title: Efficacy and safety of topical ALA-PDT in the treatment of EMPD.
abstract: BACKGROUND
  Photodynamic therapy (PDT) is a successful treatment for non-melanoma skin cancers in clinical practice. More and more doctors use PDT to cure the patients with skin cancer, especially in the elder. The purpose of this study was to evaluate the efficacy and safety of topical PDT using aminolevulinic acid (5-ALA) in the treatment of Extramammary Paget's disease (EMPD) and its role in surgical improvements.
  
  
  METHODS
  A total of 38 cases were included in this study. Lesions were located in the scrotum and the penis. Thirty-one cases had surgical resection of the lesions followed by ALA-PDT (combination of PDT and surgery group). Seven cases received ALA-PDT without receiving surgical resection because the surgery is extremely difficult or the patients refused surgery (simple PDT group). Each tumor lesion was irradiated with 120J/cm(2) using a 635-nm laser for 15min. A total of 3 times of assisted ALA-PDT was applied after surgery.
  
  
  RESULTS
  In the combination group, there was no recurrence in 6 months after treatment. In another group, recurrence occurred in 1 case in 6 months. All patients were able to complete the treatment protocol, with well cosmetic results and no moderate adverse reactions.
  
  
  CONCLUSIONS
  As an assistive therapy after tumor resection, ALA-PDT can reduce the excision range of the tumor lesions and will play more important role in the treatment of EMPD.
authors.affiliation: Department of Plastic and Cosmetic Surgery, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, PR China; Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, PR China. Electronic address: docgaoyang@yahoo.com.
authors.forename: Yang
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Plastic and Cosmetic Surgery, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, PR China. Electronic address: 79371465@qq.com.
authors.forename: Xing-Cun
authors.initials: XC
authors.lastname: Zhang
authors.affiliation: Department of Plastic and Cosmetic Surgery, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, PR China. Electronic address: ws_dream@126.com.
authors.forename: Wen-Sheng
authors.initials: WS
authors.lastname: Wang
authors.affiliation: Department of Plastic and Cosmetic Surgery, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, PR China. Electronic address: yangdoublejake@163.com.
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Plastic and Cosmetic Surgery, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, PR China. Electronic address: hl_wang@Foxmail.com.
authors.forename: Hai-Lin
authors.initials: HL
authors.lastname: Wang
authors.affiliation: Department of Plastic and Cosmetic Surgery, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, PR China. Electronic address: skin515@163.com.
authors.forename: Yuan-Gang
authors.initials: YG
authors.lastname: Lu
authors.affiliation: Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, PR China. Electronic address: fdltmmu@sina.com.
authors.forename: Dong-Li
authors.initials: DL
authors.lastname: Fan
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D003131:Combined Modality Therapy / Q000379:methods; D062109:Dermatologic Surgical Procedures; D006801:Humans; D008297:Male; D008875:Middle Aged; D010145:Paget Disease, Extramammary / Q000473:pathology / Q000628:therapy*; D011838:Radiation-Sensitizing Agents / Q000008:administration & dosage / Q000009:adverse effects; D012878:Skin Neoplasms / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D011838:Radiation-Sensitizing Agents; D000622:Aminolevulinic Acid
keywords: Aminolevulinic acid; Extramammary Paget's disease (EMPD); Therapy; Topical photodynamic therapy