Proliferating hemangioma of infancy: successful treatment with topical 5% imiquimod cream

A 4-month-old girl had a proliferating hemangioma of infancy (infantile hemangioma) affecting the chest wall. The lesion had appeared 1 week after birth, demonstrating both superficial and deep components, and was rapidly enlarging. It had become painful and superficially eroded. Treatment with topical 5% imiquimod cream three times a week was associated with signs of involution after 10 days, and complete resolution after 10 weeks of therapy. The treatment was well tolerated.     

Porokeratosis of Mibelli: Involution and resolution with 5% imiquimod cream

An 82-year-old woman presented with a longstanding, slowly enlarging annular lesion on the medial aspect of the ankle. Histology confirmed the clinical diagnosis of Porokeratosis of Mibelli. The lesion slowly involuted and resolved over 26 weeks of 5% imiquimod cream applied topically and has not recurred during a 36 month follow-up period.     

Lentigo maligna treated with 5% imiquimod cream

Lentigo maligna (LM) is considered to be an in-situ stage of lentigo maligna melanoma. Clinically, it presents as a pigmented macule, irregular in shape and tone. 30% to 35% of untreated lentigo malignas can progress into lentigo maligna melanoma. The treatment of choice for this pathology is surgical excision with margins of 0.5 cm. of clinically normal skin around the lesion, or Mohs microsurgery. Imiquimod is a topical immunomodulator that stimulates both acquired and innate immunity. We present the case of a patient with LM, treated with 5% imiquimod cream, with an excellent therapeutic response.     

Bowenoid papulosis successfully treated with imiquimod 5% cream

A 24‐year‐old healthy Japanese female was diagnosed as having bowenoid papulosis in the genital area. The histopathological findings revealed acanthosis, papillomatosis, dyskeratotic cells and clumping cells with mild atypical nuclei. Human papillomavirus type 16 was detected in the lesion. The lesion was successfully treated with topical imiquimod 5% cream after 2 months. Imiquimod 5% cream is a potentially effective treatment modality for lesions that are difficult to treat with surgical excision.     

Erythroplasia of Queyrat treated with imiquimod 5% cream

Imiquimod is an immune response-modifying agent with potent antiviral and antitumor activity effective in the treatment of various skin disorders, including in situ carcinoma of the skin (Bowen's disease). The case of a 64-year-old man affected by an in situ carcinoma of the glans mucosa, namely erythroplasia of Queyrat, successfully treated with imiquimod 5% cream is described. Because the results of tests for human papillomavirus infection were negative in this case, we suggest that imiquimod may have acted through an antitumor effect mediated by cytokine activation. This compound may represent an alternative treatment in patients with erythroplasia of Queyrat, although the dosing schedule and treatment duration require further evaluation.     

Extramammary Paget disease: successful therapy with imiquimod 5% cream

A 90-year-old woman presented with an extensive primary form of extramammary Paget disease localized in the anogenital region. An associated carcinoma could be excluded. Due to the age of the patient, the location and extent of the tumor as well as existing comorbidities, neither a surgical nor a radio-oncological treatment were advisable. A local treatment with imiquimod 5% cream applied 3 times weekly for 2 × 3 weeks led to a clinically and histopathologically complete remission. As also shown by other authors, imiquimod appears to be a treatment option for the primary form of extramammary Paget disease.     

Treatment of non-genital warts with topical imiquimod 5% cream

Common warts (verrucae vulgaris) are associated with human papillomavirus infection and are routinely treated by ablative procedures such as cryotherapy, electrodessiccation and salicylic acid. We report 10 cases of recurrent warts treated with a potential new topical therapy, imiquimod 5% cream. Nine of the 10 patients were successfully treated with imiquimod 5% cream applied, under occlusion, once daily for 4 weeks. No recurrences were reported during 3 months of follow up.