Photodynamic therapy for inoperable vulval Paget's disease using delta-aminolaevulinic acid: successful management of a large skin lesion.

A 74-year-old woman with extensive inoperable vulval extramammary Paget's disease who had lymph node and pulmonary metastases, was treated with etoposide (VP16) 100 mg and 5000 cGy electron beam irradiation, which reduced the lesion by 60%. Following these interventions, the residual lesion was successfully treated with repeated photodynamic therapy using delta-aminolaevulinic acid, which achieved a nearly complete remission.