Conservative management of extramammary Paget disease with imiquimod

Abstract Extramammary Paget disease is a rare cutaneous neoplasm that most frequently affects the vulva. Surgery remains the preferred treatment, despite its association with high recurrence rates. Few reports have described conservative treatments for vulvar Paget disease. Our aim was to evaluate the efficacy of conservative treatment with imiquimod. We performed a retrospective analysis of 4 patients who were treated with topical imiquimod 5% cream. One patient underwent vulvectomy after imiquimod therapy, and 3 patients experienced extensive recurrent disease that was unsuitable for surgical resection and were treated successfully with imiquimod. Imiquimod is an effective therapeutic agent for the conservative treatment of vulvar Paget disease.