Intralesional Photodynamic Therapy with ALA for Persistent Extramammary Paget's Disease: A Case Study
By
Jianhua Huang
Dongya Wang
Yiwu Yu
Szeman Cheung
Li Xiao
Fei Miao
Wenjing Zha
Yitao Qian
Ke Li
Lei Shi
June 30, 2026
Clinical Scorecard: Intralesional Photodynamic Therapy with ALA for Persistent Extramammary Paget's Disease: A Case Study
At a Glance
Category Detail
Condition Extramammary Paget's Disease (EMPD) Key Mechanisms Intralesional photodynamic therapy (ALA-PDT) enhances photosensitizer delivery to deep dermal lesions. Target Population Patients with residual EMPD after surgical excision with positive margins. Care Setting Dermatology department for local adjuvant therapy.
Key Highlights
Intralesional ALA-PDT achieved complete clinical regression after six sessions. Treatment was well-tolerated with mild pain and transient erythema. No recurrence observed during the 6-month follow-up period. Guideline-Based Recommendations
Diagnosis
Histopathological examination confirms EMPD diagnosis with tumor infiltration. Management
Intralesional ALA-PDT is recommended for residual EMPD when re-excision is not feasible. Monitoring & Follow-up
Pre-treatment high-frequency ultrasound and dermoscopy are useful for assessing lesion characteristics. Risks
Potential for positive surgical margins and local recurrence if not adequately treated. Patient & Prescribing Data
Elderly male with scrotal EMPD and positive surgical margins.
10% ALA solution injected intralesionally followed by light irradiation.
Clinical Best Practices
Use aseptic techniques for intralesional ALA preparation and injection. Ensure adequate incubation time for photosensitizer accumulation before irradiation. Related Resources & Content
