Successful treatment of three cases of primary extramammary Paget's disease of the vulva with Imiquimod--proposal of a therapeutic schedule

J Eur Acad Dermatol Venereol. 2010 Apr;24(4):490-2. doi: 10.1111/j.1468-3083.2009.03451.x. Epub 2009 Oct 15.

Abstract

Background/aim: Extramammary Paget's disease (EMPD) is an intraepidermal adenocarcinoma of apocrine gland-bearing skin. Although surgery remains the mainstay of treatment, loss of tissue function and high recurrence rates have been reported. Recently, topical Imiquimod has been shown as a safe and effective treatment option for extramammary Paget's disease.

Methods: Three patients diagnosed of EMPD of the vulva were treated with a daily application of 5% Imiquimod cream for three weeks, followed by an every other day application for an additional three weeks.

Results: Complete clinical and histological remission of the disease was achieved in the three patients. Mild irritation and tenderness were observed as the only side effects.

Conclusion: Based on our results, we consider that Imiquimod cream is a safe and effective therapeutic option for the treatment of vulvar EMPD. These promising results warrant further studies to determine the real efficacy and safety of Imiquimod 5% cream for the treatment of this uncommon disease.

Publication types

  • Case Reports

MeSH terms

  • Administration, Topical
  • Aged
  • Aged, 80 and over
  • Aminoquinolines / administration & dosage*
  • Aminoquinolines / adverse effects
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Agents / adverse effects
  • Drug Administration Schedule
  • Female
  • Humans
  • Imiquimod
  • Middle Aged
  • Paget Disease, Extramammary / drug therapy*
  • Remission Induction
  • Skin Neoplasms / drug therapy*
  • Vulvar Neoplasms / drug therapy*

Substances

  • Aminoquinolines
  • Antineoplastic Agents
  • Imiquimod