Long-term follow-up of in situ extramammary Paget's disease in Asian skin types IV/V treated with photodynamic therapy.
Photodynamic therapy is a potentially advantageous treatment for non-melanoma skin cancers. We evaluated the clinical response, recurrence and adverse events of photodynamic therapy for in situ extramammary Paget's disease in 14 male and 3 female Chinese patients with 21 lesions. Topical 20% 5-aminolevulinic acid was applied for 6 h. Each lesion was irradiated with 633 nm red light three times, 1 week apart, at a total dose of 339 J/cm2, followed by three assessments at 6, 12 and 24 months. Overall complete response (CR) rates were 52.4%, 42.9%, and 33.3% at 6, 12 and 24 months, respectively. The CR rate was significantly higher in scrotal lesions (66.6%) than in non-scrotal lesions (8.3%). The overall recurrence rate was 50%. The highest CR rate was for the lesions < 4 cm in diameter (62.5%), followed by those 4-8 cm (33.3%) and > 8 cm (0%). Most adverse events were well tolerated. In conclusion, photodynamic therapy for extramammary Paget's disease is not recommended as the first option except for scrotal cases or lesions < 4 cm in diameter.
Li
Qiang
Q
Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China. qiangli@fmmu.edu.cn
Gao
Tianwen
T
Jiao
Bin
B
Qi
Xianlong
X
Long
Heather Ann
HA
Qiao
Hongjiang
H
Wang
Lei
L
Lv
Yajie
Y
Hu
Xuehui
X
Liao
Wenjun
W
Wang
Shengchun
S
Li
Chunying
C
D000279:Administration, Cutaneous; D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D044466:Asian People; D002278:Carcinoma in Situ / Q000188:drug therapy* / Q000208:ethnology / Q000473:pathology; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010145:Paget Disease, Extramammary / Q000188:drug therapy* / Q000208:ethnology / Q000473:pathology; D017060:Patient Satisfaction; D010412:Penile Neoplasms / Q000188:drug therapy* / Q000208:ethnology / Q000473:pathology; D010778:Photochemotherapy / Q000009:adverse effects; D017319:Photosensitizing Agents / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D012008:Recurrence; D012611:Scrotum / Q000473:pathology; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000208:ethnology / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome
D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid