title: Fluorescence diagnostics as a guide for demarcation and biopsy of suspected anal cancer.
abstract: BACKGROUND
  Malignant epithelial tumors of the perianal skin are relatively rare however show high recurrence rates. A preoperative precise diagnosis and demarcation of the involved cancerous skin remains challenging but is worthwhile to minimize tissue defects and possible limitations of quality of life.
  
  
  OBJECTIVE
  To show the use of fluorescence diagnostics (FD) in the management of chronic perianal disease.
  
  
  METHODS
  FD was performed using methylaminolevulinate (MAL) for three hours topically followed by visualization with blue light (405 nm).
  
  
  RESULTS
  We report on two patients in whom FD helped to demarcate the involved tissue or to direct biopsy to ascertain the final diagnosis. In one patient with a history of Bowen's disease and recurrent anal carcinoma, biopsy showed extramammary Paget's disease and thus was treated by surgical anoplasty. The other patient had a history of chronic anal eczema, and FD-directed biopsy could exclude suspected malignancy so that the anal eczema was treated by local therapy.
  
  
  CONCLUSIONS
  FD is a non-invasive technique which can be used in the perianal region in order to delineate pathologic processes which may reduce the number of surgical interventions.
authors.affiliation: Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Kriz
authors.forename: Juraj
authors.initials: J
authors.lastname: Hegyi
authors.forename: Thomas
authors.initials: T
authors.lastname: Ruzicka
authors.forename: Carola
authors.initials: C
authors.lastname: Berking
mesh_terms: D000368:Aged; D000622:Aminolevulinic Acid; D001005:Anus Neoplasms / Q000473:pathology*; D001706:Biopsy; D002277:Carcinoma / Q000473:pathology*; D004485:Eczema / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D005453:Fluorescence; D006801:Humans; D008297:Male; D008875:Middle Aged; D010145:Paget Disease, Extramammary / Q000473:pathology* / Q000601:surgery; D012394:Rosaniline Dyes / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D012394:Rosaniline Dyes; C006898:carbol-fuchsin solution; D000622:Aminolevulinic Acid