ALA-PDT as palliative care in a patient with secondary perineum EMPD

Extramammary Paget's disease (EMPD) is a rare intraepithelial neoplasm arising in apocrine rich area of the skin. It is divided into primary and secondary EMPD based on whether there is an underlying malignancy, either local apocrine cancers or distant neoplasms. Therefore, all patients with EMPD should undergo an extensive and targeted cancer workup, depending on the histological staining pattern and the location. Surgical removal is considered the mainstay of treatment for patients with EMPD. Herein, we present a case of secondary EMPD where photodynamic therapy was effective in terms of improving symptoms and quality of life. Owing to preexisting comorbid conditions, large area of disease and risk of post-surgery mutilation and functional impairment, surgery could not be elected for this patient, necessitating nonsurgical approach.