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Imiquimod

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1661. A randomised study of topical 5% imiquimod vs. topical 5-fluorouracil vs. cryosurgery in immunocompetent patients with actinic keratoses: a comparison of clinical and histological outcomes including 1-year follow-up. (Abstract)

A randomised study of topical 5% imiquimod vs. topical 5-fluorouracil vs. cryosurgery in immunocompetent patients with actinic keratoses: a comparison of clinical and histological outcomes including 1-year follow-up. Actinic keratoses (AK) frequently occur on sun-exposed skin and are considered as in situ squamous cell carcinoma. To date, no treatment algorithm exists for first or second line therapies due to the lack of comparative studies.This study compared the initial and 12-month clinical (...) clearance, histological clearance, and cosmetic outcomes of topically applied 5% imiquimod (IMIQ) cream, 5% 5-fluorouracil (5-FU) ointment and cryosurgery for the treatment of AK.Patients were randomised to one of the following three treatment groups: one or two courses of cryosurgery (20-40 s per lesion), topical 5-FU (twice daily for 4 weeks), or one or two courses of topical imquimod (three times per week for 4 weeks each).Sixty-eight per cent (17/25) of patients treated with cryosurgery, 96% (23/24

2007 The British journal of dermatology Controlled trial quality: uncertain

1662. Giant condyloma acuminata of Buschke-Löwenstein: successful treatment with a combination of surgical excision, oral acitretin and topical imiquimod. (Abstract)

Giant condyloma acuminata of Buschke-Löwenstein: successful treatment with a combination of surgical excision, oral acitretin and topical imiquimod. Human papillomavirus (HPV) is the most common sexually transmitted disorder in young, sexually active populations in the USA and Europe. Giant condyloma acuminatum (GCA) is a unique variant of condyloma acuminata, characterized by local aggressive behaviour despite benign histology. It carries a substantial risk of squamous cell carcinoma. Various (...) treatments have been used, but response is often poor and recurrence rates high. We present a case of GCA successfully treated with a combination of surgical excision, oral acitretin and topical imiquimod. The diagnosis was based on histological examination, immunohistochemical analysis and in situ hybridization for HPV 6 and 11. We recommend a trial of oral retinoid and topical imiquimod in selected cases of GCA.

2008 Clinical & Experimental Dermatology

1663. Treatment of Classic Kaposi's Sarcoma with Topical Imiquimod. (Abstract)

Treatment of Classic Kaposi's Sarcoma with Topical Imiquimod. 19076206 2009 01 23 2018 12 01 1524-4725 35 1 2009 Jan Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] Dermatol Surg Treatment of classic Kaposi's sarcoma with topical imiquimod. 147-9 10.1111/j.1524-4725.2008.34397.x Goiriz Rebeca R Department of Dermatology, University Hospital, La Princesa, Madrid, Spain. rgoiriz@yahoo.es Ríos-Buceta Luis L De Arriba Ana González AG Aragüés (...) Maximiliano M García-Diez Amaro A eng Journal Article 2008 12 06 United States Dermatol Surg 9504371 1076-0512 0 Aminoquinolines 0 Antineoplastic Agents P1QW714R7M Imiquimod IM Administration, Topical Aged, 80 and over Aminoquinolines administration & dosage Antineoplastic Agents administration & dosage Humans Imiquimod Male Sarcoma, Kaposi drug therapy 2008 12 17 9 0 2008 12 17 9 0 2009 1 24 9 0 ppublish 19076206 DSU34397 10.1111/j.1524-4725.2008.34397.x

2008 Dermatologic Surgery

1664. A pharmaceutical comparison of different commercially available imiquimod 5% cream products. (Abstract)

A pharmaceutical comparison of different commercially available imiquimod 5% cream products. Alternatives to the innovator product for imiquimod 5% cream are currently marketed in South America and the People's Republic of China.Seven alternative imiquimod 5% cream products were compared with the innovator product using physiochemical tests for cream appearance, pH, drug content and presence of crystals, as well as in vitro release testing of drug using Franz diffusion cells.In contrast (...) to the innovator product, which had no crystalline imiquimod, significant amounts of suspended crystalline imiquimod were found in six of the seven alternative products. In vitro release rates of imiquimod were significantly slower in these six products compared with the innovator (p<0.001). In vitro release rates of imiquimod were significantly faster than the innovator (p<0.05) for the one alternative product without crystals.The clinical relevance of the differences observed is unknown; however, they raise

