CD4 and extramammary Paget disease: A previous study demonstrated that the number of CD4+ cells and CD8+ cells as well as the CD8+/FoxP3+ ratio were significantly decreased in the epidermis of vulvar EMPD compared with healthy controls, whereas the stromal compartment was highly infiltrated by various immune cells, including T cells and myeloid cells, suggesting immunocompromised environment in the epidermis of EMPD lesions [65].