The numbers of granulysin+ cells and perforin+ cells were significantly lower in invasive EMPD than in noninvasive EMPD (granulysin: invasive EMPD versus noninvasive EMPD; 20.7 ± 8.1 versus 49.0 ± 15.9) (perforin: invasive EMPD versus noninvasive EMPD; 3.7 ± 1.2 versus 18.7 ± 4.0) (P < 0.05). This evidence concerns the gene PRF1 and extramammary Paget disease.