Clinical Practice of Surgery Combined with Photodynamic Therapy for Extramammary Paget's Disease

Extramammary Paget’s disease (EMPD) is an aggressive cutaneous malignancy that frequently affects sensitive anatomical areas. Wide local excision (WLE) typically requires extensive reconstruction, impairing quality of life (QoL), while photodynamic therapy (PDT) alone provides limited remission. This study compares the efficacy and safety of surgery combined with PDT (S-PDT) versus WLE in treating in situ EMPD. This retrospective study enrolled 24 in situ EMPD patients, 12 treated with S-PDT and 12 with WLE. All patients were followed for at least 6 months. S-PDT showed comparable complete and partial clearance rates to WLE, with no significant recurrence difference (P > 0.05). Both groups exhibited significant improvement in postoperative itching and Dermatology Life Quality Index (DLQI) scores (P < 0.001). S-PDT demonstrated superior DLQI improvement (P = 0.011), higher satisfaction (P = 0.04), and lower costs (P = 0.01). S-PDT is a cost-effective, anatomy-preserving palliative option for EMPD, significantly enhancing QoL.