An open‐label, pilot study examining the efficacy of curettage followed by imiquimod 5% cream for the treatment of primary nodular basal cell carcinoma

Abstract

SUMMARY The short-term efficacy of imiquimod 5% cream for the treatment of primary superficial basal cell carcinoma has been established. This study investigated its efficacy following curettage (without electrodesiccation) for the treatment of primary nodular basal cell carcinoma on the trunk and limbs. Seventeen patients with a total of 34 lesions were enrolled. Curettage was used to de-bulk the lesion and confirm suitable histology. Lesions displaying more aggressive subtypes (such as micronodular or morpheoic components) were excluded. Lesions were treated daily for 6 to 10 weeks with imiquimod 5% cream. Three months post treatment all lesions were excised, and 32 of 34 treated lesions (94%) were histologically clear of basal cell carcinoma. Fourteen of 17 patients rated the cosmetic outcome of treatment as excellent or good. Curettage followed by imiquimod 5% cream is effective for the treatment of primary nodular basal cell carcinoma on the trunk and limbs, and most patients are pleased with the cosmetic outcome.

Guidelines for the management of basal cell carcinoma

“…105,106 In the first, following a single cycle of curettage, IMQ was applied daily for 6-10 weeks and this produced histological clearance of 94% (32 of 34) when the treatment sites were excised 12 weeks after treatment. 105 In the second study, 20 patients received three cycles of C&C followed by IMQ or vehicle once daily for 1 month. Histological examination revealed residual tumour in 10% (one of 10) in the IMQ group and 40% (four of 10) in the vehicle group.…”

Nonsurgical Treatment Options for Basal Cell Carcinoma

“…Furthermore, another larger study ( n = 34) evaluated the efficacy of imiquimod 5% cream following curettage only of nodular BCC on the trunk and extremities [32]. 94% of the treated lesions showed histologic eradication of BCC.…”

Basal Cell Carcinoma

“…Nevertheless, this method is contraindicated for facial tumors and in high-risk lesions (Wetzig et al, 2009). Disadvantages of this treatment option include to leave residual tumor tissue which may be demonstrated with histopathological examination and to develop hypertrophic scarring at lesion site (Wu et al, 2006). There is a risk of development of hypertrophic scarring or white scar tissue formation after the procedure and this probability increases with the number of treatment cycles (Ceilley Del & Rosso, 2006).…”