2008 Journal of Dermatological Treatment

1665. Successful treatment of intranasal papillomata with imiquimod cream in a human immunodeficiency virus positive patient. (Abstract)

Successful treatment of intranasal papillomata with imiquimod cream in a human immunodeficiency virus positive patient. To report a new, alternative treatment for nasal papillomata in human immunodeficiency virus positive patients with multiple recurrences after surgical removal.A human immunodeficiency virus positive patient presented with multiple, recurrent nasal papillomata which developed after repeated surgical removal procedures. In this patient, complete and persistent resolution (...) of the lesions was achieved after topical treatment with imiquimod cream.Imiquimod is a class of non-nucleoside imidazoquinolinamines which promotes local cytokine release from antigen-presenting cells inducing a T-h1 dominant cell-mediated response against virus-infected cells. Topical imiquimod 5 per cent cream, applied for four to 16 weeks, may offer some benefit in the management of recurrent nasal papillomata in human immunodeficiency virus positive patients. Such treatment may be preferable to surgery

2008 Journal of Laryngology & Otology

1666. Involution of infantile haemangiomas after imiquimod 5% cream. Full Text available with Trip Pro

Involution of infantile haemangiomas after imiquimod 5% cream. Infantile haemangioma is a common childhood condition, which usually resolves spontaneously and is managed expectantly. In a small percentage of complex cases, haemangiomas may be associated with complications such as persistent bleeding, ulceration, feeding difficulties or visual impairment. Active treatment is often necessary in such cases. Current interventions include surgical, laser and immunomodulatory treatments. Imiquimod 5 (...) % cream is a novel alternative topical treatment that may have a potential role in management of these patients. We present our experience of imiquimod 5% cream in the treatment of five children with difficult haemangiomas. We discuss its efficacy and some of the side effects that may be encountered, which have not previously been reported.

2008 Clinical & Experimental Dermatology

1667. Cryosurgery during topical imiquimod: a successful combination modality for lentigo maligna. (Abstract)

Cryosurgery during topical imiquimod: a successful combination modality for lentigo maligna. Either cryosurgery or topical imiquimod have been used to treat patients with lentigo maligna in cases where surgery is not feasible.We report a patient with lentigo maligna, who was treated with the combination of topical imiquimod and cryosurgery, and review the rationale, which led us to design the present combined cryo-immunological treatment modality.Sustained clearance of lentigo maligna to date (...) (26 months after treatment). The successful treatment of this patient was based on the following rationale: A cryosurgery session during continuing imiquimod application may: (i) reinforce apoptosis of tumor cells; (ii) strengthen antiangiogenesis in the treated tumor; and (iii) build-up a potent tumor-destructive immune response by a cascade of events starting with imiquimod-promoted attraction of immature dendritic antigen-presenting cells (DCs) into the tumor. DCs further mature within

2008 International Journal of Dermatology

1668. Imiquimod Leads to a Decrease of Human Papillomavirus DNA and to a Sustained Clearance of Anal Intraepithelial Neoplasia in HIV-Infected Men. Full Text available with Trip Pro

Imiquimod Leads to a Decrease of Human Papillomavirus DNA and to a Sustained Clearance of Anal Intraepithelial Neoplasia in HIV-Infected Men. Anal intraepithelial neoplasia (AIN), a human papillomavirus (HPV)-associated precursor lesion of anal carcinoma, is highly prevalent in HIV-infected men having sex with men (MSM). This prospective follow-up study evaluated the long-term results of imiquimod treatment of AIN in 19 HIV-infected MSM. Standardized follow-up examinations included high (...) ) developed new anal cytological abnormalities in previously normal, untreated anal regions. 55% of these new AIN lesions were high-grade lesions and most of them were located intra-anally and associated with high-risk HPV types not detectable before therapy. These results demonstrate that imiquimod leads to a high rate of long-term clearance of AIN in HIV-positive men together with a prolonged decrease of high-risk HPV-DNA load. However, new AIN lesions associated with previously undetected HPV types

