Failure of imiquimod 5% cream to prevent recurrence of surgically excised trunk keloids.
BACKGROUND
Keloids are characterized by benign proliferation of fibroblasts in the setting of an altered cytokine profile, with a high recurrence rate after surgical treatment. Imiquimod is a topically applied immune-response modifier. Recently, auxiliary therapy using imiquimod 5% cream to prevent keloid recurrence after excisional surgery was reported to have had good results.


OBJECTIVE
To evaluate the efficacy of topical imiquimod 5% cream applied after surgical excision and primary closure of trunk keloids in the prevention of recurrence.


METHODS
Nine patients with a keloid lesion on the trunk were treated with surgical excision and primary closure. Daily application of imiquimod 5% cream for 8 weeks was initiated the night of surgery. The patients were evaluated 2, 4, 8, 12, and 20 weeks after.


RESULTS
Keloid recurrence occurred in eight patients, seven of them 12 weeks after surgery. We lost track of one patient.


CONCLUSIONS
The results of this study suggest that imiquimod 5% cream is not effective in preventing recurrence of trunk keloids after surgical excision. Although this is a small case series, results strongly discourage other studies using imiquimod 5% cream in the prevention of surgically excised trunk keloids.
Department of Dermatology, General Hospital of São Paulo University Medical School, São Paulo, Brazil. fernandacacao@yahoo.com.br
Fernanda Marson
FM
Cação
Vanessa
V
Tanaka
Maria Cristina de Lourenzo
MC
Messina
D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000287:Administration, Topical; D000328:Adult; D000634:Aminoquinolines / Q000008:administration & dosage*; D004643:Emollients; D005260:Female; D006801:Humans; D000077271:Imiquimod; D007627:Keloid / Q000188:drug therapy* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention; D016896:Treatment Outcome; D055815:Young Adult
D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D004643:Emollients; D000077271:Imiquimod