title: The effects of 5% imiquimod cream on high-grade vulval intraepithelial neoplasia.
abstract: OBJECTIVE
  The aim of this study was to investigate the effects of topical 5% Imiquimod (3M Pharmaceuticals, St. Paul, Minnessota) on high-grade vulval intraepithelial neoplasia (VIN).
  
  
  METHODS
  A prospective uncontrolled observational study was performed. Fifteen patients with histologically confirmed VIN 3 were asked to self-administer 5% Imiquimod cream to their vulval lesions up to three times weekly for 16 weeks. Review was conducted at 1, 2, 3, 4, 6, and 9 months postrecruitment. Lesions were photodocumented and at 4 months any areas demonstrating a clinical response were biopsied.
  
  
  RESULTS
  Of 15 patients recruited, 4 demonstrated a clinical improvement in their disease, 3 of whom had negative biopsies posttreatment. Local side effects limited the frequency of application such that 7 patients applied the cream once weekly, 6 twice weekly, and 2 three times weekly.
  
  
  CONCLUSIONS
  5% Imiquimod cream appears to have an effect when used on high-grade VIN. The frequency of application was limited by local side effects which may have reduced the clinical responses seen. Measures to alleviate local side effects may allow more aggressive use of Imiquimod and lead to improved responses.
authors.affiliation: Birmingham Women's NHS Trust, Edgbaston, Birmingham, B15 2TG, United Kingdom. r.w.todd@bham.ac.uk
authors.forename: Richard W
authors.initials: RW
authors.lastname: Todd
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Etherington
authors.forename: David M
authors.initials: DM
authors.lastname: Luesley
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000634:Aminoquinolines / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D000077271:Imiquimod; D008875:Middle Aged; D009824:Ointments; D011230:Precancerous Conditions / Q000188:drug therapy*; D011446:Prospective Studies; D014846:Vulvar Neoplasms / Q000188:drug therapy*
chemical_list: D000634:Aminoquinolines; D000970:Antineoplastic Agents; D009824:Ointments; D000077271:Imiquimod