Preliminary analysis of the efficacy of Mohs micrographic surgery combined with photodynamic therapy in a case of noninvasive extramammary Paget's disease

J Dermatolog Treat. 2024 Dec;35(1):2368066. doi: 10.1080/09546634.2024.2368066. Epub 2024 Jun 19.

Abstract

Purpose: To evaluate the efficacy of Mohs micrographic surgery (MMS) combined with photodynamic therapy (PDT) in treating non-invasive extramammary Paget's disease (EMPD).

Materials and methods: A 77-year-old male patient with non-invasive EMPD was treated with MMS followed by PDT. Preoperative fluorescence localization using 5-aminolevulinic acid (ALA) was performed to determine the surgical scope. MMS was conducted under lumbar anesthesia with intraoperative frozen-section pathology. Postoperative PDT was administered weekly for three sessions.

Results: The patient achieved negative surgical margins after two rounds of intraoperative pathology. Postoperative follow-up over two years showed no recurrence, and the patient did not experience significant adverse reactions.

Conclusion: The combination of MMS and PDT was effective in treating non-invasive EMPD, demonstrating favorable clinical outcomes and no recurrence over the two-year follow-up period.

Keywords: Extramammary Paget’s disease; mohs micrographic surgery; photodynamic therapy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aminolevulinic Acid* / therapeutic use
  • Combined Modality Therapy
  • Humans
  • Male
  • Margins of Excision
  • Mohs Surgery*
  • Paget Disease, Extramammary* / drug therapy
  • Paget Disease, Extramammary* / pathology
  • Paget Disease, Extramammary* / surgery
  • Photochemotherapy*
  • Photosensitizing Agents* / therapeutic use
  • Skin Neoplasms* / drug therapy
  • Skin Neoplasms* / pathology
  • Skin Neoplasms* / surgery
  • Skin Neoplasms* / therapy
  • Treatment Outcome

Substances

  • Aminolevulinic Acid
  • Photosensitizing Agents