Abstract

A case report of a Caucasian female born in 1927 is presented in which rapid recovery from vulvar extramammary Paget’s disease (EMPD) without surgical intervention occurred following an abrupt change from fluoridated/chlorinated tap water (0.9- 1.0 mg F–/L) to low-fluoride spring and well water (both <0.1 mg F–/L) for drinking, cooking, bathing, and laundry purposes. Within weeks of switching from the tap water her condition completely cleared, with no recurrence after three years except when re-exposed to fluoridated tap water. EMPD primarily affects postmenopausal Caucasian women, but occasionally it also occurs in men. The condition presents as an itchy, rash-like condition that can be accompanied by invasive malignant changes to underlying dermal tissue, for which surgical excision of the affected region is the most common treatment. Possible reasons for recovery without surgery in this case are discussed.

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