[Paget disease of the vulva: resolution after local treatment with imiquimod--report of a case and review of the literature].
Paget disease is a rare disorder of the skin of the vulva, comprising less than 1% of vulvar neoplasms. Surgical excision is considered the standard of care. While the invasive variant of Paget disease is rare, frequent local recurrences from non-invasive disease, which are inoperable, constitute a major clinical problem. In this article we report on a 71-year-old patient with recurrent disease treated successfully with imiquimod cream. Symptoms such as local itching subsided shortly after initiation of treatment. Four weeks later, first signs of resolution could be demonstrated colposcopically. Within 8 weeks, complete clinical remission was achieved. Thus, topical imiquimod is not only effective as treatment of vulvar intraepithelial neoplasia, but may also be used for selected patients with recurrent Paget disease as an alternative to repeat surgical interventions.
Università degli Studi di Udine, Udine, Italy.
Serena
S
Bertozzi
Ambrogio P
AP
Londero
Arrigo
A
Fruscalzo
Diego
D
Marchesoni
R J
RJ
Lellé
D000287:Administration, Topical; D000368:Aged; D000634:Aminoquinolines / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D017024:Chemotherapy, Adjuvant; D003127:Colposcopy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077271:Imiquimod; D053685:Laser Therapy; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010145:Paget Disease, Extramammary / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D014844:Vulva / Q000473:pathology / Q000601:surgery; D014846:Vulvar Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery
D000634:Aminoquinolines; D000970:Antineoplastic Agents; D000077271:Imiquimod