Treatment of mammary and extramammary Paget's skin disease with topical imiquimod.

Abstract

BACKGROUND:

Paget's disease is an uncommon epidermal cancer, affecting all skin regions wherever apocrine glands are present. It is divided into extramammary (EMPD) and mammary Paget's disease (MPD). It can be confined to the epithelium or may be associated with an underlying adenocarcinoma. The diagnosis is confirmed by skin biopsy and the treatment depends on characteristics of the underlying cancer. Surgery is the first-line treatment. Imiquimod, a topical immunomodulator, approved its efficiency in several skin neoplasms and has been shown as a safe treatment for EMPD. However, it has never been reported for the treatment of MPD.

OBSERVATIONS:

We report on two cases of EMPD and MPD successfully treated with imiquimod 5% cream.

CONCLUSION:

This non-surgical method may be considered as a primary treatment when Paget's disease is not associated with an underlying malignancy. The good prognosis with a long-term survival, the anatomic localization and the poor general condition of elderly people may favor imiquimod as an alternative treatment. On the other hand, it will reduce the extent of excision when it anticipates surgery.

• Authors: Ewa Mirer, Fouad El Sayed, Alfred Ammoury, Laurence Lamant, Line Messer, Jacques Bazex
• Journal: The Journal of dermatological treatment (J Dermatolog Treat) Vol. 17 Issue 3 Pg. 167-71 ( 2006) ISSN: 0954-6634 [Print] England
• PMID: 16854759 (Publication Type: Case Reports, Journal Article)

Chemical References

• Aminoquinolines
• Antineoplastic Agents
• Imiquimod

Topics

• Administration, Cutaneous
• Aged
• Aged, 80 and over
• Aminoquinolines (administration & dosage, therapeutic use)
• Antineoplastic Agents (administration & dosage, therapeutic use)
• Breast Neoplasms (diagnosis, drug therapy, pathology)
• Diagnosis, Differential
• Female
• Groin
• Humans
• Imiquimod
• Paget Disease, Extramammary (diagnosis, drug therapy, pathology)
• Paget's Disease, Mammary (diagnosis, drug therapy, pathology)
• Skin Neoplasms (diagnosis, drug therapy, pathology)