We herein report two cases of unilateral axillary Paget's disease. Extramammary Paget's disease commonly occurs in the anogenital area. Unilateral axillary occurrence is relatively rare. One defect was reconstructed with a pedicled scapular flap, and the other was reconstructed with split‐skin graft after excision of the tumor. No recurrence was seen in either patient three years postoperatively. However, although the patient who had been reconstructed with a pedicled flap recovered uneventfully, the other patient, who had been reconstructed with a split‐skin graft, suffered from axillary contracture due to the shrinkage of the grafted skin after surgery. A skin graft requires fixation for a long period to prevent shrinkage, which causes axillary contracture. Therefore, from the viewpoint of quality of life, reconstruction using flaps is recommended for axillary lesions.
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