Treatment of primary limited cutaneous extramammary Paget's disease with topical imiquimod monotherapy: Two case reports

Zampogna, Jennifer C.; Flowers, Franklin P.; Roth, William; Hassenein, Ashraf M.

doi:10.1067/mjd.2002.126584

Cited by 119 publications

(111 citation statements)

References 20 publications

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“…Topical imiquimod has also been used in a variety of different skin disorders including nodular and superficial BCC (29), in situ and invasive SCC (30)(31), lentigo maligna (32), lentigo maligna melanoma (33), keratoacanthomas (34), primary cutaneous CD30 positive anaplastic large cell lymphoma (35), mycosis fungoides (36), extramammary Paget's disease (37), cutaneous melanoma metastases (38), cutaneous warts and molluscum contagiosum (39), stucco keratosis (40), cutaneous leishmaniasis (41) and keloids (42).…”

Section: Imiquimod: a Promising Topical Immunostimulatory Agent For Dmentioning

confidence: 99%

Efforts to Counteract Locally the Effects of Systemic Immunosupression: A Review on the Use of Imiquimod, a Topical Immunostimulator in Organ Transplant Recipients

Trakatelli

Katsanos

Ulrich

et al. 2010

Int J Immunopathol Pharmacol

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The potent systemic immunosuppression therapy necessary to sustain a life-saving solid organ transplant is associated with an increased incidence of various infections including human papillomavirus infection and skin cancers in organ transplant recipients. Imiquimod, a topical agent that functions through local induction of a specific anti-viral or anti-tumor immune response, appears to be a promising therapeutic option that could potentially counteract in situ the effects of systemic immunosupression in this vulnerable group. Up-to-date studies using this local immune-response modifier in transplanted patients have yielded reassuring and encouraging results regarding its safety and efficacy in this population. However, in order to establish the use of imiquimod as a standard treatment option for organ transplant recipients, additional research and clinical trials are required.The past decades have seen unprecedented progress in the development of solid organ transplantation as a therapeutic choice for endstage organ disease. Organ Transplant Recipients (OTR) live longer, have a good quality of life and represent a rapidly growing population of people with specific medical needs. As the number of solid organ transplants continues to rise, so too does the number of various infections including human papillomavirus (HPV) infections and skin cancers in OTR. Consequently, physicians will be called upon to manage these diseases in the sensitive OTR population and to develop novel therapeutic and preventive strategies to better deal with them.The clinical efficacy of imiquimod 5% cream (a topical therapy approved for genital warts, actinic keratoses and superficial basal cell carcinoma) stems from stimulation ofinnate and cell-mediated immune responses, resulting in antiviral, antiproliferative and antitumor activity. Because of these properties, imiquimod and other members of this family of immune response modifiers are potential agents for treatment of conditions where the immune system can affect the regression of the disease (1). In light of the role of systemic immunosupression in the development of cutaneous infections and neoplasms in OTR, the use of imiquimod to locally stimulate immune responses against cancerous, pre-cancerous

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Section: Imiquimod: a Promising Topical Immunostimulatory Agent For Dmentioning

confidence: 99%

Efforts to Counteract Locally the Effects of Systemic Immunosupression: A Review on the Use of Imiquimod, a Topical Immunostimulator in Organ Transplant Recipients

Trakatelli

Katsanos

Ulrich

et al. 2010

Int J Immunopathol Pharmacol

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“…2 Since recurrence rates between 16-50% are seen after regular surgery, 15 Mohs micrographic surgery has become the preferred treatment modality for EMPD. 16 Despite this, recurrences rates of 27% following Mohs surgery have been reported.…”

Section: Discussionmentioning

confidence: 99%

Treatment of vulvar Paget disease with topical imiquimod: a case report and review of the literature

Feldmeyer¹,

Kerl²,

Kamarashev³

et al. 2011

J Dermatol Case Rep

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Background: Extramammary Paget's disease is a cutaneous neoplasm that presents as erythematous crusted patches and plaques reminiscent of contact dermatitis or inverse psoriasis that can be a challenge to treat in a tissue-sparing manner. The most commonly involved site for this rare disorder is the anogenital region. Surgery is considered as the gold standard therapy. In the last years, the topical use of imiquimod cream in the treatment of this condition has been reported.

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“…That technique consists of removal of tumour, review of margins under the microscope by the surgeon, tumour mapping, and resection of positive margins, potentially sparing normal tissue while achieving complete tumour resection 44 . Additionally, the reported recurrence rates are lower after Mohs micrographic surgery than after conventional excision (12.5%-28% vs. 33%-60%) 20,43,45,46 . When surgical margins are negative, patients experience durable relapse-free survival.…”

Section: 21mentioning

confidence: 99%

Management of Penoscrotal Extramammary Paget Disease: Case Series and Review of the Literature

et al. 2013

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The medical literature available to guide the management of empd is limited, particularly for metastatic disease. Another challenge is to differentiate metastatic empd from a concurrent invasive cancer. Here, we present our case series of 6 patients with empd of the penoscrotal region, our experience with systemic therapy, and a literature review for this rare malignancy. METHODSWe identified 6 cases of penoscrotal empd treated at The Ottawa Hospital from 2007 to 2012. All cases underwent pathology review. After research ethics board approval, clinical and demographic data, including age at presentation, presence of a second malignancy, management, and follow-up were collected from patient records. The literature was reviewed for clinical and pathologic features, treatment options, and outcomes. RESULTS 3

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Treatment of primary limited cutaneous extramammary Paget's disease with topical imiquimod monotherapy: Two case reports

Cited by 119 publications

References 20 publications

Efforts to Counteract Locally the Effects of Systemic Immunosupression: A Review on the Use of Imiquimod, a Topical Immunostimulator in Organ Transplant Recipients

Efforts to Counteract Locally the Effects of Systemic Immunosupression: A Review on the Use of Imiquimod, a Topical Immunostimulator in Organ Transplant Recipients

Treatment of vulvar Paget disease with topical imiquimod: a case report and review of the literature

Management of Penoscrotal Extramammary Paget Disease: Case Series and Review of the Literature

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