Treatment of all basal cell carcinoma variants including large and high-risk lesions with 5% imiquimod cream: histological and clinical changes, outcome, and follow-up.
Forty-one patients with 47 basal cell carcinomas (BCCs; 15 superficial, 26 nodular, and 6 sclerodermiform) were treated with 5% imiquimod cream once daily 5 times a week for 6 weeks in an open-label clinical trial. The overall response rate was 95.7%. Local side effects occurred in 68% of the patients as mild to moderate reactions with a clear association to the histological BCC subtype. Follow-up examinations for up to 17 months (median 10 months) showed scars in 14.9% of the patients and a recurrence rate of 6.6%. Overall, imiquimod represents a safe and effective treatment option for a selected cohort of BCC patients. Notably, by the second week of treatment 72.7% of BCC biopsies were histologically tumor-free, which correlated with a substantial decrease of the inflammatory infiltrate by up to 58% between weeks 3 to 6. This early imiquimod response might have important implications for the final definition of potentially shorter imiquimod treatment periods.
Department of Dermatology and Venereology, Federal University Teaching Hospital, Feldkirch, Austria.
Claudia
C
Schiessl
Carola
C
Wolber
Martina
M
Tauber
Felix
F
Offner
Robert
R
Strohal
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000634:Aminoquinolines / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002280:Basal Cell Carcinoma / Q000145:classification / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077271:Imiquimod; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012878:Skin Neoplasms / Q000145:classification / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
D000634:Aminoquinolines; D000970:Antineoplastic Agents; D000077271:Imiquimod