Notably, the recurrence rate after broad-section surgery remains at 33-36%. This number can be reduced to about 16% if Mohs surgery is applied. The average recurrence time is about three years after treatment.
Dr. Nguyen Hong Son emphasized that even if treatment is successful, patients still need to have regular check-ups for many years to detect the risk of recurrence early.
Signs that should not be subjective
Doctors recommend that people should see a dermatologist or oncologist when prolonged abnormalities appear in the genitals, anus or armpits such as:
Persistent red patches, with scales or discharge;
Damage has relatively clear boundaries;
The condition lasts for over 4-6 weeks;
Treatment with conventional topical medication but no improvement;
Damage spreads over time.
In particular, if skin fungus, dermatitis or eczema have been treated for 2-4 weeks without recovery, patients need to have a biopsy to accurately determine the cause.
According to Dr. Nguyen Hong Son, early detection of Paget genital disease is of great significance in treatment, helping to reduce the risk of complications, limit invasion and metastasis, and improve the quality of life for patients.
