Imiquimod 5% cream in the treatment of Bowen's disease and invasive squamous cell carcinoma

Abstract

Background: Imiquimod has been successfully used for treatment of various epithelial cutaneous neoplasms.

Objective: 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.

Method: Five Bowen's disease lesions and 7 invasive SCC lesions on 10 patients were treated with imiquimod once daily 5 times a week for a maximum of 16 weeks.

Results: After 8 to 12 weeks of treatment, 4 of 5 Bowen's disease lesions (80%) and 5 of 7 invasive SCCs (71.4%) showed complete clinicopathologic regression. The remaining 3 lesions showed partial regression after 16 weeks of treatment. No recurrence has been detected after a follow-up period of 24 to 38 months (mean, 31 months).

Limitations: The study is an open-label clinical trial on a small number of selected patients, with lack of excision with serial step sections.

Conclusion: Topical application of imiquimod 5% cream might represent an alternative topical treatment to surgery in selected cases of Bowen's disease and invasive SCC.