{"id":"https://openalex.org/W7208834684","doi":"https://doi.org/10.20431/2456-0022.0902003","title":"Extramammary Paget\u2019s Disease: Current Treatment Paradigms and Future Therapeutic Directions","display_name":"Extramammary Paget\u2019s Disease: Current Treatment Paradigms and Future Therapeutic Directions","publication_year":2026,"publication_date":"2026-06-26","ids":{"openalex":"https://openalex.org/W7208834684","doi":"https://doi.org/10.20431/2456-0022.0902003"},"language":"en","primary_location":{"id":"doi:10.20431/2456-0022.0902003","doi":"https://doi.org/10.20431/2456-0022.0902003","is_oa":true,"landing_page_url":"https://doi.org/10.20431/2456-0022.0902003","pdf_url":"https://www.arcjournals.org/pdfs/ajd/v9-i2/3.pdf","source":{"id":"https://openalex.org/S4210178286","display_name":"ARC Journal of Dermatology","issn_l":"2456-0022","issn":["2456-0022"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"ARC Journal of Dermatology","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://www.arcjournals.org/pdfs/ajd/v9-i2/3.pdf","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5020422964","display_name":"Andrew Pugliese","orcid":"https://orcid.org/0009-0009-2291-3517","observed_orcids":["https://orcid.org/0009-0009-2291-3517"]},"institutions":[{"id":"https://openalex.org/I200437953","display_name":"Touro College","ror":"https://ror.org/05hwfvk38","country_code":"US","type":"education","lineage":["https://openalex.org/I200437953"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Andrew Pugliese","raw_affiliation_strings":["Touro College of Osteopathic Medicine , Middletown , NY"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Touro College of Osteopathic Medicine , Middletown , NY","institution_ids":["https://openalex.org/I200437953"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5107136787","display_name":"Grace Herrick","orcid":"https://orcid.org/0009-0009-2087-3005","observed_orcids":["https://orcid.org/0009-0009-2087-3005"]},"institutions":[{"id":"https://openalex.org/I2799524434","display_name":"Alabama College of Osteopathic Medicine","ror":"https://ror.org/02rzdts70","country_code":"US","type":"education","lineage":["https://openalex.org/I2799524434"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Grace Herrick","raw_affiliation_strings":["Alabama College of Osteopathic Medicine , Dothan , AL"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Alabama College of Osteopathic Medicine , Dothan , AL","institution_ids":["https://openalex.org/I2799524434"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5093118369","display_name":"Kelly M Frasier","orcid":"https://orcid.org/0000-0002-6808-9174","observed_orcids":["https://orcid.org/0000-0002-6808-9174"]},"institutions":[{"id":"https://openalex.org/I1302444339","display_name":"Northwell Health","ror":"https://ror.org/02bxt4m23","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1302444339"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Kelly Frasier","raw_affiliation_strings":["Department of Dermatology , Northwell Health , New Hyde Park , NY"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Dermatology , Northwell Health , New Hyde Park , NY","institution_ids":["https://openalex.org/I1302444339"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5009270681","display_name":"Paslene Pericles","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I264019182","display_name":"University of Medicine and Health Sciences","ror":"https://ror.org/01p6z3b24","country_code":"KN","type":"education","lineage":["https://openalex.org/I264019182"]}],"countries":["KN"],"is_corresponding":false,"raw_author_name":"Paslene Pericles","raw_affiliation_strings":["University of Medicine and Health Sciences , St. Kitts , West Indies 5 ,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Medicine and Health Sciences , St. Kitts , West Indies 5 ,","institution_ids":["https://openalex.org/I264019182"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5114516524","display_name":"Lana Danial","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I200437953","display_name":"Touro