Treatment of perianal Paget's disease using photodynamic therapy with assistance of fluorescence examination: case report.
Our aim was to determine the usefulness of fluorescence examination and photodynamic therapy (PDT) for the management of perianal extramammary Paget's disease. A 75-year-old woman underwent two courses of PDT. The first treatment was carried out with topically applied 5-aminolevulinic acid (ALA) to the affected area (2.5 x 2.5 cm(2)) 3 h before light treatment. We used ALA/protoporphyrin IX (PpIX)-mediated fluorescence to visualize the lesion and its margins. The lesion was treated with a 630 nm laser at 120 J/cm(2). Forty days later, the residual lesion was given a second treatment at the same light dose after topical application of ALA and intravenous injection of HiPorfin. ALA/PpIX-mediated fluorescence served as a useful tool to visualize the lesion's location. Complete cure was achieved after the second course of PDT. During 7 months of follow up, no recurrence, scarring or functional loss was noticed. We concluded that ALA-assisted fluorescence examination can be a useful tool to determine the lesion and its margins. ALA-PDT is effective for superficial lesions, but, for thicker and deeper lesions, the systemic administration of photosensitizer is needed.
Li
Libo
L
Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China. li_libo2008@yahoo.com.cn
Deng
Yongjian
Y
Zhang
Lanying
L
Liao
Wangjun
W
Luo
Rongcheng
R
Huang
Zheng
Z
D000368:Aged; D000622:Aminolevulinic Acid / Q000627:therapeutic use; D001005:Anus Neoplasms / Q000175:diagnosis* / Q000188:drug therapy*; D005260:Female; D005453:Fluorescence; D006801:Humans; D053685:Laser Therapy; D010145:Paget Disease, Extramammary / Q000175:diagnosis* / Q000188:drug therapy*; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011524:Protoporphyrins / Q000627:therapeutic use
D017319:Photosensitizing Agents; D011524:Protoporphyrins; D000622:Aminolevulinic Acid; C028025:protoporphyrin IX