Unfortunately, the different treatment protocols chosen in these publications prevent from perianal paget's disease treatment with aldara a clear protocol. Protocol based on a thrice a week basis seems reasonable as adhesion to the treatment is mandatory to have it performed till the end. In the literature, this treatment has been offered to patients who have refused surgery. In our case, imiquimod has been proposed as an alternative because of multiple relapses despite the surgery. Imiquimod is well tolerated when applied every two or three other day.



Epreuves corriges par l'auteur. However, recurrence rate remains high and surgery has often significant consequences for the functional anatomy with irreparable tissue damage. Since its diagnosis, he had had excisionnal local surgeries performed on perianal paget's disease treatment with aldara occasions, the last one having been performed nine years ago. He had had pruritic erythematous lesions of the scrotal area for the past several months prior to consultation. Examination revealed large erythematous, welldemarcated, slightly infiltrated, eczematouslike lesions of the scrotum.

Imiquimod could be proposed as first line treatment in replacement of surgery, especially if the patient refuses surgery or if surgical intervention has been already attempted without complete success. Imiquimod could also be given as neoadjuvant therapy to aldara order the size of the lesion before surgery. However, it must be noted that imiquimod has been reported in only epidermal forms and without underlying neoplasia. Randomized controlled studies are necessary to define a standard treatment protocol. Medium and longterm follow up is essential to evaluate the rate of recurrence.





No regional perianal paget's disease treatment with aldara node enlargement was palpated and there was no other skin lesion elsewhere. Physical examination was unremarkable except prostate hypertrophy suggestive of prostate adenoma. Two punch skin biopsies were performed, one on the penis and one on the scrotum. Laboratory investigations including prostate specific antigen and pelvic imaging including rectosigmoidoscopy, urinary tract and inguinal lymph node ultrasonographies proved either negative or within normal ranges. Extramammary pagets disease of the scrotum and the base of the penil shaft.

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Scrotum and penis one month following completion of imiquimod 5% cream application. However, after one month, marked erythema and tenderness on the affected area where the topical treatment was applied, prompted us to reduce the frequency of its application to threetimes per week for six aldara price australia. After 12 months of followup, no clinical recurrence was noted. Our patients underwent four excisions over a two yearperiod without achieving full eradication of the disease. The ideal treatment should offer a minimal amount of tissue destruction and low rates of recurrence.