title: Extramammary Paget's disease resistant to surgery and imiquimod monotherapy but responsive to imiquimod combination topical chemotherapy with 5-fluorouracil and retinoic acid: a case report.
abstract: Extramammary Paget's disease (EMPD) is an uncommon skin neoplasm that usually affects the elderly population and occurs in the genital, anorectal, or axillary areas. The recommended treatment of EMPD involves surgical excision, including Mohs micrographic surgery; however, surgery is associated with a high rate of recurrence. There have been reports of successful treatment of recurrence with monochemotherapy involving topical imiquimod 5% cream. We report a case of EMPD recurrence after surgery that was resistant to imiquimod monotherapy but that completely resolved after imiquimod was combined with topical 5-fluorouracil (5-FU) and retinoic acid. To our knowledge, this is the first reported case of imiquimod combination therapy with 5-FU and retinoic acid for the treatment of recurrent EMPD.
authors.affiliation: Dermatology and Laser Service, School of Medicine, University of California, Davis, USA. jimyedai@aol.com
authors.forename: Jian Nan
authors.initials: JN
authors.lastname: Ye
authors.forename: David C
authors.initials: DC
authors.lastname: Rhew
authors.forename: Felix
authors.initials: F
authors.lastname: Yip
authors.forename: Leon
authors.initials: L
authors.lastname: Edelstein
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D000634:Aminoquinolines / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D005472:Fluorouracil / Q000008:administration & dosage; D005834:Genital Neoplasms, Male / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D006801:Humans; D000077271:Imiquimod; D008297:Male; D010145:Paget Disease, Extramammary / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D014212:Tretinoin / Q000008:administration & dosage
chemical_list: D000634:Aminoquinolines; D014212:Tretinoin; D000077271:Imiquimod; D005472:Fluorouracil