A 67-year-old gentleman entered the clinic and closed the door. 5 years ago, he had itchy skin and some red spots on the root of his penis near his right scrotum, which he was ashamed to talk about because of its special location. The actual fact is that you can find a lot of people who are not able to get a good deal on this. This time, because he had run out of his original prostate enlargement medication, he went to the urology department to fill his prescription, but the hot weather caused itching in the scrotum of his penis, so he wanted to be given some anti-itch medication at the same time. At the time of the consultation, my first instinct was to tell me that I could not treat this as simple eczema and that I needed to rule out Paget’s disease (Paget, or what is called eczema-like carcinoma outside the breast). The old man underwent a biopsy and the pathology report 1 week later was as I expected: Paget’s disease. Paget, a skin tumor often mistaken for eczema What is Paget’s disease? It is actually a skin tumor with the formal academic name “Paget’s disease of the breast”, and the early symptoms are similar to eczema dermatitis, so it is also called “eczema-like carcinoma of the breast”. The disease often occurs in areas rich in sweat glands, such as the scrotum of the penis in the perineum and the perianal area and the mons pubis and labia majora and minora of women, and in a few cases in the armpits. The onset of the disease is common in men over 50 years of age, but it can also occur in women. The lesions start as single, well-defined red lesions with oozing, crusting or flaking on the surface, and gradually expand and infiltrate the surrounding area, or even develop ulcers on the surface and become pruritic. The etiology of the disease is unclear and is generally divided into primary and secondary, with secondary often arising from superficial manifestations of deep-seated tumors, such as prostate, bladder, rectal or cervical cancers. The disease is often mistaken for “dermatitis or eczema” at the beginning, and many patients think it is not a big deal, because the lesions are mostly located in “private” parts, so they are too shy to go to the hospital, but buy some topical creams to apply on their own, and sometimes the symptoms can be relieved. Sometimes the symptoms can be relieved. But in fact, this not only conceals the disease, but also delays the treatment, and even leads to the bad consequences of tumor metastasis. Therefore, this disease has become an invisible “killer” of middle-aged and elderly people. However, we should not talk about “cancer”, as long as it is treated correctly and timely, Paget’s disease can be completely cured without chemotherapy. If surgery is not suitable, i.e. contraindicated, photodynamic therapy or radiotherapy can be considered. The key to treatment is whether the tumor can be removed cleanly, thus reducing the recurrence rate of the tumor. This requires adequate knowledge of the tumor and effective plastic repair of the local wound after resection. When the tumor is small, excision and repair are relatively simple, but once the skin tumor expands, it requires the surgeon to be able to effectively excise the tumor lesion and at the same time effectively repair the wound with minimal trauma, such as applying various flap techniques or skin grafting. In addition, post-surgery follow-up is also very important, as it aims to provide early treatment in case of abnormalities. As for the follow-up time, it also depends on the depth of tumor infiltration. The deeper the tumor invasion is, the shorter the follow-up interval can be, for example, once in 2-3 months, and once in half a year if there is no recurrence after 1 year. Finally, we remind middle-aged and elderly friends that if skin lesions like eczema-like changes such as erythema, papules, blisters and oozing appear in the perineum and perianal area, please do not think it is eczema or be embarrassed, but go to the hospital in time, do not make the diagnosis of eczema easily, and perform skin histopathological biopsy if necessary to exclude the possibility of Paget’s disease. Through timely and appropriate treatment, it is entirely possible to cure and also make your senior life happier and healthier.