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European Journal of Dermatology

, Volume 28, Issue 3, pp 351–355 | Cite as

Efficacy and tolerance of photodynamic therapy for vulvar Paget’s disease: a multicentric retrospective study

  • Diane-Iris Rioli
  • Mahtab Samimi
  • Nathalie Beneton
  • Ewa Hainaut
  • Ludovic Martin
  • Laurent Misery
  • Gaëlle Quereux
Therapy
  • 13 Downloads

Abstract

Background

Extra-mammary Paget’s disease is a rare form of intraepithelial adenocarcinoma with a variable pattern of invasion, sometimes associated with distant malignancy. Vulvar Paget’s disease (VPD) represents 1% of all vulvar cancers. Standard treatment is surgical excision, however, the recurrence rate is high and surgery leads to anatomical, functional, and sexual morbidity. Some case series suggest efficacy of photodynamic (PDT) as treatment for this indication.

Objectives

Our aim was to assess the efficacy and tolerance of PDT in women suffering from VPD.

Materials & Methods

A retrospective study was conducted on all patients suffering from VPD, treated with PDT at six hospitals in France. Clinical data, histopathological reports at diagnosis, therapeutic history, PDT schedule, tolerance, and clinical response were reported.

Results

Thirteen women were included, with a mean age of 70.1 years. Ten women had an in situ disease, two had <1-mm dermal involvement, and one had adnexal involvement. All PDT courses were carried out using the same light source and photosensitizing agent. Complete response was achieved in two patients (15%) and partial response in five patients (38%). Five patients (38%) had stable disease and one (7%) had progressive disease. Ten of the 13 patients underwent pain evaluation; in six cases (60%), pain was described as moderate to intense.

Conclusion

PDT appears to be a therapeutic option for patients with VPD, with a response rate similar to that of other therapies usually recommended, such as surgery and imiquimod. There is a need to harmonise PDT procedures and pain assessment.

Key words

extra-mammary Paget’s disease vulvar Paget’s disease photodynamic therapy non-surgical treatment vulvar disease 

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Copyright information

© John Libbey Eurotext 2018

Authors and Affiliations

  • Diane-Iris Rioli
    • 1
  • Mahtab Samimi
    • 2
  • Nathalie Beneton
    • 3
  • Ewa Hainaut
    • 1
  • Ludovic Martin
    • 4
  • Laurent Misery
    • 5
  • Gaëlle Quereux
    • 6
  1. 1.Service de DermatologiePoitiers University HospitalPoitiersFrance
  2. 2.Service de DermatologieTours University HospitalToursFrance
  3. 3.Service de DermatologieLe Mans HospitalLe MansFrance
  4. 4.Service de DermatologieAngers University HospitalAngersFrance
  5. 5.Service de DermatologieBrest University HospitalBrestFrance
  6. 6.Service de DermatologieNantes University HospitalNantesFrance

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