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

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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 × 2.5 cm2) 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/cm2. 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.

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Correspondence to Libo Li.

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Li, L., Deng, Y., Zhang, L. et al. Treatment of perianal Paget’s disease using photodynamic therapy with assistance of fluorescence examination: case report. Lasers Med Sci 24, 981–984 (2009). https://doi.org/10.1007/s10103-009-0653-8

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  • DOI: https://doi.org/10.1007/s10103-009-0653-8

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