College","ror":"https://ror.org/05hwfvk38","country_code":"US","type":"education","lineage":["https://openalex.org/I200437953"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Lana Danial","raw_affiliation_strings":["Touro College of Osteopathic Medicine , Middletown , NY"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Touro College of Osteopathic Medicine , Middletown , NY","institution_ids":["https://openalex.org/I200437953"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5107058321","display_name":"Mary Grace Hash","orcid":"https://orcid.org/0000-0002-1675-9404","observed_orcids":["https://orcid.org/0000-0002-1675-9404"]},"institutions":[{"id":"https://openalex.org/I896114043","display_name":"Edward Via College of Osteopathic Medicine","ror":"https://ror.org/00sda2672","country_code":"US","type":"education","lineage":["https://openalex.org/I896114043"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Mary Grace Hash","raw_affiliation_strings":["Edward Via College of Osteopathic Medicine , Auburn , AL"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Edward Via College of Osteopathic Medicine , Auburn , AL","institution_ids":["https://openalex.org/I896114043"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5150322573","display_name":"Mary-Pascale Pericles","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Mary-Pascale Pericles","raw_affiliation_strings":[","],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":",","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5114415841","display_name":"Younis Sutari","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Younis Sutari","raw_affiliation_strings":["Still University School of Osteopathic Medicine , AZ"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Still University School of Osteopathic Medicine , AZ","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5073457377","display_name":"David A. Kiken","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"David Kiken","raw_affiliation_strings":["Dermatology and Skin Surgery Center , Florham Park , NJ"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Dermatology and Skin Surgery Center , Florham Park , NJ","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":5,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"9","issue":"2","first_page":"26","last_page":"34"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11868","display_name":"Cancer and Skin Lesions","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2708","display_name":"Dermatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11868","display_name":"Cancer and Skin Lesions","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2708","display_name":"Dermatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11306","display_name":"Nonmelanoma Skin Cancer Studies","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2708","display_name":"Dermatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13597","display_name":"Medicine and Dermatology Studies History","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2708","display_name":"Dermatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/extramammary-paget-s-disease","display_name":"extramammary Paget's disease","score":0.9980000257492065},{"id":"https://openalex.org/keywords/topical-therapy","display_name":"topical treatment","score":0.7260000109672546},{"id":"https://openalex.org/keywords/imiquimod","display_name":"imiquimod","score":0.9789999723434448},{"id":"https://openalex.org/keywords/5-fluorouracil","display_name":"5-fluorouracil","score":0.9990000128746033},{"id":"https://openalex.org/keywords/ingenol-mebutate","display_name":"ingenol mebutate","score":1.0},{"id":"https://openalex.org/keywords/surgical-excision","display_name":"surgical excision","score":0.9139999747276306},{"id":"https://openalex.org/keywords/recurrence","display_name":"recurrence","score":0.5130000114440918},{"id":"https://openalex.org/keywords/cosmetic-outcome","display_name":"cosmetic outcome","score":0.5879999995231628},{"id":"https://openalex.org/keywords/elderly-patients","display_name":"elderly