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A Journal on Dermatology and Sexually Transmitted Diseases

Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
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Giornale Italiano di Dermatologia e Venereologia 2007 June;142(3):285-9

language: English

Topical imiquimod 5% cream in difficult-to-treat non melanoma skin cancer: experiences in a dermatological clinical settings

Cavicchini S., Vezzoli P., Moretti D., Sala F.

Department of Dermatological Sciences University of Milan IRCCS Foundation Ospedale Maggiore Policlinico Mangiagalli e Regina Elena, Milan, Italy


Aim. Imiquimod (IMQ) is an immune response modifier exerting its biological activity through activation of toll-like receptor 7 of antigen presenting cells. The consequent induction of cytokine and interferon alfa production stimulate the innate and cell-mediated immune response. Imiquimod also induces a selective apoptosis acting on Bcl-2 protein family and mitochondrial release of cytochrome c and activation of caspase 9. The rationale of Imiquimod use in non melanoma skin cancer (NMSC) is the induction of a cell-mediated immune response against tumoral cells. These properties seem to be useful in a selected group of patients with superficial and ulcerated basal cell carcinoma, Bowen’s disease and actinic keratosis of problematic surgical approach.
Methods. According to literature indications, we treated 11 patients with NMSC (7 with superficial basal cell carcinoma, 1 with ulcerated basal cell carcinoma, 2 with Bowen’s disease and 1 with actinic keratosis).
Results. All patients had clinical clearance of treated lesions and are included in a mean follow-up period of 20 months. The treatment was well tolerated, following the prescribed supportive measures.
Conclusion. Our experience confirm IMQ as an effective, well tolerated and easy to apply therapeutic solution in patients where surgical excision is complicated, risky or refused by the patient.

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