2008 Journal of Investigative Dermatology

1669. Pyogenic granuloma: complete remission under occlusive imiquimod 5% cream. (Abstract)

Pyogenic granuloma: complete remission under occlusive imiquimod 5% cream. An 82-year-old man was referred to our department for evaluation and treatment of a recurrent pyogenic granuloma on his right hand. After previous histopathological confirmation of the clinical diagnosis, he had been treated twice with electrocautery, but the lesion recurred 10 and 8 days later, respectively. After a 3-week topical application of imiquimod 5% cream twice daily under occlusion, complete remission

2008 Clinical & Experimental Dermatology

1670. Treatment of Lentigo Maligna with Imiquimod before Staged Excision. (Abstract)

Treatment of Lentigo Maligna with Imiquimod before Staged Excision. Imiquimod 5% cream has demonstrated effectiveness in the treatment of lentigo maligna (LM) in several small studies. None of the studies to date have included posttreatment surgical removal to confirm negative histologic margins.The aim of this retrospective analysis was to assess the efficacy of topical imiquimod in LM by circumferentially examining vertically oriented sections from a geometrically designed "picture frame (...) " margin as well as bread-loafed sections of the central portion after staged excisions of imiquimod-treated lesions of LM.Forty patients with biopsy-confirmed LM were treated five times a week for 3 months with 5% imiquimod cream before staged excision. Tazarotene 0.1% gel was added when no clinical signs of erythema developed with imiquimod alone after 1 month (10 patients). After the course of topical therapy, patients were assessed for clinical and complete histologic clearance after staged

2007 Dermatologic Surgery

1671. Multicentre, open-label study using imiquimod 5% cream in one or two 4-week courses of treatment for multiple actinic keratoses on the head. (Abstract)

Multicentre, open-label study using imiquimod 5% cream in one or two 4-week courses of treatment for multiple actinic keratoses on the head. In the USA, Imiquimod 5% cream is approved for use 2-3 times per week over 16 weeks for the treatment of actinic keratoses (AKs). This study evaluated the efficacy of imiquimod in another treatment schedule, for AKs on the head.Open-label, phase IIIb.180 dermatology clinics and practices in Germany.Patients were eligible if they had clinically typical (...) in the treatment area at the course 1 or course 2 post-treatment visit.829 patients entered the study. Overall, the complete clearance rate was 68.9% (571/829) and the partial clearance rate (percentage of patients with >/= 75% reduction in the number of baseline AK lesions) was 80.2%. Local skin reactions (LSRs) and application site reactions (ASRs) were the most commonly reported adverse events. Four patients discontinued from the study due to LSRs or ASRs.Shorter treatment regimen of imiquimod 5% cream can

2007 British Journal of Dermatology

1672. Evaluation of imiquimod for the therapy of external genital and anal warts in comparison with destructive therapies. (Abstract)

Evaluation of imiquimod for the therapy of external genital and anal warts in comparison with destructive therapies. External genital and anal warts (acuminate condyloma) were the first medical indication the topical immune response modifier imiquimod was approved for in 1997. Since then, many placebo controlled randomized clinical trials have demonstrated the efficacy and safety of this synthetic imidazoquinoline derivate for the treatment of different human papillomavirus infections (...) and tumours. Treatment modalities for genital warts (5% cream, three times weekly, minimum duration 4 weeks, control of side-effects) have been optimized and assured by further clinical trials and meta-analyses. For a few years clinical studies focussed on the long-term efficacy of the immunomodulatory therapy (sustained clearance from warts) and most recent studies compared the efficacy of ablative, destructive and imiquimod monotherapy as well as combination therapies.

