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Imiquimod

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1721. 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

1722. 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

1723. 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

1724. Localized morphea treated with imiquimod 5% and dermoscopic assessment of effectiveness. (Abstract)

Localized morphea treated with imiquimod 5% and dermoscopic assessment of effectiveness. The cases are reported of two women patients presenting asymptomatic solitary lesions: one in the anterior tibial region of the right leg, the other on the right arm. The first patient's lesion was 3 cm in diameter and had appeared 2 years earlier as a translucent oval atrophic patch with a definite border. The second patient presented a whitish area with a lilac ring, 2.5 cm in diameter, which had appeared (...) nearly a year earlier. Both patients had no other similar cutaneous lesions, and their family histories for cutaneous disease were negative. The lesions underwent punch biopsy, and the histopathological findings confirmed the diagnosis of morphea. Laboratory investigations showed no abnormalities. Imiquimod 5% cream was prescribed for 5 consecutive days a week for 16 weeks. Clinical and dermoscopic assessment of the lesions was performed before treatment, during follow-up and at treatment end point

2008 Journal of Dermatological Treatment

1725. 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

1726. Does imiquimod histologically rejuvenate ultraviolet radiation-damaged skin? (Abstract)

Does imiquimod histologically rejuvenate ultraviolet radiation-damaged skin? Imiquimod (IMI) 5% is believed by some to result in an improved cosmetic appearance of chronically ultraviolet radiation (UV)-damaged skin.The objective was to determine what histologic and immunohistologic changes were present in actinically damaged skin after treatment with IMI.Pre- and posttherapy biopsies of 12 patients with histories of actinic keratoses were evaluated with routine histology

2007 Dermatologic Surgery

1727. Imiquimod: an effective alternative for the treatment of invasive cutaneous squamous cell carcinoma. (Abstract)

Imiquimod: an effective alternative for the treatment of invasive cutaneous squamous cell carcinoma. Some patients with invasive cutaneous squamous cell carcinoma are either not adequate surgical candidates or present with lesions in cosmetically sensitive areas in which a surgical procedure might result in an apparent and/or a cosmetically unacceptable scar.To evaluate the effectiveness of imiquimod 5% cream in the treatment of an invasive squamous cell carcinoma in the nose of a young (...) man.Imiquimod 5% cream was applied to the lesion five times a week for 12 weeks.Complete clinicopathologic tumor clearance and an excellent cosmetic result were achieved after 12 weeks of imiquimod treatment.Imiquimod 5% cream may represent a reasonably effective alternative for the management of invasive squamous cell carcinoma in selected patients.

2005 Dermatologic Surgery

1728. Infiltrative trichilemmal carcinoma treated with 5% imiquimod cream. (Abstract)

Infiltrative trichilemmal carcinoma treated with 5% imiquimod cream. Trichilemmal carcinoma (TLC) is a rare cutaneous neoplasm that occurs in the sun-exposed skin of the elderly. Although the clinical behavior of TLC appears to be relatively indolent, wide excision or Mohs micrographic surgery is the recommended treatment owing to its locally aggressive growth. Recently, imiquimod has become an important part of the armamentarium in the treatment of nonmelanoma skin cancer.This article serves (...) to remind dermatologists that in addition to Mohs micrographic surgery and surgical excision, imiquimod 5% cream may have a role in the treatment of TLC.In addition to a review of the literature, we present a case of TLC successfully treated with 5% imiquimod cream.Its nonsurgical approach and excellent cosmetic result make imiquimod 5% cream another promising therapeutic option for TLC, even though it is histologically infiltrative.

2005 Dermatologic Surgery

1729. Eruptive epidermoid cysts resulting from treatment with imiquimod. (Abstract)

Eruptive epidermoid cysts resulting from treatment with imiquimod. Because of its unique mechanism of action and safety profile, imiquimod, a topical immune response modifier, is used for many benign and malignant dermatologic conditions. Adverse effects are typically limited to treatment site erythema and erosion.To describe a newly recognized adverse effect of imiquimod.A 79-year-old woman being treated with imiquimod 5 days per week for a nodular basal cell developed a verrucous plaque over (...) the treatment area after 7 weeks of therapy.Scouting biopsies demonstrated multiple comedones and ruptured epidermoid cysts. There was no evidence of residual basal cell carcinoma.Imiquimod is a new and novel treatment option for cutaneous malignancies. We report its successful use in the treatment of a nodular basal cell carcinoma. The multiple comedones and ruptured epidermoid cysts are newly reported adverse effects of imiquimod therapy.

