Clinical Report: Intralesional Photodynamic Therapy with ALA for EMPD
Overview
This case study reports the use of intralesional 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in treating persistent extramammary Paget's disease (EMPD) with deep dermal invasion. Complete clinical regression was noted after six treatment sessions, with no recurrence during a 6-month follow-up.
Background
Extramammary Paget's disease (EMPD) is a rare cutaneous malignancy characterized by high local recurrence rates and often positive surgical margins. Standard treatment involves wide local excision, but this may not be feasible in anatomically sensitive areas. There is a need for effective non-surgical alternatives, particularly for cases with deep dermal invasion, as highlighted in recent literature.
Data Highlights
No numerical data or trial data provided in the article.
Key Findings
EMPD is associated with high local recurrence rates, ranging from 4.8% to 57.6%.
Topical photodynamic therapy (PDT) has limited efficacy due to poor penetration of photosensitizers.
Intralesional ALA-PDT was administered monthly, with a 10% ALA solution injected directly into the lesion.
Complete clinical regression was achieved after six sessions of ALA-PDT.
The treatment was well-tolerated, with only mild pain and transient erythema reported.
No recurrence was observed during the 6-month follow-up period.
Clinical Implications
Intralesional ALA-PDT provides a minimally invasive treatment option for patients with residual EMPD when surgical re-excision is not feasible.
Conclusion
Intralesional ALA-PDT achieved complete regression in this case study. Further studies are needed to evaluate its role in broader clinical practice.
