Compression treatment of auricular pseudocyst with thermoplastic splinting (Aquaplast(®)).

357 In both cases the treatment chosen was Mohs micrographic surgery.The differential diagnosis of EMPD in the frontotem-poral area should be established with seborrheic dermatitis, nummular eczema, Bowen disease and, less frequently, with lichen-sclerosus et atrophicus and lichen simplex chroni-cus. The histological differential diagnosis should be made with other malignancies that occupy the epidermis and are characterized by cells with clear cytoplasm and patchy distribution, mainly superficial spreading melanoma and malignant lentigo, in which case the epithelial markers would be negative and the melanocytic markers (S-100, Melan-A, HMB-45, etc.) positive. P63 can be used to differentiate EMPD from the Pagetoid variant of Bowen disease. In general, EMPD is only locally aggressive. However, in cases of advanced or metastatic EMPD, 7 systemic chemotherapy is indicated. Surgery is the treatment of choice in EMPD. 2,3 However , recurrence rates are high even when the lesions are removed with wide surgical margins. Recurrence is probably due to the multifocal nature of the disease and subclinical involvement of skin that is apparently unaffected. Recurrence rates are higher in cases of invasive disease. 5,7 The use of Mohs micrographic surgery improves cure rates but does not prevent recurrence. Radiation therapy may be useful as adjuvant therapy in patients at high risk of recurrence. 5 Because EMPD has a patchy distribution and the affected area often extends beyond the clinically visible tumor, pho-todynamic therapy may be a useful treatment when there is intraepithelial involvement and surgery is high-risk or when there is a high risk of morbidity due to the anatomical location of the lesion. However, because of the small number of studies and case reports of patients treated with this technique, photodynamic therapy should only be used when other approaches are not feasible. We report the third case of EMPD affecting the face (the frontotemporal region). We call attention to the need to include this disease in the list of lesions that simulate other dermatoses and to the fact that its diagnosis requires immunohistochemical evaluation of the usual breast tumor markers. Ours is the first case treated with photodynamic therapy. The patient achieved complete temporary remission , so this treatment may be a good therapeutic option when involvement is exclusively intraepidermal and when a surgical approach is difficult. and extramammary Paget's disease: an immunohistochemical study 83 cases. Her2/neu expression in extramammary Paget disease: a clinicopathologic and immuno-histochemical study of 47 cases with and without underlying …