2007 British Journal of Dermatology

1673. Imiquimod: mode of action. (Abstract)

Imiquimod: mode of action. Since imiquimod, a nucleoside analogue of the imidazoquinoline family, has shown efficacy against many tumour entities, its mode of action has become a focus of scientific interest.The major biologic effects of imiquimod are mediated through agonistic activity towards toll-like receptors (TLR) 7 and 8, and consecutively, activation of nuclear factor-kappa B (NF-kappaB). The result of this activity is the induction of pro-inflammatory cytokines, chemokines and other (...) mediators leading to activation of antigen-presenting cells and other components of innate immunity and, eventually, the mounting of a profound T-helper (Th1)-weighted antitumoral cellular immune response. Several secondary effects on the molecular and cellular level may also be explained, at least in part, by the activation of NF-kappaB. Moreover, independent of TLR-7 and TLR-8, imiquimod appears to interfere with adenosine receptor signalling pathways, and the compound causes receptor-independent

2007 British Journal of Dermatology

1674. Imiquimod treatment of papilloma virus and DMBA /TPA-induced cutaneous skin cancer in Mastomys coucha: an unique animal model system useful for preclinical studies. (Abstract)

Imiquimod treatment of papilloma virus and DMBA /TPA-induced cutaneous skin cancer in Mastomys coucha: an unique animal model system useful for preclinical studies. Immune response modifiers including imiquimod can be topically applied for the treatment of both genital warts and benign and malignant skin tumours (e.g. actinic keratosis). In an initial pilot study, we examined the response of spontaneously papillomavirus caused skin lesions (e.g. papillomas, keratoacanthomas) vs. chemically (...) induced skin tumours of Mastomys coucha to imiquimod.Fourteen spontaneously and 16 chemically [initiation with 7,12-dimethylbenzanthracene (DMBA) followed by repeated 12-O-Tetradecanoylphorbol-13-acetate (TPA) applications] induced skin tumours were treated two to three times per week with 5% imiquimod or placebo.Notably, significant higher regression or growth arrest rates of imiquimod treated animals were observed in chemically vs. spontaneously induced skin tumours [9/14 (64%) vs. 2/11 (18%), P

2007 British Journal of Dermatology

1675. Possible mechanisms in the induction of vitiligo-like hypopigmentation by topical imiquimod. Full Text available with Trip Pro

Possible mechanisms in the induction of vitiligo-like hypopigmentation by topical imiquimod. The pathogenesis of vitiligo was examined for clues to the pigmentary changes that may occur after treatment with topical imiquimod. The literature varies on the pigmentary changes induced by topical use of imiquimod. The US Food and Drugs Administration lists 68 reports of pigmentary changes out of a total of 1257 reports related to imiquimod lodged from 1997 to 2003. Some studies describe vitiligo (...) -like hypopigmentation associated with imiquimod treatment of genital warts (as with the patient described in this report), molluscum contagiosum, basal cell carcinoma, extramammary Paget's disease and murine melanoma. Other studies report hyperpigmentation associated with imiquimod. The possible mechanisms of hypopigmentation associated with imiquimod treatment are discussed, including antibodies found in sera of patients with vitiligo to nonpigment cell antigens, cytoplasmic pigment cell antigens

2007 Clinical & Experimental Dermatology

1676. Efficacy of imiquimod, an immunomodulatory agent, on experimental endometriosis. (Abstract)

Efficacy of imiquimod, an immunomodulatory agent, on experimental endometriosis. To investigate the efficacy of imiquimod on endometriosis.Randomized, placebo-controlled, single-blind, experimental study.Experimental surgery laboratory at a university in Turkey.Thirty Wistar female rats.After the peritoneal implantation of endometrial tissue, rats were randomized to two equal intervention groups: [1] the control group and [2] the imiquimod group. Six weeks later, after implant volume (...) was measured (volume 1) by performing a second laparotomy, imiquimod (10 mg intraperitoneally per rat, 2 times per wk) was administered to the imiquimod group, and saline solution (0.1 mL SC, once per wk), to the control group, for 8 weeks. At the end of the treatment, a third laparotomy was performed to remeasure implant volumes (volume 2), and implants were totally excised for histopathologic examination.To compare volume 1 and volume 2 within the groups, as well as stromal and glandular tissues between

