Long-term Follow-up of In situ Extramammary Paget’s Disease in Asian Skin Types IV/V Treated with Photodynamic Therapy
Qiang Li, Tianwen Gao, Bin Jiao, Xianlong Qi, Heather Ann Long, Hongjiang Qiao, Lei Wang, Yajie Lv, Xuehui Hu, Wenjun Liao, Shengchun Wang, Chunying Li
Photodynamic therapy is a potentially advantageous treatment for non-melanoma skin cancers. We evaluated the clinical response, recurrence and adverse events of photodynamic therapy for in situ extramammary Paget’s disease in 14 male and 3 female Chinese patients with 21 lesions. Topical 20% 5-aminolevulinic acid was applied for 6 h. Each lesion was irradiated with 633 nm red light three times, 1 week apart, at a total dose of 339 J/cm2, followed by three assessments at 6, 12 and 24 months. Overall complete response (CR) rates were 52.4%, 42.9%, and 33.3% at 6, 12 and 24 months, respectively. The CR rate was significantly higher in scrotal lesions (66.6%) than in non-scrotal lesions (8.3%). The overall recurrence rate was 50%. The highest CR rate was for the lesions < 4 cm in diameter (62.5%), followed by those 4–8 cm (33.3%) and > 8 cm (0%). Most adverse events were well tolerated. In conclusion, photodynamic therapy for extramammary Paget’s disease is not recommended as the first option except for scrotal cases or lesions < 4 cm in diameter.