Is EMPD associated with underlying malignancies?

Yes. Some cases with a similar clinical and histologic presentation arise when an underlying gastrointestinal or genitourinary adenocarcinoma demonstrates a similar pagetoid spread of epithelial cells. Some authorities refer to those cases that arise in the epidermis without an underlying carcinoma as “primary extramammary Paget’s disease,” and those that arise from an underlying malignancy as “secondary extramammary Paget’s disease.”