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Imiquimod

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1841. Experience in treating molluscum contagiosum in children with imiquimod 5% cream. (Abstract)

Experience in treating molluscum contagiosum in children with imiquimod 5% cream. There is a wide variety of topical or surgical treatment options for molluscum contagiosum (MC). However, treatment in young or anxious children is difficult, time-consuming and often painful. We studied the topical efficacy and tolerance of imiquimod, a topical immune-response modifier, which stimulates the production of interferon-alpha and other cytokines in children with MC. In an open-label, follow-up trial (...) , imiquimod 5% cream was applied three times a week for 16 weeks to 15 children aged 4-11 years with multiple MC. Nine of 13 children (69%) who completed treatment responded. Two patients (15%) showed a complete remission, and seven (54%) had a partial response, with a remarkable reduction of the MC lesions. Four children (31%) showed stable or progressive disease. In three children (23%) with partial remission, the number of mollusca were considerably reduced, thus avoiding surgical treatment. In general

2003 British Journal of Dermatology

1842. Summary of actinic keratosis studies with imiquimod 5% cream. (Abstract)

Summary of actinic keratosis studies with imiquimod 5% cream. Imiquimod is being investigated as a therapeutic option for the management of actinic keratosis. Three recent clinical trials have demonstrated a reasonable efficacy rate and high safety profile. 'Cycle' therapy may improve the safety profile while maintaining efficacy. 'Field' treatment with imiquimod may uncover and treat 'subclinical' actinic keratoses, which in turn may potentially result in fewer recurrences. Longer follow-up

2003 British Journal of Dermatology

1843. Excellent response of basal cell carcinomas and pigmentary changes in xeroderma pigmentosum to imiquimod 5% cream. (Abstract)

Excellent response of basal cell carcinomas and pigmentary changes in xeroderma pigmentosum to imiquimod 5% cream. Xeroderma pigmentosum (XP) is an autosomal recessive disease in which patients have a 1000-fold increased risk of developing cutaneous neoplasms. Management of patients with XP is a difficult therapeutic challenge as they usually present with many cutaneous malignancies and continue to form skin tumours at a high rate. We describe a 19-year-old woman with XP who had been previously (...) treated with many different therapeutic approaches. She had an excellent clinical response of her multiple small pigmented basal cell carcinomas and pigmentary changes using imiquimod 5% cream with only minor side-effects.

2003 British Journal of Dermatology

1844. Imiquimod in basal cell carcinoma: how does it work? (Abstract)

Imiquimod in basal cell carcinoma: how does it work? Imiquimod is a topical immune response modifier that binds to Toll-like receptor-7 and -8, inducing interferon-alpha. We treated superficial basal cell carcinomas (BCC) with imiquimod 5% cream daily for 5-8 days. The BCC lesions were biopsied before treatment and following imiquimod treatment, when the lesion showed the signs of erosion. We applied histology, immunohistochemistry and gene array technology (Affymetrix) to gain further insight (...) into the mode of action of imiquimod. Our findings demonstrate that imiquimod-induced BCC regression is associated with a strong activity of the innate immune response, mediated by cells of macrophage-monocyte origin and is associated with the induction of apoptosis.

2003 British Journal of Dermatology

1845. Expression of Fas-receptor on basal cell carcinomas after treatment with imiquimod 5% cream or vehicle. (Abstract)

Expression of Fas-receptor on basal cell carcinomas after treatment with imiquimod 5% cream or vehicle. Treatment with imiquimod 5% cream, capable of inducing interferon (IFN)-alpha, effectively cures basal cell carcinoma (BCC), both clinically and histologically. IFN-alpha induces expression of CD95-receptor (FasR) on BCC cells, which normally fail to express Fas receptor (FasR). Expression of the FasR is postulated to lead to apoptosis via CD95 receptor-CD95 ligand (FasL) interaction. Absence (...) of this receptor may be responsible for the longevity of the cells of BCCs by preventing them undergoing 'suicidal' apoptosis, as well as apoptosis induced by neighbouring BCC cells and/or by infiltrating T-lymphocytes. We examined the expression of FasR on BCC after very short-term exposure to imiquimod 5% cream or vehicle. In a double-blind study, 10 patients with BCC applied either imiquimod (n = 5) or vehicle (n = 5) five times per week for up to 2 weeks. At the end of treatment, the treated area

