Treatment of primary vulvar paget disease with 5% imiquimod cream.

Abstract

INTRODUCTION:

Our objective was to evaluate the efficacy of conservative treatment with imiquimod in Paget vulvar disease.

MATERIALS AND 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: Claudia Marchitelli, Maria Sol Peremateu, Maria Celeste Sluga, Maria Teresa Berasategui, Delia Graciela Lopez, Alejandra Wernicke, Andrea Velazco, Sebastian Gogorza
• Journal: Journal of lower genital tract disease (J Low Genit Tract Dis) Vol. 18 Issue 4 Pg. 347-50 (Oct 2014) ISSN: 1526-0976 [Electronic] United States
• PMID: 25259595 (Publication Type: Case Reports, Journal Article)

Chemical References

• Aminoquinolines
• Antineoplastic Agents
• Imiquimod

Topics

• Administration, Topical
• Aged
• Aged, 80 and over
• Aminoquinolines (adverse effects, therapeutic use)
• Antineoplastic Agents (therapeutic use)
• Female
• Humans
• Imiquimod
• Middle Aged
• Paget Disease, Extramammary (drug therapy)
• Skin Cream (adverse effects, therapeutic use)
• Treatment Outcome
• Vulvar Neoplasms (drug therapy)