Extramammary Paget'S Disease: In Vivo Dynamic Optical Coherence Tomography Imaging

Extramammary Paget\u0027s disease (EMPD) is a rare, slow-growing cancer related to Paget\u0027s disease of the breast, or mammary Paget\u0027s disease (MPD). EMPD most commonly affects hormonally targeted tissues, such as vulvar skin in women and scrotal skin in men. Generally, a biopsy is required to establish the diagnosis. We report a case of a EMPD of the scrotum and highlight the use of dynamic optical coherence tomography (D-OCT) as a diagnostic adjunct. A 60-year-old man presented with a three-year history of an enlarging red rash on the scrotum. The patient\u0027s medical history was unremarkable except for benign prostatic hypertrophy, and he denied any personal history of malignancy. His first symptom was itching with no reported pain or bleeding. It was initially treated as dermatitis or possible fungal infection without any improvement. On physical examination, an erythematous hypertrophic plaque with ill-defined borders was observed over the left scrotum with slight enhancement of the rugae (Figure 1).