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Vulvar Paget disease. The large cells of Paget’s disease are seen predominantly in the basal epithelium, but percolate up the epithelium in what is known as ‘Pagetoid spread’. Negative markers of melanoma, and positive markers of Paget, such as periodic acid Schiff stain with diastase (PAS-D), and breast markers such as Gata-3, are helpful in making this diagnosis (hematoxylin and eosin, x 10 magnification)