2003 British Journal of Dermatology

1846. Topical application of imiquimod 5% cream to keloids alters expression genes associated with apoptosis. (Abstract)

Topical application of imiquimod 5% cream to keloids alters expression genes associated with apoptosis. Keloids are benign mesenchymal tumours, usually present at and extending beyond the margins of sites of previous injury. It is reported that keloids display aberrant expression of apoptotic genes: TGFB1 is activated, whereas caspase 8 and 3 are not, thus indicating a block upstream in the apoptosis cascade in keloids. Interferon-alpha 2b normalizes the excessive synthesis of collagen (...) , glycosaminoglycans and collagenase by keloidal fibroblasts, reduces recurrences following keloid excision, and enhances the expression of native p53 and apoptosis. Imiquimod, a rapid and potent inducer of interferons locally at the site of application to the skin, reduces recurrences following keloid excision and alters gene expression of markers of apoptosis in basal cell carcinoma cells. We investigated the effects with respect to the expression of apoptotic genes in keloidal tissue compared with nontreated

2003 British Journal of Dermatology

1847. Treatment of lentigo maligna with topical imiquimod. (Abstract)

Treatment of lentigo maligna with topical imiquimod. A published case report and anecdotal experience suggested that topical imiquimod is an effective treatment for stage 0 melanoma (lentigo maligna). To gauge the efficacy of this therapy, we undertook a trial of topical imiquimod in 30 subjects with histologically confirmed lentigo maligna. Thirty subjects with lentigo maligna were recruited for an open-labelled efficacy trial with daily topical application of imiquimod 5% cream for 3 months (...) , 26 (93%) were complete responders and two were treatment failures at the time of the 4-quadrant biopsy. Over 80% of the 28 subjects that completed treatment have been followed for more than 1 year with no relapses. The results of this study demonstrate that topical imiquimod produces a high complete response rate in lentigo maligna when applied daily for 3 months.

2003 British Journal of Dermatology

1848. Evaluation of superficial basal cell carcinomas after treatment with imiquimod 5% cream or vehicle for apoptosis and lymphocyte phenotyping. (Abstract)

Evaluation of superficial basal cell carcinomas after treatment with imiquimod 5% cream or vehicle for apoptosis and lymphocyte phenotyping. To characterize the immune response and the apoptotic pathways that result in regression of imiquimod-treated basal cell carcinomas (BCCs).The trial was conducted as an open-label, matched controlled, nonrandomized study. Twelve patients were assigned as either active-treatment patients or matched control subjects. After treatment, lesions were excised (...) and stained for CD20, CD3, CD4, CD56, bcl-2, bax, caspase-3, and p53. Additionally, a DNA fragmentation assay was performed using the terminal deoxynucleotidyltransferase-mediated dUTP nick-end-labeling method.All vehicle-treated BCCs (six of six) had residual tumor compared with four of six imiquimod-treated BCCs. A dense mononuclear infiltrate surrounded all of the imiquimod-treated tumors and only one of six vehicle-treated BCCs. Staining for CD20, CD3, and CD4 revealed that the infiltrate consisted

2003 Dermatologic Surgery

1849. Imiquimod to treat different cancers of the epidermis. (Abstract)

Imiquimod to treat different cancers of the epidermis. Topical immunomodulatory therapy with imiquimod has been recently used for the treatment of actinic keratoses, intraepithelial carcinoma, and small basal cell carcinoma (BCC) besides the licensed indication of extragenital warts (condyloma).We treated several patients with particular epidermal neoplasias such as squamous cell cancer (SCC) and basal cell cancer of sclerodermiform type three times per week for 4 to 12 weeks.We report several (...) novel aspects of the treatment of epidermal cancers with self-applied, nonpainful, immunomodulatory therapy. First, we treated-for the first time-two immunosuppressed renal transplant patients for invasive SCC with imiquimod. Interestingly, systemic immunosuppression did not adversely affect the response to therapy. Second, one patient with the high-risk and aggressive growth pattern of basal cell cancer (sclerodermiform histology) was cured from his disease at a particular location in the face

2003 Dermatologic Surgery

1850. Lip silicone granulomatous foreign body reaction treated with aldara (imiquimod 5%). (Abstract)

Lip silicone granulomatous foreign body reaction treated with aldara (imiquimod 5%). We report a case of a lip granulomatous reaction after injection of silicone being treated successfully with topical Aldara (Imiquimod 5%). Silicone granulomas and the inflammatory foreign body reaction that can occur are some of the complications that arise from using silicone for cosmetic enhancement. The inflammatory reaction of this patient first appeared shortly after silicone injection of both the upper (...) and lower lips. Histopathologic examination revealed a foreign body inflammatory reaction that is consistent with silicone granuloma. Although this reaction has been described extensively in the dermatologic literature as one of the disfiguring side effects of silicone injection, its treatment has plagued cosmetic dermatologists. We report the use of an immunomodulatory cream Aldara (Imiquimod 5%) to treat this type of reaction.

