A case of extramammary Paget's disease treated with 5% imiquimod cream

Abstract

Extramammary Paget's disease (EMPD) is a rare intraepidermal adenocarcinoma. Mohs micrographic surgery is considered the standard treatment. Other treatment modalities such as surgical excision, radiotherapy, topical chemotherapy, and photodynamic therapy are associated with varying degrees of effectiveness, and possible loss of tissue function and disease recurrence are seen. The search for an effective, safe treatment with minimal side effects proves to be challenging. Imiquimod is the first representative of a new class of immunomodulating drugs demonstrating potent antiviral and antitumor activity, and has been approved by the FDA for treating anogenital warts, actinic keratosis and basal cell carcinoma. Recent research has demonstrated its effective usage as a 5% cream in the management of EMPD. We report a case of EMPD of the scrotum successfully treated with topical 5% imiquimod cream. This has never been published in the Korea dermatologic literature.