title: [Solar keratosis: from precancerous lesion to pre-invasive squamous cell carcinoma--therapeutic approach with a bioinductive method].
abstract: BACKGROUND
  Solar keratoses are precancerous lesions in chronically UV-damaged skin with histological features consistent with pre-invasive squamous cell carcinoma. They require therapeutic intervention in order to prevent progression towards invasive carcinoma. Treatment options include topical medications and destructive methods. We report on a new approach--topical bioinductive therapy with imiquimod 5% cream.
  
  
  METHODS
  In a prospective case series, 7 patients with solar keratoses have been treated with topical imiquimod 5%. The cream was applied 5 days/week over 2 weeks. After end of treatment, the outcome was assessed at regular control visits and, in some cases, histologically confirmed. One patient was followed up as untreated control.
  
  
  RESULTS
  In 6 of the 7 treated patients, the lesions cleared completely; one patient did not respond. The patients did not show new solar keratoses during a follow-up period of about 2 years. The untreated patient showed spontaneous clearance of his keratoses. Local skin reactions during treatment included erythema, oedema and erosions in varying degrees, all of which completely resolved.
  
  
  CONCLUSIONS
  Bioinductive therapy with imiquimod 5% cream represents a promising therapeutic approach for cutaneous precancerous lesions such as solar keratoses.
authors.affiliation: oster-schmidt@t-online.de
authors.forename: Claus
authors.initials: C
authors.lastname: Oster-Schmidt
authors.forename: Peter
authors.initials: P
authors.lastname: Altmeyer
authors.forename: Stücker
authors.initials: S
authors.lastname: Markus
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D000634:Aminoquinolines / Q000008:administration & dosage / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077271:Imiquimod; D007369:Interferon Inducers / Q000008:administration & dosage / Q000627:therapeutic use*; D007642:Keratosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009824:Ointments; D011230:Precancerous Conditions / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D014466:Ultraviolet Rays / Q000009:adverse effects
chemical_list: D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D000970:Antineoplastic Agents; D007369:Interferon Inducers; D009824:Ointments; D000077271:Imiquimod