2005 Dermatologic Surgery

1730. Treatment of patch and plaque stage mycosis fungoides with imiquimod 5% cream. (Abstract)

Treatment of patch and plaque stage mycosis fungoides with imiquimod 5% cream. Systemic interferon is effective in the treatment of mycosis fungoides (MF). Imiquimod is effective in the treatment of some epidermal neoplasms and induces localized interferon production.To evaluate the safety and efficacy of topical imiquimod 5% cream for the treatment of patch and plaque stage MF.Six patients with stage IA to IIB MF were treated with topical imiquimod 5% cream 3 times per week for 12 weeks (...) imiquimod 5% cream was well tolerated and associated with a histologic and clinical response rate of 50%.

2005 Journal of American Academy of Dermatology

1731. Aphthous ulcers associated with imiquimod and the treatment of actinic cheilitis. (Abstract)

Aphthous ulcers associated with imiquimod and the treatment of actinic cheilitis. Our case series report is the first documented depiction of the appearance of aphthous ulcers secondary to imiquimod application. This case series presentation discusses the underlying pathophysiology of aphthous ulcer development and imiquimod therapy in terms of the stimulation of proinflammatory cytokines, such as tumor necrosis factor alpha (TNF-alpha). The literature review suggests more than just a mere (...) coincidence for the development of aphthous ulcers subsequent to the treatment of actinic cheilitis with imiquimod application.

2005 Journal of American Academy of Dermatology

1732. Imiquimod in the treatment of extensive recurrent lentigo maligna. (Abstract)

Imiquimod in the treatment of extensive recurrent lentigo maligna. We report the case of a 70-year-old white male with an extensive recurrence of lentigo maligna in a skin-transplanted region. He was treated with imiquimod 5% cream topically applied 5 times a week for a total duration of 9 months. Clinically and histologically, a complete clearing of the lesion was observed after treatment. Topical treatment with imiquimod seems to be effective and safe in lentigo maligna.

2005 Journal of American Academy of Dermatology

1733. Clinical and histopathologic observations of the action of imiquimod in an epithelioid hemangioendothelioma and Paget's mammary disease. (Abstract)

Clinical and histopathologic observations of the action of imiquimod in an epithelioid hemangioendothelioma and Paget's mammary disease. An epithelioid hemangioendothelioma and Paget's disease of the breast were treated with topical imiquimod 5% cream with very impressive results. In both of the tumors complete disappearance of the lesions occurred. In this article, in addition to describing the treatment approach, the findings in biopsy specimens of the epithelioid hemangioendothelioma (...) and the Paget's disease before, during, and after therapy will be described. The histologic findings show ample evidence that there is both a lymphocytic T helper 1-like and T helper 2-like response from imiquimod. Direct evidence of lymphocytotoxicity was found. Furthermore, mast cells appear to be involved in the development of regression in the vascular tumor. Although the study is very limited and reports only two cases, the results are striking. We considered it important to describe these findings

2006 Journal of American Academy of Dermatology

1734. Imiquimod 5% cream in the treatment of Bowen's disease and invasive squamous cell carcinoma. (Abstract)

Imiquimod 5% cream in the treatment of Bowen's disease and invasive squamous cell carcinoma. Imiquimod has been successfully used for treatment of various epithelial cutaneous neoplasms.Our aim was to evaluate the efficacy and tolerability of imiquimod 5% cream for treatment of Bowen's disease and invasive squamous cell carcinoma (SCC) in patients who were unsuitable candidates for surgery.Five Bowen's disease lesions and 7 invasive SCC lesions on 10 patients were treated with imiquimod once (...) sections.Topical application of imiquimod 5% cream might represent an alternative topical treatment to surgery in selected cases of Bowen's disease and invasive SCC.

2006 Journal of American Academy of Dermatology

1735. Imiquimod is a strong inhibitor of tumor cell-induced angiogenesis. Full Text available with Trip Pro

Imiquimod is a strong inhibitor of tumor cell-induced angiogenesis. Imiquimod, a potent immunomodulator, not having a direct antiproliferative activity, was found to be effective in genital and cutaneous premalignancies and malignancies. As tumor development depends on blood vessel supply, the inhibition of angiogenesis could be responsible for the antitumor activity.To find in a murine model whether imiquimod has antiangiogenic activity and whether this activity is mediated by locally induced (...) cytokines.The study was performed in two cell lines: Skv human keratinocytes containing multiple integrated copies of HPV16 derived from bowenoid papulosis, and murine L1 lung sarcoma cells of Balb/c mice. The murine model of cutaneous angiogenesis was used to assess and count the new blood vessel formation. The mice were immunosuppressed by a total body X-ray irradiation and treated with 5% or 2.5% imiquimod cream before or after induction of angiogenesis with intradermally injected tumor cell suspension

2005 International Journal of Dermatology

1736. Successful treatment of malignant melanoma in situ with topical 5% imiquimod cream. (Abstract)

Successful treatment of malignant melanoma in situ with topical 5% imiquimod cream. Current treatment recommendations for malignant melanoma in situ include surgical excision with at least 0.5 cm margins. On the head or neck, obtaining adequate surgical margins for melanoma can be challenging and often disfiguring. In addition, some elderly patients may not be good surgical candidates and may request less aggressive interventions.We report herein three cases of malignant melanoma in situ (...) on the face treated with topical imiquimod cream.Complete regression of malignant melanoma in situ was observed on treatment with 5% topical imiquimod cream. The varied treatment regimens, rationale for using imiquimod rather than performing surgery, and the possible mechanisms of action are discussed.Topical imiquimod can be used successfully for the treatment of malignant melanoma in situ on the face.

