Treatment of extramammary Paget disease of the vulva with imiquimod: A retrospective, multicenter study by the German Colposcopy Network

Luyten, Alexander; Sörgel, Philipp; Clad, Andreas; Gieseking, Friederike; Maass-Poppenhusen, Karin; Lellé, Ralph J.; Harter, Philipp; Buttmann, Nina; Petry, Karl Ulrich

doi:10.1016/j.jaad.2013.12.008

Cited by 71 publications

(33 citation statements)

References 31 publications

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“…Paget cells often arrange themselves into a glandular pattern (11). They also share many antigens with the apocrine glands of the skin (9,22,27). EMPD may be a miscarried attempt to form apocrine glands.…”

Section: Resultsmentioning

confidence: 99%

Pre-Paget cells: Evidence of keratinocyte origin of extramammary Paget's disease

Smith

2019

IRDR

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Section: Resultsmentioning

confidence: 99%

Pre-Paget cells: Evidence of keratinocyte origin of extramammary Paget's disease

Smith

2019

IRDR

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“…In the next step, 18 articles were further excluded for the following reasons: cases were not EPDV but Paget's disease in other locations (n = 12); patients already reported in a previous publication (n = 1); narrative review without reporting new cases (n = 3); extramammary Paget's disease without reporting the exact location (n = 1); EPDV, but not treated with imiquimod (n = 1). Finally, 20 articles [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] and our own case containing data of 70 cases of EPDV treated with imiquimodincluding our own case -were extracted and analyzed. From these studies, patients numbers, efficacy rates in terms of CR, PR, stable disease (where available), and progressive disease, the rate of treatment discontinuation, side effects, and length of follow-up were extracted.…”

Section: Literature Reviewmentioning

confidence: 99%

“…In addition to these indications, imiquimod has also been used to treat women with EPDV. For example, Luyten et al [15] published a retrospective cohort of women with EPDV treated with imiquimod. They summarized the treatment effects of 5% imiquimod cream in a series of 21 women with EPDV from 8 centers in Germany.…”

Section: Introductionmentioning

confidence: 99%

Paget's Disease of the Vulva Treated with Imiquimod: Case Report and Systematic Review of the Literature

Doğan

Hilal

Krentel

et al. 2016

Gynecol Obstet Invest

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Background: Extramammary Paget's disease of the vulva (EPDV) is a rare adenocarcinoma in situ of the vulvar skin and is often resected with involved margins due to its reticular growth pattern. Adjuvant treatment with the immunomodulator imiquimod may be suitable to avoid repeated and mutilating surgery. Case Presentation: We present the case of a 73-year-old woman with EPDV, initially treated with surgical resection and re-resection for involved margins. Final histology revealed Paget's disease of the left vulva with 8 cm in the largest diameter and again involved margins. Subsequently, topical therapy with imiquimod 5% cream twice weekly was applied for 3 months. Vulvoscopy and local biopsies confirmed complete remission (CR). Based on a literature search using PubMed and the Cochrane Central Register of Controlled Trials, 21 reports on the therapeutic efficacy of imiquimod in 70 women with EPDV have been published. Pooled rates of CR and partial remission were 71% (50/70) and 16% (11/70), respectively. There were 4 cases of disease progression under imiquimod and the therapy was generally well tolerated with mild to moderate local reactions in >50% of cases. Conclusion: EPDV is a rare genital neoplasia and may be successfully treated with the topical immunomodulator imiquimod. Specifically, adjuvant imiquimod is a feasible and efficacious treatment option for women with involved resection margins after surgery.

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“…Topical treatment with 5 % imiquimod cream has been tried with 52.4 % complete response and 28.6 % partial response with mean duration of treatment more than 16 weeks [10]. MPD has been treated with other modalities like photodynamic therapy, CO 2 laser, topical 5 FU cream and combination of above mentioned therapies [11].…”

Section: Treatmentmentioning

confidence: 99%

Extra Mammary Paget’s Disease of Vulva—a Case Report

Tomar

Suchetha

Nair

et al. 2016

Indian J Surg Oncol

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Extra mammary Paget's disease (EMPD) is a rare condition involving the vulva, anogenital region, and axilla. Vulvar disease usually presents as a slow growing well-defined itchy plaque with crustations or ulcerations over the affected area in postmenopausal women. Well-established guidelines for diagnosis and management are not available for this rare condition. Our patient is a 64-year-old postmenopausal woman with a history of similar complaints of 2 years duration, not responding to multiple topical treatments. She was diagnosed with EMPD on incisional biopsy and treated with surgery at our centre.

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Treatment of extramammary Paget disease of the vulva with imiquimod: A retrospective, multicenter study by the German Colposcopy Network

Cited by 71 publications

References 31 publications

Pre-Paget cells: Evidence of keratinocyte origin of extramammary Paget's disease

Pre-Paget cells: Evidence of keratinocyte origin of extramammary Paget's disease

Paget's Disease of the Vulva Treated with Imiquimod: Case Report and Systematic Review of the Literature

Extra Mammary Paget’s Disease of Vulva—a Case Report

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