patients","score":0.5860000252723694},{"id":"https://openalex.org/keywords/comorbidity","display_name":"comorbidities","score":0.7229999899864197}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8924999833106995},{"id":"https://openalex.org/C150875184","wikidata":"https://www.wikidata.org/wiki/Q6151549","display_name":"Apocrine","level":2,"score":0.5347999930381775},{"id":"https://openalex.org/C16005928","wikidata":"https://www.wikidata.org/wiki/Q171171","display_name":"Dermatology","level":1,"score":0.49050000309944153},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.46160000562667847},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.42570000886917114},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.35370001196861267},{"id":"https://openalex.org/C2778842199","wikidata":"https://www.wikidata.org/wiki/Q1563560","display_name":"Electrosurgery","level":2,"score":0.3499000072479248},{"id":"https://openalex.org/C3019477240","wikidata":"https://www.wikidata.org/wiki/Q1755504","display_name":"Invasive surgery","level":2,"score":0.3483000099658966},{"id":"https://openalex.org/C3020063470","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgical excision","level":2,"score":0.3416000008583069},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.33880001306533813},{"id":"https://openalex.org/C2779122609","wikidata":"https://www.wikidata.org/wiki/Q3077016","display_name":"Extramammary Paget's disease","level":3,"score":0.32600000500679016},{"id":"https://openalex.org/C2777701055","wikidata":"https://www.wikidata.org/wiki/Q1427096","display_name":"Immunotherapy","level":3,"score":0.3156999945640564},{"id":"https://openalex.org/C2780140570","wikidata":"https://www.wikidata.org/wiki/Q3545481","display_name":"Surgical oncology","level":2,"score":0.30160000920295715},{"id":"https://openalex.org/C61434518","wikidata":"https://www.wikidata.org/wiki/Q932510","display_name":"General surgery","level":1,"score":0.30079999566078186},{"id":"https://openalex.org/C2778303017","wikidata":"https://www.wikidata.org/wiki/Q7998643","display_name":"Wide local excision","level":2,"score":0.29660001397132874},{"id":"https://openalex.org/C140608501","wikidata":"https://www.wikidata.org/wiki/Q7318358","display_name":"Review article","level":2,"score":0.2948000133037567},{"id":"https://openalex.org/C8891405","wikidata":"https://www.wikidata.org/wiki/Q1059","display_name":"Immune system","level":2,"score":0.2937999963760376},{"id":"https://openalex.org/C2778384578","wikidata":"https://www.wikidata.org/wiki/Q16930687","display_name":"Therapeutic approach","level":3,"score":0.28839999437332153},{"id":"https://openalex.org/C3018634341","wikidata":"https://www.wikidata.org/wiki/Q171171","display_name":"Dermatologic surgery","level":2,"score":0.28519999980926514},{"id":"https://openalex.org/C143998085","wikidata":"https://www.wikidata.org/wiki/Q162555","display_name":"Oncology","level":1,"score":0.26579999923706055}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.20431/2456-0022.0902003","doi":"https://doi.org/10.20431/2456-0022.0902003","is_oa":true,"landing_page_url":"https://doi.org/10.20431/2456-0022.0902003","pdf_url":"https://www.arcjournals.org/pdfs/ajd/v9-i2/3.pdf","source":{"id":"https://openalex.org/S4210178286","display_name":"ARC Journal of Dermatology","issn_l":"2456-0022","issn":["2456-0022"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"ARC Journal of Dermatology","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.20431/2456-0022.0902003","doi":"https://doi.org/10.20431/2456-0022.0902003","is_oa":true,"landing_page_url":"https://doi.org/10.20431/2456-0022.0902003","pdf_url":"https://www.arcjournals.org/pdfs/ajd/v9-i2/3.pdf","source":{"id":"https://openalex.org/S4210178286","display_name":"ARC Journal of Dermatology","issn_l":"2456-0022","issn":["2456-0022"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"ARC Journal of