Basal cell carcinoma: treatment with imiquimod

Abstract

Our experience indicates that imiquimod is a reasonable option for the treatment of BCC. It is low cost, can be delivered via ambulatory care, and has tolerable side-effects.

Superficial basal cell carcinoma treated with imiquimod 5% topical cream for a 4‐week period: a case series

“…Our results presented in Table 6 show that imiquimod is associated with less intense development of local side-effects compared to the findings of our previous study that also used the same dosage regimen for 6 weeks. 5 Finally, and based on our results, it is our belief that we are in front of a therapeutic approach for which, despite having been available for a decade, new indications are continually being discovered. Consequently, new therapeutic regimens should be studied in depth so as to facilitate its usage.…”

“…Even though there are not any data to support which BCC cases are the best candidates to respond to imiquimod yet, the different reported case series suggest that those with the shortest evolution and smallest size are more likely to have a quicker therapeutic response. 5 In our opinion, this points out that imiquimod may be a perfect first-line therapy for small-sized superficial BCC. The safety profile of imiquimod in our series is similar to that expected according to other case series and clinical trials.…”

Periungual basal cell carcinoma: A case report with review of literature

“…[2] The exact mechanism of action of Imiquimod in BCC is not known but it is thought that Imiquimod acts on toll-like-receptor-7 (TLR-7) present on dendritic cells, macrophages and monocytes and stimulates the expression of interferons, Th-1 cytokines, tumor necrosis factor alpha and G-CSF. Th-2 cytokines which are raised in BCC are thereby neutralized.…”

“…Many therapeutic options have been suggested, such as excision by Moh's surgery, radiotherapy, topical 5-fluorouaracil, intralesional interferon, curettage and electrodessication, cryosurgery, laser and standard excision. [2] Topical Imiquimod, an immunomodulator, has been effective in some cases of BCC. This drug is an imidazoquinolone amine and is known to promote cytokine-mediated cellular immune response.…”

Density of dendritic cells around basal cell carcinomas is related to tumor size, anatomical site and stromal characteristics, and might be responsible for the response to topical therapy

“…The tumor stroma is involved in regression and metastasis of the neoplasia, with both stimulatory and restrictive effects upon tumor progression 1 . Dermal dentritic cells (DCs) with immunoreactivity for factor XIIIa are an important component of the host defense participating in the control of neoplastic growth 3–7 . An effective DC displays processed antigen in the context of MHC molecules and expresses costimulatory molecules necessary for the activation of T cells.…”