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Treatment of perianal Paget's disease using photodynamic therapy with assistance of fluorescence examination: case report.

Abstract
Our aim was to determine the usefulness of fluorescence examination and photodynamic therapy (PDT) for the management of perianal extramammary Paget's disease. A 75-year-old woman underwent two courses of PDT. The first treatment was carried out with topically applied 5-aminolevulinic acid (ALA) to the affected area (2.5 x 2.5 cm(2)) 3 h before light treatment. We used ALA/protoporphyrin IX (PpIX)-mediated fluorescence to visualize the lesion and its margins. The lesion was treated with a 630 nm laser at 120 J/cm(2). Forty days later, the residual lesion was given a second treatment at the same light dose after topical application of ALA and intravenous injection of HiPorfin. ALA/PpIX-mediated fluorescence served as a useful tool to visualize the lesion's location. Complete cure was achieved after the second course of PDT. During 7 months of follow up, no recurrence, scarring or functional loss was noticed. We concluded that ALA-assisted fluorescence examination can be a useful tool to determine the lesion and its margins. ALA-PDT is effective for superficial lesions, but, for thicker and deeper lesions, the systemic administration of photosensitizer is needed.
AuthorsLibo Li, Yongjian Deng, Lanying Zhang, Wangjun Liao, Rongcheng Luo, Zheng Huang
JournalLasers in medical science (Lasers Med Sci) Vol. 24 Issue 6 Pg. 981-4 (Nov 2009) ISSN: 1435-604X [Electronic] England
PMID19242772 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Photosensitizing Agents
  • Protoporphyrins
  • protoporphyrin IX
  • Aminolevulinic Acid
Topics
  • Aged
  • Aminolevulinic Acid (therapeutic use)
  • Anus Neoplasms (diagnosis, drug therapy)
  • Female
  • Fluorescence
  • Humans
  • Laser Therapy
  • Paget Disease, Extramammary (diagnosis, drug therapy)
  • Photochemotherapy
  • Photosensitizing Agents (therapeutic use)
  • Protoporphyrins (therapeutic use)

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