The Man Behind the EMPD Name

Sir James Paget (1814–1899) was a pioneering British surgeon and pathologist whose name lives on in several important medical conditions. Born in Great Yarmouth, England, Paget trained at St Bartholomew’s Hospital in London and became one of the most respected medical figures of the 19th century. His careful observations, detailed record-keeping, and passion for teaching helped shape modern pathology—the study of disease through tissues and cells.

Over his long career, Paget described several conditions that now carry his name:

• Paget’s disease of bone – A chronic disorder where bones break down and rebuild abnormally, becoming enlarged, misshapen, and sometimes fragile. It usually affects older adults and is not cancerous, though it can cause pain and deformity.

• Paget’s abscess – A deep-seated abscess that forms in tissues long after an original infection has healed, often due to lingering bacteria.

• Paget–Schroetter syndrome – A rare type of blood clot in a large vein of the upper arm or shoulder, usually linked to repetitive arm movements.

• Paget’s disease of the nipple – A rare cancer involving the skin of the nipple and areola, often associated with underlying breast cancer.

It was his work on Paget’s disease of the nipple, first described in 1874, that would later influence the recognition of extramammary Paget’s disease (EMPD). Paget documented the symptoms, progression, and microscopic features of this breast condition, noting its frequent link to an underlying malignancy.

In 1901—nearly three decades after his discovery—British dermatologist H. Radcliffe Crocker described a very similar condition affecting areas of the body rich in apocrine glands, such as the vulva, scrotum, penis, and perianal region. Although these cases occurred outside the breast, they looked identical under the microscope to the nipple disease Paget had described. This new condition was named extramammary Paget’s disease in his honor.

Sir James Paget never personally identified extramammary Paget’s disease (EMPD), but his earlier work made it possible to recognize it. The naming of EMPD reflects how one medical discovery can spark another—sometimes long after the original researcher’s lifetime.

Beyond his eponymous diseases, Paget was a reformer in medical education, advocating for high scientific standards and combining clinical practice with pathology. His influence extended to generations of doctors, and his insistence on looking at disease both through the patient’s symptoms and the microscope remains central to medicine today.

For those living with EMPD now, the connection to Sir James Paget is a reminder that our understanding of rare diseases is built on the dedication of those who came before—and that ongoing awareness, research, and advocacy are the next steps in that legacy.

Not to Be Confused: EMPD vs. Paget’s Disease of Bone

Extramammary Paget’s disease (EMPD) and Paget’s disease of bone are entirely different conditions. EMPD is a rare skin cancer that typically occurs in areas with apocrine glands, such as the vulva, scrotum, or perianal region. Paget’s disease of bone, on the other hand, is a chronic bone disorder that affects how bone tissue is replaced and remodeled. They share a name because both were first described by Sir James Paget, but they affect completely different parts of the body and have no direct medical connection.

Image Credits:

• The image of Henry Radcliffe Crocker, used on this page, is in the public domain, sourced from Wikimedia Commons, and has been cropped.

• The image of Sir James Paget, used on this page and on the t-shirt, are licensed under the Creative Commons Attribution 4.0 International License, sourced from Wikimedia Commons, and have been cropped.