Neoadjuvant use of Imiquimod Before Surgery in Extramammary Paget’s Disease

  • M. Costa e Silva Interno do Internato Complementar de Dermatologia e Venereologia/Resident, Dermatology and Venereology, Centro Hospitalar São João, EPE, Porto, Portugal
  • M. A. Costa Professora Doutora, Especialista em Ginecologia e Obstetrícia/ Professor, Consultant of Gynecology, Centro Hospitalar São João, EPE, Porto, Portugal; Departamento da Mulher e da Criança, Faculdade de Medicina da Universidade do Porto, Portugal
  • J. S. Costa Especialista em Cirurgia Plástica/ Consultant of Plastic Surgery, Centro Hospitalar São João, EPE, Porto, Portugal
  • F. Azevedo Diretora do Serviço de Dermatologia e Venereologia/Head of the Dermatology and Venereology Department, Centro Hospitalar São João, EPE, Porto, Portugal
  • Carmen Lisboa Professora Doutora, Especialista em Dermatologia e Venereologia/Professor, Consultant of Dermatology and Venereology, Centro Hospitalar São João, EPE, Porto, Portugal; Serviço de Microbiologia, Faculdade de Medicina do Porto, Porto, Portugal
Keywords: Imiquimod, Neoadjuvant Therapy, Paget Disease, Extramammary/therapy, Vulvar


Extramammary Paget's disease (EMPD) is a distinct form of a rare malignant skin neoplasm, primarily seen in postmenopausal Caucasian women. Surgery is the most common treatment. However, concerning vulvar EMPD, radical surgery can be mutilating and leads to loss of femininity. Recent therapeutic development has included medical and medical-surgical approaches, allowing better preservation of genital anatomy with subsequent reduced morbidity. Accordingly, off-label use of imiquimod has been reported as a monotherapy or adjuvant therapy in EMPD.

We report the case of a woman with extensive EMPD in the anogenital area, submitted to surgical resection complemented with plastic reconstruction and preceded by imiquimod medical treatment. Neoadjuvant imiquimod induced a significant cytoreduction of the tumor area, minimizing surgical radicality and maintaining local function and morphology


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How to Cite
Costa e Silva, M., Costa, M. A., Costa, J. S., Azevedo, F., & Lisboa, C. (2018). Neoadjuvant use of Imiquimod Before Surgery in Extramammary Paget’s Disease. Journal of the Portuguese Society of Dermatology and Venereology, 76(2), 197-200.
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