2007 Fertility and Sterility

1677. Imiquimod enhances the systemic immunity attained by local cryosurgery destruction of melanoma lesions. Full Text available with Trip Pro

Imiquimod enhances the systemic immunity attained by local cryosurgery destruction of melanoma lesions. Melanoma lesions can be frozen in vivo, resulting in necrotic death of malignant cells and in tumor antigen release suitable for cross-presentation by professional antigen-presenting cells. Imiquimod is a small molecule with adjuvant pro-inflammatory effects that can be topically delivered as a cream. Local cryosurgery of B16/ovalbumin (OVA)-derived subcutaneous tumor nodules leads (...) to curative destruction of the lesions. If imiquimod is repeatedly applied on the cryo-treated lesion, a conspicuous, leukocyte-rich inflammatory infiltrate appears during the days following treatment. Mice treated by cryosurgery plus imiquimod rejected rechallenges of B16/OVA in 90% of the cases, whereas cryosurgery alone failed to prevent tumor grafting in 70% of the cases. The combination treatment of B16/OVA tumors was also able to protect 60% of the mice against outgrowth of a lethal dose of non

2007 Journal of Investigative Dermatology

1678. Epidermodysplasia verruciformis: unsuccessful therapeutic approach with imiquimod. (Abstract)

Epidermodysplasia verruciformis: unsuccessful therapeutic approach with imiquimod. Epidermodysplasia verruciformis (EV) is a rare heritable disease characterized by an unusual susceptibility to infection with specific types of human papillomavirus and a propensity for developing skin malignant tumors. Partial defects in cell-mediated immunity have been demonstrated in this disease. Here, we describe a patient with EV who was treated unsuccessfully with imiquimod.

2007 International Journal of Dermatology

1679. Imiquimod-induced interleukin-1 alpha stimulation improves barrier homeostasis in aged murine epidermis. Full Text available with Trip Pro

Imiquimod-induced interleukin-1 alpha stimulation improves barrier homeostasis in aged murine epidermis. In response to acute disruption of the permeability barrier of aged mammals there is a diminished capacity for barrier recovery, analogous to other aged organs when stressed. Acute barrier disruption increases levels of epidermal cytokines, and cytokines are known regulators of keratinocyte mitogenesis, as well as lipid synthesis in extracutaneous tissues. Underlying the sluggish barrier (...) recovery in aged skin are diminished mRNA and protein levels for the interleukin-1 cytokine family, and its receptors. To further elucidate the role of the interleukin-1 family of cytokines in the barrier repair response, cytokine production was stimulated in aged murine skin with topical imiquimod application. Imiquimod accelerated barrier recovery after acute insults to aged and young skin. These functional results correlated temporally with increased interleukin-1 alpha production in the epidermis

2004 Journal of Investigative Dermatology

1680. Death receptor-independent apoptosis in malignant melanoma induced by the small-molecule immune response modifier imiquimod. Full Text available with Trip Pro

Death receptor-independent apoptosis in malignant melanoma induced by the small-molecule immune response modifier imiquimod. Bypassing molecular mechanisms of apoptosis deficiency may be of great utility for the successful treatment of malignant tumors. We have discovered that imiquimod, a small-molecule immunomodulator, exerts rather tumor-selective direct pro-apoptotic activity in vivo and in vitro towards cutaneous metastases of malignant melanoma, an aggressive skin tumor. This pro (...) -apoptotic activity was not detectable with resiquimod, a closely related structural analogue whose pro-inflammatory activity is even greater than that of imiquimod. Unresponsiveness of some melanoma metastases to imiquimod in vivo corresponded to resistance towards imiquimod-induced apoptosis in vivo and in vitro. At the molecular level, the pro-apoptotic activity of imiquimod was independent of membrane-bound death receptors, but depended on Bcl-2 expression as demonstrated by overexpression of Bcl-2

2004 Journal of Investigative Dermatology

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