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The lesions of extramammary Paget disease were located in the suprapubic region, pubic area, groin, buttocks, thighs and perineum--including the penile shaft and urethral meatus, the scrotum, and the vulva.
Lesions of extramammary Paget disease usually appeared as patches of macular erythema, (14,16) an "erythematous eruption", (13) or erythematous papules and plaques, (8,15,16) current report.
Complete healing, without recurrence, of the cutaneous extramammary Paget disease was noted in seven patients whose disease was treated with topical imiquimod 5% cream: three patients with previously untreated extramammary Paget disease (6,13) (also current report) and four patients whose disease was recurrent following various initial treatments such as aminolevulinic acid photodynamic therapy, (14) electrodes-iccation and curettage, (8) surgical excision using the Mohs micrographic technique, (9-12) and wide surgical excision.
A partial response to imiquimod after topical treatment of extramammary Paget disease was observed in two patients.
20,21) However, the current availability of the topical immunomodulator imiquimod presents the option for an alternative approach to the management of extramammary Paget disease.
Based on our review of the currently published reports of extramammary Paget disease patients whose disease has been successfully treated with imiquimod cream, we suggest that topical application of imiquimod may be considered as an initial treatment of primary cutaneous extramammary Paget disease.
Extramammary Paget disease has successfully been treated with topical imiquimod.
Cutaneous lesions of extramammary Paget disease can mimic other conditions such as chronic candidal intertrigo, dermatitis (contact, irritant, or seborrheic), dermatophyte-related tinea cruris, psoriasis vulgaris (inverse), and squamous cell carcinoma in situ (Bowen disease).