Sex differences in initial treatment for genital extramammary Paget disease in the United States: A systematic review.
J Am Acad Dermatol
; 88(3): 577-586, 2023 03.
Article
en En
| MEDLINE
| ID: mdl-31015011
ABSTRACT
BACKGROUND:
Surgery is the standard treatment for genital extramammary Paget disease (gEMPD).OBJECTIVE:
To determine if gEMPD treatments and outcomes differ by sex and US region.METHODS:
A systematic review was performed of all English-language studies on initial gEMPD treatment in Medline via PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov. At least 2 reviewers performed title and abstract review and data extraction. Surgical categories included total skinning procedures, partial skinning procedures, Mohs micrographic surgery (MMS), or unspecified surgery. Chi-squared tests of association were used for comparisons.RESULTS:
A total of 60 studies comprising 302 (79.7%) female and 77 (20.3%) male patients met criteria. Women were most often initially recommended partial skinning procedures. In all, 74 (24.5%) women and 0 men underwent a total skinning procedure. Men were more likely to be offered MMS than women (40.3% vs 1.9%, P < .0001), despite men having a significantly greater extent of disease involving the perineum and perianal skin (21.1% vs 1.7%, P < .0001). Treatment recommendations varied by US region.LIMITATIONS:
Only 20 states were represented.CONCLUSION:
Women are more frequently offered total skinning procedures for gEMPD while men are more frequently offered MMS. MMS offers less recurrence and morbidity than total skinning procedures and should be recommended equally to both female and male patients with gEMPD.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enfermedad de Paget Extramamaria
Tipo de estudio:
Guideline
/
Systematic_reviews
Límite:
Female
/
Humans
/
Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Am Acad Dermatol
Año:
2023
Tipo del documento:
Article