Photodynamic therapy for the treatment of extramammary Paget's disease

Summary Background Surgical and ablative treatment modalities for extramammary Paget's disease (EMPD) have high recurrence rates and can be associated with significant morbidity. Objectives To evaluate photodynamic therapy (PDT) for the treatment of EMPD. Methods We conducted a retrospective re...

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Bibliographic Details
Published in:	British journal of dermatology (1951) Vol. 146; no. 6; pp. 1000 - 1005
Main Authors:	Shieh, S., Dee, A.S., Cheney, R.T., Frawley, N.P., Zeitouni, N.C., Oseroff, A.R.
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Science Ltd 01-06-2002 Blackwell Oxford University Press
Subjects:	5-aminolaevulinic acid Aged Aminolevulinic Acid - therapeutic use Biological and medical sciences Biopsy - methods Dermatology Diseases of the skin. Cosmetics extramammary Paget's disease Humans Male Medical sciences Middle Aged Paget Disease, Extramammary - drug therapy Paget Disease, Extramammary - pathology Photochemotherapy - methods photodynamic therapy Photofrin Photosensitizing Agents - therapeutic use Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Retrospective Studies Skin involvement in other diseases. Miscellaneous. General aspects Treatment Outcome Human Skin disease Apocrine gland Photodynamic therapy Treatment Paget disease Physiotherapy Retrospective
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Summary:	Summary Background Surgical and ablative treatment modalities for extramammary Paget's disease (EMPD) have high recurrence rates and can be associated with significant morbidity. Objectives To evaluate photodynamic therapy (PDT) for the treatment of EMPD. Methods We conducted a retrospective review of notes and histology of five men with anogenital, groin and axillary EMPD treated with PDT at Roswell Park Cancer Institute between 20 April 1995 and 1 February 2001. Results Sixteen EMPD lesions were treated with topical aminolaevulinic acid (ALA)‐PDT. Eleven of these lesions had failed previous Mohs micrographic surgery, excision or laser ablation. When evaluated 6 months after one treatment with ALA‐PDT, eight of 16 (50%) sites achieved a complete clinical response (CR); six of eight CRs were in lesions that had failed prior conventional therapies. Three of the eight CRs (37·5%) recurred at 9, 10 and 10 months. One patient who was partially responsive to topical ALA‐PDT subsequently received systemic Photofrin®‐PDT, with a complete clinical and histological response at 1 year. Functional and cosmetic outcome was excellent in all patients. Conclusions PDT is an effective treatment for EMPD. Recurrence rates are high with topical ALA‐PDT, but comparable with standard therapies. Topical ALA‐PDT causes little scarring and is preferred for superficial disease and mucosal surfaces. Systemic Photofrin®‐PDT may be better suited for bulky disease. While further studies are indicated, PDT is well tolerated and appears to be a useful therapy for EMPD.
Bibliography:	ArticleID:4801 istex:FA7787037E09BFD099151EA8F9A06A95FFDA8C52 ark:/67375/WNG-PQCRR49P-X ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0007-0963 1365-2133
DOI:	10.1046/j.1365-2133.2002.04801.x