Previous reports also revealed antitumor response induced by topical IMQ in EMPD cases, and van et Linden et al. revealed that the numbers of CD8+ cells and the ratio of CD8/FoxP3 in the epidermis of vulvar EMPD were increased after IMQ treatment, suggesting that IMQ may induce a shift toward effective anti-tumor immune responses [65]. This evidence concerns the gene CD8A and extramammary Paget disease.