title: Treatment of primary vulvar paget disease with 5% imiquimod cream.
abstract: BACKGROUND
  Our objective was to evaluate the efficacy of conservative treatment with imiquimod in Paget vulvar disease.
  
  
  METHODS
  We describe a case series that includes 10 patients with histopathologic diagnosis of extramammary Paget disease of the vulva, who were treated with 5% imiquimod cream. Of these patients, 3 were treated for recurrent disease and 7 were treated for initial primary disease. The patients applied the cream every other day until the lesions were no longer clinically detected.They were previously instructed on how and where to apply the cream by making them use a mirror while following the physician's directions.
  
  
  RESULTS
  Complete clinical and histologic remission of the disease was achieved in 9 patients. The remaining patient had partial histologic response and is still under treatment. The treatment was well tolerated despite moderate irritation. No recurrences were observed during a mean follow-up of 18 months.
  
  
  CONCLUSIONS
  On the basis of the results, the authors consider that 5% imiquimod cream could be considered a safe and effective therapeutic option for the treatment of primary vulvar Paget disease. Further studies are needed to determine the real efficacy and safety of 5% imiquimod cream for the treatment of this infrequent disease.
authors.affiliation: 1Gynecology and 2Pathology Departments, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Claudia
authors.initials: C
authors.lastname: Marchitelli
authors.forename: Maria Sol
authors.initials: MS
authors.lastname: Peremateu
authors.forename: Maria Celeste
authors.initials: MC
authors.lastname: Sluga
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Berasategui
authors.forename: Delia Graciela
authors.initials: DG
authors.lastname: Lopez
authors.forename: Alejandra
authors.initials: A
authors.lastname: Wernicke
authors.forename: Andrea
authors.initials: A
authors.lastname: Velazco
authors.forename: Sebastian
authors.initials: S
authors.lastname: Gogorza
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000634:Aminoquinolines / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000077271:Imiquimod; D008875:Middle Aged; D010145:Paget Disease, Extramammary / Q000188:drug therapy*; D063465:Skin Cream / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome; D014846:Vulvar Neoplasms / Q000188:drug therapy*
chemical_list: D000634:Aminoquinolines; D000970:Antineoplastic Agents; D000077271:Imiquimod