Considering the non-aggressive nature of EMPD, in that it arises in the epithelium of the skin and mucosa and remains indolent there for a long period as an in situ lesion 2, the overexpression of FOXM1 in EMPD is interesting since such overexpression is commonly related to aggressiveness in many other cancers 57–59. Here, FOXM1 is linked to extramammary Paget disease.