2003 Dermatologic Surgery

1851. Imiquimod 5% cream for keloid management. (Abstract)

Imiquimod 5% cream for keloid management. Keloid treatment represents a therapeutic challenge. New adjuvant therapy is needed to reduce the high recurrence rate (50%) of excised keloids.To describe the method for using imiquimod 5% cream in the prevention of keloid recurrence after surgery.This is a review of the scientific rationale and clinical experience of using imiquimod 5% cream for keloid management.Topical application of imiquimod 5% cream after surgery reduces keloid recurrences.

2003 Dermatologic Surgery

1852. Topical imiquimod treatment of superficial and nodular basal cell carcinomas in patients affected by basal cell nevus syndrome: a preliminary report. (Abstract)

Topical imiquimod treatment of superficial and nodular basal cell carcinomas in patients affected by basal cell nevus syndrome: a preliminary report. Imiquimod 5% cream has been shown to be effective in the treatment of superficial basal cell carcinomas (sBCCs).To evaluate the efficacy, safety and compliance of imiquimod 5% cream for the treatment of sBCCs and nodular BCCs (nBCCs) in patients affected by basal cell nevus syndrome.Three patients (two male, one female) were enrolled in the study

2002 Journal of Dermatological Treatment

1853. Mechanisms underlying imiquimod-induced regression of basal cell carcinoma in vivo. Full Text available with Trip Pro

Mechanisms underlying imiquimod-induced regression of basal cell carcinoma in vivo. Imiquimod is a local immune response modifier that has demonstrated potent antiviral and antitumor activity. It enhances innate and acquired immune responses via endogenous cytokine production and has proven efficacious in clearing superficial basal cell carcinoma (sBCC).To evaluate the mechanisms by which topical imiquimod treatment leads to sBCC clearance in vivo.A pilot, open-label, nonrandomized study.Zurich (...) , Switzerland.Six persons 18 years or older who had nonrecurrent primary tumors that had not undergone previous biopsy or treatment but were suitable for treatment by surgical excision. The tumors were located on the scalp, extremities, or trunk; had a minimum diameter of 1 cm and a maximum diameter of 2 cm; and were clinically and histologically consistent with sBCC.Daily application of 5% imiquimod cream 5 times per week for a maximum of 6 weeks. When the tumor began to show signs of erosion

2003 Archives of Dermatology

1854. Application of imiquimod by suppositories (anal tampons) efficiently prevents recurrences after ablation of anal canal condyloma. (Abstract)

Application of imiquimod by suppositories (anal tampons) efficiently prevents recurrences after ablation of anal canal condyloma. After surgical removal, anal canal condyloma (ACC) has a higher risk of recurrence compared with extragenital warts.To reduce local recurrences of ACC using follow-up treatment with imiquimod-containing suppositories (anal tampons).After ablation of ACC, 10 male patients received treatment with imiquimod suppositories three times weekly for 3-4 months.Treatment (...) with imiquimod anal tampons was well tolerated. Early initial recurrences in some patients cleared after treatment with the imiquimod suppositories. Within a mean follow-up of 9 months no patient demonstrated recurrence of ACC.These data suggest that imiquimod anal tampons may represent a new therapeutic option to prevent recurrences of ACC following ablative surgery.

2002 British Journal of Dermatology

1855. A randomized, controlled, safety study using imiquimod for the topical treatment of anogenital warts in HIV-infected patients. Imiquimod Study Group. (Abstract)

A randomized, controlled, safety study using imiquimod for the topical treatment of anogenital warts in HIV-infected patients. Imiquimod Study Group. To assess the safety of imiquimod, an immune response modifier, in the topical treatment of external anogenital warts in HIV-infected patients.Clinical sites in the United Kingdom (eight) and the United States (five).A prospective, randomized, double-blind, vehicle-controlled study of imiquimod 5% cream or vehicle applied for 8+/-2 h three times (...) treated with imiquimod (n = 65) and vehicle (n = 35), the most common local skin reaction was erythema, (41.9 and 26.7%, respectively) and the incidence of patients reporting at least one adverse event was 69.2 and 65.7%, respectively. No clinically meaningful differences or changes in laboratory values were observed between treatment groups, nor were drug-related adverse effects observed in regard to HIV disease. While there was no significant difference between treatment groups in the number

1999 AIDS Controlled trial quality: uncertain

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