What is WIDE LOCAL EXCISION surgery?

A wide local excision (WLE) surgery is a procedure that removes diseased tissue, leaving a margin of normal tissue. WLE is sometimes used when a larger area of extramammary Paget's disease (EMPD) is located or in combination with Mohs surgery.

WLE surgery is often used in an attempt to avoid recurrence of EMPD due to insufficient margins. Since it is difficult to know how far EMPD may extend into underlying tissue, many surgeons will excise beyond visible margins in an attempt to reduce recurrence. A surgeon may also use scouting or mapping biopsies prior to surgery to help guide them. Nonetheless, recurrence with EMPD is common. Depending upon location, WLE surgery can also be associated with reconstruction surgery.

Treatments for extramammary Paget’s disease (EMPD) often differ but frequently include one or more of the following: Mohs surgery, wide local excision (WLE) surgery, topical creams, carbon dioxide (CO2) laser, photodynamic therapy (PDT), cavitational ultrasonic surgical aspiration (CUSA), radiation therapy, skin grafts, and chemotherapy.