Summary of case history,　Patient Guo, male, 86 years old, sought medical attention on January 13, 2022 due to "scrotal skin rash and itching for more than 3 months". Three months ago, the patient developed scrotal skin erythema rash with itching without obvious inducement and was poorly treated with topical dermatoprost and erythromycin cream. After visiting Yifu Hospital of Southern Medical University and Jiangsu Provincial People's Hospital, he was diagnosed with Paget's disease. Because of the fear that surgery and radiotherapy are harmful and the effect of photodynamic therapy cannot be guaranteed, the patient gave up western medical treatment and was referred to professor He's clinic to seek Chinese medicine treatment. Mr. He used the method of clearing heat, drying dampness, cooling the blood and detoxifying the toxin to formulate a formula for treatment. The clinical efficacy is good and the patient's erythematous rash and itching gradually disappeared. Although accompanied by immune thrombocytopenia during the course of the disease, the hormone was successfully removed with the help of traditional Chinese medicine, allowing platelets to return to normal and the condition to be stable. ,TCM diagnosis, Festering sore, purpura disease, damp heat toxin injection, heat entering blood syndrome. ,Diagnosis, Extramammary Paget's disease, immune thrombocytopenia. ,Therapeutic methods, To clear heat and dry dampness, cool blood and detoxify for the treatment of the proposed prescription. ,Clinical outcomes, clinical remission.