This article discusses the repair of a total scrotal defect that extended into the perianal area. The patient had extramammary Paget disease on the scrotum, and three stages of Mohs micrographic surgery were required to remove the tumor. To reconstruct the scrotal defect, two full-thickness skin grafts (FTSGs) were performed, while secondary intention healing was chosen for the right inguinal fold and perineum. The bilateral upper inner arms were chosen as the donor sites for the FTSGs. The article also discusses considerations for scrotal repair and alternative techniques for large scrotal defects. [Extracted from the article]