About Mohs Surgery for Extramammary Paget's Disease:
EMPD’s edges are deceptive: the disease often extends well beyond the visible red patch, which is why recurrence rates after standard excision have historically been high.
At Charleston Dermatology, our surgeons use Mohs surgery to trace EMPD’s true boundaries, examining the complete margin microscopically and removing additional tissue only where disease remains. In sensitive anatomic areas, that tissue-sparing precision matters enormously.
Because a minority of EMPD cases are linked to an underlying internal cancer, screening is part of the treatment plan, and we coordinate with urology, gynecology, or colorectal colleagues when appropriate. With thorough treatment and follow-up, skin-confined EMPD is managed successfully in most patients. Schedule a consultation for a clear plan.
Frequently Asked Questions
Why is Mohs used for extramammary Paget's disease?
EMPD spreads microscopically beyond its visible borders more than almost any other skin cancer, and standard excision misses those extensions often enough that recurrence rates run high. Mohs examines the entire margin, which lowers recurrence while sparing as much normal tissue as possible in areas where that comfort and function matter.
What should I expect from EMPD surgery?
EMPD cases can require multiple Mohs stages because of the disease’s reach, so plan for a longer day — and occasionally a staged approach. Repair depends on the size and location of the final defect. Your surgeon will discuss the realistic scope, recovery, and any reconstructive coordination beforehand.
What follow-up is needed after treatment?
Lifelong periodic exams. EMPD can recur even after clear margins, so scheduled skin checks of the area continue indefinitely, along with age-appropriate screening for associated internal cancers when your diagnosis calls for it. Catching recurrence early keeps re-treatment simple.