Fluorouracil Plus Calcipotriene May Help Refractory Extramammary Paget Disease

NEW YORK (Reuters Health) - In patients who fail other therapies for extramammary Paget disease (EMPD), palliative therapy with topical fluorouracil and calcipotriene may be an option, a small case series suggests.

"EMPD occurs most frequently in the groin and genital area, and treatment is associated with a significant amount of morbidity and high recurrence rates," Dr. Peggy Wu of the University of California, Davis in Sacramento told Reuters Health by email.

"Because EMPD disproportionally affects a part of the body that is functionally, psychologically, and socially significant, optimizing treatment to deliver the greatest benefit while minimizing side effects is paramount," said Dr. Wu, who was at Beth Israel Deaconess Medical Center in Boston during the study.

"Most patients are offered surgery as initial therapy, but even with the movement towards tissue-sparing Mohs surgery, the potentially disfiguring nature of surgery is challenging," she noted. "Although other modalities, such as radiation, chemotherapy, and photodynamic therapy have also been tried, the data on efficacy are limited at best. Thus, finding a topical therapy which is both well-tolerated and efficacious would be ideal."