FIGURE LEGENDS
Figure 1 . a) Clinical image at presentation: erythematosquamous plaques affecting the skin of the right labia majora and ipsilateral gluteus. b) Clinical detail: Superficial erosions on the surface of the plaques separate white hiperkeratotic areas giving the characteristic “cake-icing” or “strawberries and cream” appearance.
Figure 2 . Histopathology a) Punch skin biopsy - Hematoxylin and eosin (10x): epidermal infiltration by large atypical cells with eosinophilic, wide cytoplasm and prominent marginal nuclei, consistent with Paget’s cells, in an acanthotic epidermis. b) Punch skin biopsy - Hematoxylin and eosin (20x): Paget’s cells scattered throughout all layers of epidermis, arranged predominantly in groups. c) Immunohistochemistry CK7 stain: positive in skin Paget’s cells. d) Immunohistochemistry CK20 stain: negative in skin Paget’s cells.