Many chemotherapy treatments have been used, however the results are not desirable as prognosis remains to be poor. Surgery remains to be the preferred treatment of choice. Wide local excision with a 3cm margin and intra-operative frozen sections are suggested, due to high risk of local extension despite normal appearing tissue. In cases where<unk>  cells have invaded the dermis and metastasized, complete removal is often unsuccessful. Recurrence is a common result. Lymphadenoectomy is often performed for infiltrative cases. In lieu of surgery, radiotherapy is also an option and is especially preferred for elderly patients or for inoperable cases where the tumour size is too large. This form of treatment is also considered as possible adjuvant therapy following excision to combat the high recurrence rate. However, there are side effects of radiotherapy, including but not limited to: vulvitis, post-radiation atrophy of mucus membranes, vaginal stenosis and sexual dysfunction. Laser therapy and photodynamic therapies were also used in the past, but it was discovered the carbon dioxide laser did not penetrate deep enough and both treatment modalities resulted in high recurrence rates. Topical chemotherapy treatments are effective, with imiquimod showing promising results. However, overall survival begins to decline 10 months following treatment with chemotherapy. Patients suffering from metastatic<unk> D only survive for a median of 1.5 years, and have a 7% 5-year survival rate.
Extramammary Paget's disease
Acral lentiginous melanoma
Arsenical keratosis
Acral fibrokeratoma
Hydrocarbon keratosis
Seborrheic keratosis
Lentigo maligna melanoma
Actinic keratosis