Introduction:

Extramammary Paget disease of the vulva is a rare, malignant skin neoplasm that typically develops in postmenopausal Caucasian women.

Case report:

A 70-year-old women reported to the Dermatology Outpatient Clinic with a history of extramammary Paget disease of the vulva, with positive margins after vulvectomy. Considering non-resectability of the lesion, a decision was made to use imiquimod in local therapy on the remaining extramammary Paget disease foci, clinically corresponding to the areas of whitening within the vulva. After 3 months of local therapy, clinical improvement was achieved, and 10 months after the end of treatment, remission was confirmed in histopathological examination based on biopsy.

Conclusions:

Surgical excision of lesions remains the standard procedure in extramammary Paget disease. Subsequent treatment with imiquimod appears to be beneficial in cases of positive excision margins, to avoid further, mutilating surgery.