title: A comparison of cryotherapy and imiquimod for treatment of actinic keratoses: lesion clearance, safety, and skin quality outcomes.
abstract: BACKGROUND
  There is limited direct comparative data on imiquimod versus cryotherapy to treat actinic keratoses.
  
  
  OBJECTIVE
  Compare lesion response through 12 months post-initial treatment.
  
  
  METHODS
  Patients with ≥ 10 lesions on the face or scalp were randomized to cryotherapy (up to 10 lesions per session, up to 4 sessions, every 3 months) or imiquimod (3-times-per-week for 3-4 weeks, up to 2 courses) with repeat treatment depending on response.
  
  
  RESULTS
  In 36 patients assigned to cryotherapy and 35 to imiquimod, lesion complete response rates were 85.0 percent (306/360) and 66.9 percent (234/350) for cryotherapy and imiquimod, respectively (P<0.0002). For completely cleared lesions, global skin quality was excellent in 82 percent (250/306) versus 100 percent (234/234) for cryotherapy and imiquimod, respectively (P<0.0001). More cryotherapy than imiquimod patients had hypopigmentation (54.8% versus 24.0%, P=0.0197), as well as blister formation, redness/erythema, flaking/scaling/dryness, and scabbing/crusting (P<0.05).
  
  
  CONCLUSIONS
  12-month lesion complete clearance rate was higher with repeated cryotherapy, but cosmetic outcome was better with imiquimod.
authors: University of Melbourne, Department of Medicine, Fitzroy, Victoria, Australia. Peter.FOLEY@svhm.org.au
authors: Peter
authors: P
authors: Foley
authors: Kate
authors: K
authors: Merlin
authors: Simon
authors: S
authors: Cumming
authors: Jan
authors: J
authors: Campbell
authors: Rohan
authors: R
authors: Crouch
authors: Shannon
authors: S
authors: Harrison
authors: Jennifer
authors: J
authors: Cahill
mesh_terms: D000276:Adjuvants, Immunologic / Q000009:adverse effects / Q000627:therapeutic use*; D000368:Aged; D000634:Aminoquinolines / Q000009:adverse effects / Q000627:therapeutic use*; D017679:Cryotherapy; D005148:Facial Dermatoses / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077271:Imiquimod; D055623:Keratosis, Actinic / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D012536:Scalp Dermatoses / Q000188:drug therapy / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D000077271:Imiquimod