Tratamiento de la enfermedad de Bowen con imiquimod 5% crema

Imiquimod is an immune modifier that has been shown to be effective for some skin cancer and precancer such as solar keratoses, basal cell carcinoma and Bowen's disease. It has been proved to have antiviral and antitumor properties in animal models. The biological pathway is closely related with the release of some cytokines, mainly interferon (INF)-α and tumoral necrosis factor (TNF)-α.A trial with imiquimod 5% cream, twice daily, three times a week, during 8 weeks was undertaken in 5 patients with biopsy-proven Bowen's disease. One patient had undergone a renal transplantation and was on chronic immunosupressive chemotherapy for 8 years. Lesions were located on the legs, hands and face. After treatment all lesions had cleared up, and in three patients clearance was histologically confirmed with a posttreatment biopsy. All patients complained of mild erythema and itching, but the treatment was well tolerated. Within follow-up periods of 3 to 11 months after treatment none has shown evidence of recurrence.Even though this is a short series of patients, we believe that imiquimod 5% cream is an effective and safe treatment for Bowen's disease at a shorter term than previously advised. Since Bowen's lesions were not fully excised at the end of the treatment, only a longer follow up of our patients will confirm their clearance.