2005 International Journal of Dermatology

1737. Topical imiquimod as an adjuvant to laser removal of mature tattoos in an animal model. (Abstract)

Topical imiquimod as an adjuvant to laser removal of mature tattoos in an animal model. Lasers are a commonly employed method of tattoo removal; however, numerous treatments are often needed and laser treatment may fail to eliminate the tattoo completely. It has been shown in animal studies that topical application of imiquimod cream, alone, fades tattoos. It is suspected that the combination of both imiquimod and laser treatment will result in enhanced tattoo pigment clearance.The objective (...) was to evaluate the efficacy of topical imiquimod cream as an adjuvant to laser removal of mature tattoos.Fourteen albino guinea pigs were tattooed with black ink, then randomly assigned into two groups: one underwent sequential laser treatments with a Q-switched alexandrite laser in conjunction with triweekly applications of 5% imiquimod cream, while the other group underwent laser therapy alone. Subjects were evaluated with clinical photographs and skin biopsies after six laser treatment sessions.The

2007 Dermatologic Surgery

1738. Treatment of Bowen's disease with topical 5% imiquimod cream: retrospective study. (Abstract)

Treatment of Bowen's disease with topical 5% imiquimod cream: retrospective study. Topical 5% imiquimod cream is an FDA-approved treatment for superficial basal cell carcinomas. It has also been utilized in the treatment of Bowen's disease (squamous cell in situ). The current literature on this subject, however, is scant, and this treatment is only validated by case reports and two small open label studies.The objective was to assess the efficacy of topical 5% imiquimod cream in the treatment (...) of squamous cell in situ in a larger open-label case series. METHODS A retrospective study of 49 patients was performed.Forty-two of the 49 (86%) patients in the study had a complete response with topical imiquimod. The remaining 7 (14%) failed therapy and required additional treatments. The mean follow-up duration was 19 months, with a range of 1 to 44 months.Topical 5% imiquimod cream appears to be clinically beneficial in the treatment of Bowen's disease and should be considered as a treatment option.

2007 Dermatologic Surgery

1739. Postsurgical use of imiquimod 5% cream in the prevention of earlobe keloid recurrences: results of an open-label, pilot study. (Abstract)

Postsurgical use of imiquimod 5% cream in the prevention of earlobe keloid recurrences: results of an open-label, pilot study. Traditional surgical modalities for the management of earlobe keloids are often associated with high recurrence rates. A recent report suggests that imiquimod 5% cream can be effective in the prevention of keloid recurrences after surgical excision.To establish the safety and efficacy of imiquimod 5% cream in the prevention of recurrences of excised earlobe (...) keloids.Patients who attended a dermatologic surgery clinic for the treatment of earlobe keloids were recruited into the study. Earlobe keloids underwent parallel shave excision. Imiquimod 5% cream was applied daily for 8 weeks followed by an observation period of 16 weeks. In patients who presented with bilateral earlobe keloids, paired comparisons of imiquimod versus intralesional steroid injections were performed.Eight earlobes were treated with imiquimod 5% cream after parallel keloid removal. Twenty-four

2005 Dermatologic Surgery

1740. Successful treatment of earlobe keloids with imiquimod after tangential shave excision. (Abstract)

Successful treatment of earlobe keloids with imiquimod after tangential shave excision. The treatment of earlobe keloids has historically been suboptimal; characterized by discomfort, poor response, and high rates of recurrence. Keloids are characterized by increased fibroblast activity in the setting of an altered cytokine profile.To investigate whether topical imiquimod 5% cream applied postoperatively after tangential excision can prevent recurrence of earlobe keloids.Four patients (...) with a total of eight large pedunculated earlobe keloids (five of which were recurrent lesions) were treated with debulking by tangential shave excision followed by daily application of imiquimod 5% cream for 6 weeks.At 6 and 12 months post-treatment there was an excellent cosmetic result and no evidence of recurrence in any of the lesions. Patients with keloids that were itchy and painful were completely asymptomatic at the conclusion of the study.In this pilot study, imiquimod 5% cream following

2006 Dermatologic Surgery

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