After disease extension evaluation and symptoms assessment women with EMPD were prospectively treated with aminolevulinic-acid methyl-esther (M-ALA) PDT. Clinical and symptoms response were evaluated after 3 cycles and after any further PDT.
Thirty-two patients with vulvar EMPD underwent M-ALA PDT. In sixteen (50 % ) patients the lesion extended to the perineal and/or perianal area. After three courses of treatment, three patients (9.4 % ) had a complete resolution of the symptoms; 25 patients (78.1 % ) a partial resolution and a stable disease was recorded in four patients (12.5 % ). None of the patients had progression of disease. Both size of the lesion and EMPD associated symptoms decreased significantly after three courses of treatment. Eighteen patients (56.2 % ) recurred and 16 (88.9 % ) were treated with further PDT. Among the 26 patients who underwent a further PDT, 16 patients (61.5 % ) achieved at least a partial response.
M-ALA PDT even if not curative is a reliable strategy to control EMPD and its associated symptoms even in an outpatient setting. M-ALA PDT is able to control large and multiple lesions regardless of the area involved, preserving cosmetic and/or functional anatomy.