title: Imiquimod 5% cream for the treatment of large nodular basal cell carcinoma at the medial canthal area.
abstract: Context (Background): Imiquimod (IMQ) 5% cream is an immunomodulatory and antitumorigenic agent, which was used as a topical treatment regimen, who had periocular basal cell carcinoma (BCC).
  
  
  OBJECTIVE
  This study aims to present three cases with large BCC at the medial canthal area treated with IMQ 5% cream.
  
  
  METHODS
  IMQ 5% cream was used in three patients with ages 45, 49, and 73 who preferred medical treatment over surgery. Following incisional biopsy IMQ cream was used once a day, 5 times a week and the patients were followed up weekly during 12 week treatment period and monthly after the clearance of the lesion.
  
  
  RESULTS
  Erythema and erosion on the surface of the lesion, injection of conjunctiva, burning and itching sensation, epiphora and punctate keratitis were seen in all patients during the treatment period. The ophthalmic side effects could be managed by topical lubricating eye drops and the inflammatory reactions resolved within 1 month after cessation of therapy. The patients were followed up for at least 3 years without tumor recurrence and the biopsies taken from the suspected area were found to be tumor free.
  
  
  CONCLUSIONS
  Surgical excision of carcinoma of the eyelid at medial canthal area can be difficult without causing damage to the lacrimal system and reconstruction of the defect may need grafts or flaps. IMQ may provide an alternative therapy to surgery in certain cases.
authors.affiliation: Department of Ophthalmic and Plastic Surgery, Istanbul Beyoglu Eye Research and Training Hospital, Galata, 34421 Istanbul, Turkey.
authors.forename: Gamze Ozturk
authors.initials: GO
authors.lastname: Karabulut
authors.affiliation: Department of Ophthalmic and Plastic Surgery, Istanbul Beyoglu Eye Research and Training Hospital, Galata, 34421 Istanbul, Turkey.
authors.forename: Pelin
authors.initials: P
authors.lastname: Kaynak
authors.affiliation: Department of Ophthalmic and Plastic Surgery, Istanbul Beyoglu Eye Research and Training Hospital, Galata, 34421 Istanbul, Turkey.
authors.forename: Can
authors.initials: C
authors.lastname: Ozturker
authors.affiliation: Department of Ophthalmic and Plastic Surgery, Istanbul Beyoglu Eye Research and Training Hospital, Galata, 34421 Istanbul, Turkey.
authors.forename: Korhan
authors.initials: K
authors.lastname: Fazil
authors.affiliation: Department of Ophthalmology, Istanbul Beyoglu Eye Research and Training Hospital, Galata, 34421 Istanbul, Turkey.
authors.forename: Osman Bulut
authors.initials: OB
authors.lastname: Ocak
authors.affiliation: Department of Ophthalmology, Istanbul Beyoglu Eye Research and Training Hospital, Galata, 34421 Istanbul, Turkey.
authors.forename: Muhittin
authors.initials: M
authors.lastname: Taskapılı
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000634:Aminoquinolines / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001706:Biopsy; D002280:Basal Cell Carcinoma / Q000175:diagnosis / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005142:Eyelid Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077271:Imiquimod; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009824:Ointments / Q000008:administration & dosage; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000634:Aminoquinolines; D000970:Antineoplastic Agents; D009824:Ointments; D000077271:Imiquimod