Dermatology","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7208834684.pdf","grobid_xml":"https://content.openalex.org/works/W7208834684.grobid-xml"},"referenced_works_count":12,"referenced_works":["https://openalex.org/W1977915223","https://openalex.org/W2144692182","https://openalex.org/W2560664813","https://openalex.org/W2917112139","https://openalex.org/W3108871058","https://openalex.org/W3135538312","https://openalex.org/W3189687277","https://openalex.org/W3201010266","https://openalex.org/W4383743893","https://openalex.org/W4394015610","https://openalex.org/W4394738546","https://openalex.org/W4399870882"],"related_works":["https://openalex.org/W2060527571","https://openalex.org/W2154640697","https://openalex.org/W1901860922","https://openalex.org/W3140563213","https://openalex.org/W1801285609","https://openalex.org/W1560917585","https://openalex.org/W4415987793","https://openalex.org/W3015943862","https://openalex.org/W2316021371","https://openalex.org/W7202175044"],"abstract_inverted_index":{"Extramammary":[0],"Paget\u2019s":[1],"disease":[2],"(EMPD)":[3],"is":[4,195],"a":[5,90,143,236],"rare":[6],"cutaneous":[7],"adenocarcinoma":[8],"arising":[9],"in":[10,48,151,163,190],"apocrine":[11],"gland-bearing":[12],"areas,":[13],"such":[14,200],"as":[15,31,98,184,201,216],"the":[16,120],"perineal,":[17],"genital,":[18],"and":[19,156,174],"axillary":[20],"regions,":[21],"characterized":[22],"by":[23],"pruritic,":[24],"erythematous":[25],"plaques":[26],"that":[27,147],"can":[28],"be":[29,244],"misdiagnosed":[30],"dermatitis":[32],"or":[33,64,84,110,188,208],"fungal":[34],"infections.":[35],"Standard":[36],"treatment":[37],"involves":[38],"surgical":[39,193,212,248],"excision":[40,194],"with":[41,73,205,210],"wide":[42],"margins;":[43],"however,":[44],"EMPD":[45],"frequently":[46],"occurs":[47],"anatomically":[49],"sensitive":[50],"areas":[51],"where":[52,192],"surgery":[53,82,109],"may":[54,243],"lead":[55],"to":[56,80,112,134,180],"severe":[57],"functional":[58],"impairments,":[59],"including":[60,127,169],"incontinence,":[61],"sexual":[62],"dysfunction,":[63],"substantial":[65],"aesthetic":[66],"disfigurement.":[67],"Many":[68],"of":[69,122,239],"these":[70,220],"concerns,":[71],"coupled":[72],"potential":[74,175,217],"postoperative":[75],"morbidity,":[76],"often":[77],"prompt":[78],"patients":[79,103,209],"avoid":[81,113],"altogether":[83],"seek":[85],"less":[86],"invasive":[87],"alternatives.":[88],"As":[89],"result,":[91],"non-surgical":[92,221,241],"topical":[93,123,144],"treatments":[94,187],"are":[95,105,178,214],"gaining":[96],"interest":[97],"viable":[99],"alternatives,":[100],"particularly":[101],"for":[102,108,125,219,233],"who":[104],"either":[106],"unsuitable":[107],"wish":[111],"its":[114],"associated":[115],"complications.":[116],"This":[117,223],"review":[118],"investigates":[119],"efficacy":[121],"therapies":[124],"EMPD,":[126,234],"imiquimod,":[128],"an":[129],"immune":[130],"response":[131],"modifier":[132],"shown":[133],"enhance":[135],"local":[136],"cell-mediated":[137],"immunity":[138],"against":[139],"malignant":[140],"cells;":[141,155],"5-fluorouracil,":[142],"chemotherapeutic":[145],"agent":[146],"disrupts":[148],"DNA":[149],"synthesis":[150],"rapidly":[152],"proliferating":[153],"tumor":[154],"ingenol":[157],"mebutate,":[158],"which":[159],"induces":[160],"rapid":[161],"apoptosis":[162],"epidermal":[164],"neoplasms.":[165],"Additionally,":[166],"long-term":[167],"outcomes,":[168],"recurrence":[170],"rates,":[171],"cosmetic":[172],"results,":[173],"side":[176],"effects,":[177],"evaluated":[179],"assess":[181],"their":[182],"suitability":[183],"stand":[185],"alone":[186],"adjuncts":[189],"cases":[191],"contraindicated.":[196],"Specific":[197],"patient":[198],"populations,":[199],"elderly":[202],"individuals,":[203],"those":[204],"significant":[206],"comorbidities,":[207],"high":[211],"risk,":[213],"identified":[215],"candidates":[218],"approaches.":[222],"comprehensive":[224],"analysis":[225],"provides":[226],"critical":[227],"insights":[228],"into":[229],"expanding":[230],"therapeutic":[231],"options":[232],"offering":[235],"nuanced":[237],"understanding":[238],"when":[240],"management":[242],"preferable":[245],"over":[246],"traditional":[247],"interventions":[249]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-09-06T00:00:00"}