BACKGROUND: Malignant epithelial tumors of the perianal skin are relatively rare however show high recurrence rates. A preoperative precise diagnosis and demarcation of the involved cancerous skin remains challenging but is worthwhile to minimize tissue defects and possible limitations of quality of life. OBJECTIVES: To show the use of fluorescence diagnostics (FD) in the management of chronic perianal disease. METHODS: FD was performed using methylaminolevulinate (MAL) for three hours topically followed by visualization with blue light (405 nm). RESULTS: We report on two patients in whom FD helped to demarcate the involved tissue or to direct biopsy to ascertain the final diagnosis. In one patient with a history of Bowen's disease and recurrent anal carcinoma, biopsy showed extramammary Paget's disease and thus was treated by surgical anoplasty. The other patient had a history of chronic anal eczema, and FD-directed biopsy could exclude suspected malignancy so that the anal eczema was treated by local therapy. CONCLUSIONS: FD is a non-invasive technique which can be used in the perianal region in order to delineate pathologic processes which may reduce the number of surgical interventions.
BACKGROUND:Malignant epithelial tumors of the perianal skin are relatively rare however show high recurrence rates. A preoperative precise diagnosis and demarcation of the involved cancerous skin remains challenging but is worthwhile to minimize tissue defects and possible limitations of quality of life. OBJECTIVES: To show the use of fluorescence diagnostics (FD) in the management of chronic perianal disease. METHODS: FD was performed using methylaminolevulinate (MAL) for three hours topically followed by visualization with blue light (405 nm). RESULTS: We report on two patients in whom FD helped to demarcate the involved tissue or to direct biopsy to ascertain the final diagnosis. In one patient with a history of Bowen's disease and recurrent anal carcinoma, biopsy showed extramammary Paget's disease and thus was treated by surgical anoplasty. The other patient had a history of chronic anal eczema, and FD-directed biopsy could exclude suspected malignancy so that the anal eczema was treated by local therapy. CONCLUSIONS: FD is a non-invasive technique which can be used in the perianal region in order to delineate pathologic processes which may reduce the number of surgical interventions.