title: Successful treatment of earlobe keloids with imiquimod after tangential shave excision.
abstract: BACKGROUND
  The treatment of earlobe keloids has historically been suboptimal; characterized by discomfort, poor response, and high rates of recurrence. Keloids are characterized by increased fibroblast activity in the setting of an altered cytokine profile.
  
  
  OBJECTIVE
  To investigate whether topical imiquimod 5% cream applied postoperatively after tangential excision can prevent recurrence of earlobe keloids.
  
  
  METHODS
  Four patients with a total of eight large pedunculated earlobe keloids (five of which were recurrent lesions) were treated with debulking by tangential shave excision followed by daily application of imiquimod 5% cream for 6 weeks.
  
  
  RESULTS
  At 6 and 12 months post-treatment there was an excellent cosmetic result and no evidence of recurrence in any of the lesions. Patients with keloids that were itchy and painful were completely asymptomatic at the conclusion of the study.
  
  
  CONCLUSIONS
  In this pilot study, imiquimod 5% cream following tangential shave excision was efficacious for the treatment of earlobe keloids. Further study is warranted to confirm the utility of imiquimod 5% cream in the treatment of earlobe keloids, as illustrated herein.
authors.affiliation: The Clinical Center of Northern Virginia, Fairfax, Virginia 22033, USA.
authors.forename: Mitchell E
authors.initials: ME
authors.lastname: Stashower
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000634:Aminoquinolines / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D017024:Chemotherapy, Adjuvant; D004426:Ear Deformities, Acquired / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077271:Imiquimod; D007627:Keloid / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D010865:Pilot Projects; D055502:Secondary Prevention; D016896:Treatment Outcome
chemical_list: D000634:Aminoquinolines; D000970:Antineoplastic Agents; D000077271:Imiquimod