Self-administered topical imiquimod treatment of vulvar intraepithelial neoplasia. A report of four cases.
BACKGROUND
Vulvar intraepithelial neoplasia (VIN) generally can be classified into viral and nonviral etiologies. The histopathologic diagnosis is often separable into basaloid and warty types. A large percentage of VIN lesions have been shown to harbor human papillomavirus (HPV), principally type 16. Imiquimod, an immune response modifier, has been shown to be safe and effective for the treatment of external and perianal genital warts caused by HPV.


METHODS
Four cases occurred of clinical and histopathologically diagnosed viral VIN 3. An imiquimod treatment protocol, previously used in a study of this drug for the treatment of external genital warts, was followed. Imiquimod 5% cream was patient applied three times per week until all lesions cleared, for a maximum of 16 weeks.


CONCLUSIONS
Imiquimod may be an effective treatment modality for viral VIN 3 in the future.
Davis
G
G
Arizona Vulva Clinic, Phoenix 85013, USA.
Wentworth
J
J
Richard
J
J
D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000279:Administration, Cutaneous; D000328:Adult; D000634:Aminoquinolines / Q000008:administration & dosage*; D002278:Carcinoma in Situ / Q000188:drug therapy* / Q000821:virology; D003218:Condylomata Acuminata / Q000188:drug therapy / Q000821:virology; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D000077271:Imiquimod; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000821:virology; D009824:Ointments; D027383:Papillomaviridae / Q000302:isolation & purification; D012646:Self Administration; D014412:Tumor Virus Infections / Q000188:drug therapy* / Q000821:virology; D014846:Vulvar Neoplasms / Q000188:drug therapy* / Q000821:virology
D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D009824:Ointments; D000077271:Imiquimod