Paget's disease of the vulva treated by combined surgery and laser

Six patients with Paget's disease of the vulva, four after local excision of the gross lesion, one after multiple biopsies, and one after a radical vulvectomy, were successfully treated using the CO2 laser. Biopsy specimens 2 cm peripheral to the excised gross lesion were used in four of the patients in planning subsequent laser treatment. Two patients were admitted to the hospital because they had hysterectomies necessitated by endometrial cancer at the time of the wide local excision. A third patient was admitted twice: initially for a radical vulvectomy and subsequently for laser vaporization and simple hysterectomy for vaginal prolapse. Local excision and the subsequent laser treatment can usually be done on an outpatient basis. Use of skin grafts was avoided in all cases. There have been no recurrences in follow-up periods ranging from 4 months to 4 1/2 years.