Extramammary Paget’s disease (EMPD) is a rare neoplasm that usually develops in apocrine gland-bearing areas, such as the vulva, scrotum, and penis. EMPD may present with a focal, multifocal, or an ectopic lesion. Clinically, EMPD lesions often exhibit infiltrative erythema, which is sometimes similar to other skin disorders such as eczema. While primary EMPD arises as intraepithelial neoplasm of the epidermis, EMPD-like lesions may occur from epidermotropic spread of malignant cells or direct extension from an underlying internal neoplasm, known as secondary EMPD. Because treatment strategies differ for primary EMPD and secondary EMPD, accurate diagnosis based on detailed histopathological evaluation is required. In the early stages, EMPD usually shows indolent growth, and most cases are diagnosed as carcinoma in situ. However, invasive lesions may result in metastases, and deep invasion is associated with high incidence of metastases. Conventional chemotherapies have been used for EMPD treatment in patients with distant metastases, but the efficacy is not satisfactory, and the prognosis for such patients remains poor. Recent studies have provided various insights into the molecular pathogenesis of the development and advancement of EMPD, which may lead to novel treatment approaches for metastatic EMPD. This review addresses the diagnosis, pathogenesis, and treatment of EMPD with focus on recent progress in understanding this disease.

Surgical-site infection (SSI) is one of the major postoperative complications in surgery. Although the rate of SSI in dermatological surgery is regarded as low, it may cause significant morbidity such as ruptured suture or skin necrosis. 1 Dermatological surgeries for skin tumors involve various tumor types, surgical methods, and surgical sites, and these factors differ in each case. However, factors associated with SSI in dermatological surgery are not fully elucidated.Moreover, there are currently no standards for perioperative antibiotic use in dermatological surgery for skin tumors. Therefore, we retrospectively investigated 512 patients who underwent outpatient surgery for skin tumors to analyze factors associated with postoperative SSI.

Cutaneous angiosarcoma (CAS) is a rare and highly aggressive type of vascular tumor. Although chemoradiotherapy with taxanes is recognized as a first‐line therapy for CAS, second‐line therapy for CAS remains controversial. From the above findings, the efficacy and safety profiles of taxane‐switch (change paclitaxel to docetaxel or vise), eribulin methylate, and pazopanib regimens in second‐line chemotherapy were evaluated retrospectively in 50 Japanese taxane‐resistant CAS patients. Although there was no significant difference in progression‐free survival (P = 0.3528) among the regimens, the incidence of all adverse events (AEs) (P = 0.0386), as well as severe G3 or more AEs (P = 0.0477) was significantly higher in the eribulin methylate group and pazopanib group than in the taxane‐switch group. The present data suggest that switching to another taxane should be considered for the treatment of taxane‐resistant CAS in second‐line therapy based on the safety profiles.

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Several studies have demonstrated the usefulness of negative pressure closure (NPC) for the stabilization of skin grafts because it provides a uniform pressure to the graft.The results of our previous retrospective study also suggested the superiority of NPC over tie-over methods for the stabilization of split-thickness skin graft (STSG) in large or muscle-exposing defects. However, the usefulness of NPC for graft stabilization is yet to be fully established. This prospective, phase II clinical study was conducted to investigate the safety and efficacy of NPC for the stabilization of STSG in large or muscle-exposing defects. Patients who would require STSG for reconstruction of defects in the trunk and extremities other than hands and feet measuring >10 cm in the longest diameter or with muscle exposure were enrolled. NPC was applied for skin graft stabilization. Seven patients who had received wide excision of malignant tumors and resulted in muscleexposed skin defects were included. All patients underwent meshed STSG. The mean size of the defect was 94.5 cm 2 (range 63.6-164.9). The mean time from the skin graft harvesting to the NPC stabilization was 15.6 min (range 10.7-19.5). The mean survival rate of the skin graft at postoperative day 7 and 10 was 98.7% (range 97-100) and 96.5% (range 89.4-98.4), respectively. No adverse events associated with the procedure were observed. This prospective study provided further evidence of the safety and efficacy of NPC for STSG stabilization in patients with large or muscle-exposing skin defects.