title: 5-Aminolevulinic acid-based photodynamic therapy for the treatment of two patients with extramammary Paget's disease.
abstract: Photodynamic therapy (PDT), which employs a combination of a tumor-localizing photosensitizer and visible light, has been used in the treatment of extramammary Paget's disease (EMPD). Two patients with EMPD were treated with PDT using 5-aminolevulinic acid (ALA). Histologically, in both cases, Paget's cells were present within the epidermis. Case 1 was a 92-year-old male who underwent total extirpation for treatment of EMPD. Two topical ALA-PDT treatments were applied to parts of the lesions at a total dose of 200J/cm2. Case 2 was a 73-year-old female, whose lesions in the right labia majora were treated with 3 topical ALA-PDT sessions at a total dose of 300 J/cm2. Clinical findings after the irradiation showed improvement in both patients, and elimination of tumor cells in the epidermis was confirmed histologically. Case 1 had no recurrence in the irradiation field at three months after PDT. Case 2 had a recurrence only in the periphery parts of the lesions at two months after PDT, but the periphery lesions remitted with two more PDT treatments. Topical ALA-PDT is an effective treatment for EMPD with tumor cells within the epidermis. It is noninvasive and achieves a cosmetically excellent outcome, especially in elderly patients and those in poor general condition.
authors.affiliation: Department of Dermatology, Aichi Medical University School of Medicine, Nagakute, Aichi-gun, Aichi 480-1195, Japan.
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Mikasa
authors.forename: Daisuke
authors.initials: D
authors.lastname: Watanabe
authors.forename: Chiharu
authors.initials: C
authors.lastname: Kondo
authors.forename: Miyuki
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Hirono
authors.initials: H
authors.lastname: Nakaseko
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Yokoo
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Tamada
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Matsumoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000008:administration & dosage*; D005260:Female; D005833:Genital Neoplasms, Female / Q000188:drug therapy* / Q000473:pathology; D005834:Genital Neoplasms, Male / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D010145:Paget Disease, Extramammary / Q000188:drug therapy* / Q000473:pathology; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000008:administration & dosage*
chemical_list: D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid