title: Imiquimod for restoring local immunity in a renal transplant patient with persistent keratoacanthoma.
abstract: Keratoacanthoma (KA), a cutaneous neoplasm histologically resembling squamous cell carcinoma, is characterized by rapid growth and common spontaneous regression. The regression depends on an individual's immune response. We are reporting a case of a 53-year-old man who presented with an ulcerated tumor, which had arisen as a nodular lesion 9 months earlier. This was localized on the the left thumb. The patient had undergone a kidney transplant after severe glomerulonephritis. Following the operation, he was treated with systemic immunosuppressive drugs and developed multiple non-melanoma skin cancers. The histology examination of biopsy specimens was consistent with keratoacanthoma and showed low-density chronic inflammatory cells. Our patient refused surgical excision, so we prescribed imiquimod 5 percent cream once daily for 5 days a week. After 6 weeks of treatment the lesion had regressed completely, yielding an excellent cosmetic result. Continued resolution was documented 3 years after treatment. The patient had no signs of graft rejection related to the imiquimod treatment.
authors.affiliation: Department of Dermatology, University of Rome Tor Vergata, Rome, Italy. evelin.paterno@libero.it
authors.forename: Evelin Jasmine
authors.initials: EJ
authors.lastname: Paternò
authors.forename: Elena
authors.initials: E
authors.lastname: Campione
authors.forename: Laura
authors.initials: L
authors.lastname: Diluvio
authors.forename: Augusto
authors.initials: A
authors.lastname: Orlandi
authors.forename: Sergio
authors.initials: S
authors.lastname: Chimenti
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000634:Aminoquinolines / Q000627:therapeutic use*; D006801:Humans; D000077271:Imiquimod; D016867:Immunocompromised Host; D007636:Keratoacanthoma / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology
chemical_list: D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D000077271:Imiquimod