Extramammary Paget disease of the vulva treated with imiquimod

Introduction: Extramammary Paget disease of the vulva is a rare, mali-gnant skin neoplasm that typically develops in postmenopausal Cauca-sian women.Case report: A 70-year-old women reported to the Dermatology Outpa-tient Clinic with a history of extramammary Paget disease of the vulva, with positive margins after vulvectomy. Considering non-resectability of the lesion, a decision was made to use imiquimod in local therapy on the remaining extramammary Paget disease foci, clinically corresponding to the areas of whitening within the vulva. After 3 months of local therapy, clinical improvement was achieved, and 10 months after the end of treat-ment, remission was confirmed in histopathological examination based on biopsy.Conclusions: Surgical excision of lesions remains the standard procedu-re in extramammary Paget disease. Subsequent treatment with imiqu-imod appears to be beneficial in cases of positive excision margins, to avoid further, mutilating surgery.

Automated summary

This article reports a case of extramammary Paget disease of the vulva with positive margins after vulvectomy. Local therapy with imiquimod achieved clinical improvement, and remission was confirmed in long-term follow-up.