Extramammary Paget’s disease (EMPD) is a rare intraepithelial adenocarcinoma, predominantly affecting the apocrine gland-bearing skin of the genital, perineal, and perianal regions. This typically presents as a slow-growing, poorly defined, erythematous and eczematous rash, difficult to distinguish from other benign pathologies. Wide surgical excision (2-3cm margins) remains the standard of care however, achieving negative margins can prove difficult, often resulting in extensive surgical defects requiring complex reconstruction. Penoscrotal EMPD defects represent a challenge of functional and aesthetic considerations, in a region with high contamination risk.
Given the issues with previously described EMPD defect reconstructive methods, an ideal novel reconstructive method would be robust, adaptable, cosmetically appropriate, and have minimal morbidity.
Results & Methodology: We present a case of the novel application of NovoSorb® Biodegradable Temporising Matrix (BTM) for the reconstruction of a large EMPD defect. Reconstruction was achieved in two-stages. Application of the BTM synthetic dermal substitute was followed in a second stage by autologous split skin grafting.
Conclusion: BTM application in this case provided a simple yet aesthetically and functionally successful method of reconstruction following resection of a large penoscrotal and perineal EMPD lesion where alternative reconstructive methods may have been unsuccessful. BTM should be considered for use in perineal reconstruction following cancer resection.