Imiquimod 5% Cream Use in Dermatology, Side Effects and Recent Patents

Abstract

Imiquimod is an immune response modifier that stimulates the patient's own immune system to release various chemical substances, such as interferon and interleukin-12. Although, approved by the United States Food and Drug Administration since 1997 as a topical treatment for genital and perianal warts, investigators have found that this product may offer an alternative treatment for a wide variety of medical conditions, such as for actinic keratoses, molluscum contagiosum, genital herpes, and various skin tumours. Clinical trials are now demonstrating the beneficial effects that its administration may have in treating other immune-related, dermatologic disorders. Understanding the pharmacology of this kind of drug is another step to fully understanding the power of the human immune system. Local reactions occur most frequently and include itching, burning, pain, soreness, flaking, erosions, and crusting. Since, it is administered locally; only a small amount of drug should reach systemic circulation, if used correctly. However, uncommon systemic side effects have been reported including headache, flu-like symptoms, fatigue, nausea, and myalgia. This article reviews imiquimod use in dermatology including its off-label use, side effects, future developments, new molecules related to dermatology and relevant patents.

Topical CpG Adjuvantation of a Protein-Based Vaccine Induces Protective Immunity to Listeria monocytogenes

“…However, bacterial toxins, such as enterotoxins, have persistent safety concerns. Further, even limited amounts of topical TLR7 agonist may induce systemic cytokine release and splenomegaly in mice (28) and may induce systemic symptoms and side effects in humans (40). Synthetic ODNs with CpG motifs are larger molecules that have less penetration after topical application than imiquimod and similar TLR7 agonists.…”

Immunomodulatory Effectiveness of Fish Oil and omega-3 Fatty Acids in Human Non-melanoma Skin Carcinoma Cells

“…Therefore, TNF-α expression in SCC and BCC cell lines was determined and concentration-dependent response was plotted for the IMQ, IMQ-FO, and omega-3 fatty acids. Imiquimod is known for its inflammatory side effects 3,4 , and during the study IMQ concentrations appeared to increase the TNF-α expression in both carcinoma cell lines Fig. 5 .…”

“…Imiquimod is an immune response modifier 1 and has been widely prescribed by dermatologists as a topical treatment, especially for curing skin conditions such as actinic keratosis, skin warts, and carcinoma 2 . Conversely, it is also known for its inflammatory-like side effects, such as severe skin inflammation 3,4 . In our earlier work, we demonstrated an interaction between fish oil and imiquimod 5 to explain observations seen in the delivery of imiquimod from fish oil-based gel system.…”

Laser facilitates vaccination

“…For instance, the Imiquimod cream (Aldara r ), 48 is clinically used as a topical treatment for genital/perianal warts, super¯cial basal cell carcinoma and actinic keratosis. 49 It is a potent activator of plasmacytoid dendritic cells, binding to TLR-7. When Imiquimod was applied on NAFL treated area, it activated plasmacytoid dendritic cells accumulated in the skin and strengthened adaptive immune responses.…”