Paget’s disease is a slowly growing malignancy of the skin of the vulva.

Visually, Paget’s disease looks like a very bad case of vulvar Monilia. However:

• It has an asymmetrical distribution over the vulvar skin, and
• It doesn’t’ get better with conventional anti-fungal agents.
• It has an eczematoid appearance, with dry, crusty skin in some areas, but moist and weepy in other areas. Contact bleeding is significant.

The diagnosis is confirmed with a vulvar biopsy.

It is usually treated successfully with local excision.