title: Conservative management of extramammary paget disease with imiquimod.
abstract: OBJECTIVE
  Extramammary Paget disease is a rare cutaneous neoplasm that most frequently affects the vulva. Surgery remains the preferred treatment, despite its association with high recurrence rates. Few reports have described conservative treatments for vulvar Paget disease. Our aim was to evaluate the efficacy of conservative treatment with imiquimod.
  
  
  METHODS
  We performed a retrospective analysis of 4 patients who were treated with topical imiquimod 5% cream.
  
  
  RESULTS
  One patient underwent vulvectomy after imiquimod therapy, and 3 patients experienced extensive recurrent disease that was unsuitable for surgical resection and were treated successfully with imiquimod.
  
  
  CONCLUSIONS
  Imiquimod is an effective therapeutic agent for the conservative treatment of vulvar Paget disease.
authors.affiliation: Department of Gynecologic Oncology, AC Camargo Cancer Hospital, Sao Paulo, Brazil. glbaiocchi@yahoo.com.br
authors.forename: Glauco
authors.initials: G
authors.lastname: Baiocchi
authors.forename: Maria Dirlei Ferreira Souza
authors.initials: MD
authors.lastname: Begnami
authors.forename: Elza Mieko
authors.initials: EM
authors.lastname: Fukazawa
authors.forename: Walyson Silva
authors.initials: WS
authors.lastname: Surima
authors.forename: Levon
authors.initials: L
authors.lastname: Badiglian-Filho
authors.forename: Felipe D'Almeida
authors.initials: FD
authors.lastname: Costa
authors.forename: Renato Almeida Rosa
authors.initials: RA
authors.lastname: Oliveira
authors.forename: Carlos Chaves
authors.initials: CC
authors.lastname: Faloppa
authors.forename: Lillian Yuri
authors.initials: LY
authors.lastname: Kumagai
authors.forename: Fernando Augusto
authors.initials: FA
authors.lastname: Soares
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000634:Aminoquinolines / Q000008:administration & dosage / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000077271:Imiquimod; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology; D010145:Paget Disease, Extramammary / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D014844:Vulva / Q000473:pathology / Q000601:surgery; D014846:Vulvar Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery
chemical_list: D000634:Aminoquinolines; D000970:Antineoplastic Agents; D000077271:Imiquimod