Treatment of periocular lentigo maligna with topical 5% Imiquimod: a review

Topical and Intralesional Immunotherapy for the Management of Skin Cancer in Special Locations: Lips and Eyelids

“…These rates of ocular involvement differ from those of other reports: a review found that conjunctivitis was stated in only 9 out of 81 patients receiving periocular imiquimod for different pathologies [38]. However, redness was found in 89% of patients, without specifying whether cutaneous or ocular [38]. Rarer more serious AEs, such as infectious keratitis, corneal oedema, or ectropion, were also reported once each [38].…”

“…They were all self-limited [30]. These rates of ocular involvement differ from those of other reports: a review found that conjunctivitis was stated in only 9 out of 81 patients receiving periocular imiquimod for different pathologies [38]. However, redness was found in 89% of patients, without specifying whether cutaneous or ocular [38].…”

“…However, redness was found in 89% of patients, without specifying whether cutaneous or ocular [38]. Rarer more serious AEs, such as infectious keratitis, corneal oedema, or ectropion, were also reported once each [38].…”

Rare Cutaneous Side Effects of Imiquimod: A Review on Its Mechanisms, Diagnosis, and Management

“…The pleiotropic effect of imiquimod makes it an effective treatment for many dermatological conditions. With increasing depth of research, the off-label use of imiquimod for the treatment of other diseases, such as herpes simplex [ 16 ], lentigo maligna [ 11 ], vulvar Paget’s disease [ 17 ], cutaneous leishmaniasis [ 18 ], primary cutaneous anaplastic large cell lymphoma [ 19 ], and folliculotropic mycosis fungoides [ 20 ], is becoming increasingly common. In most of the literature, imiquimod is considered to be a safe drug and is generally well tolerated.…”

“…Despite widespread investigation of imiquimod’s mechanism of action, it is still unclear due to its pleiotropic effects on a variety of diseases. Imiquimod plays its potential antitumor and antiviral roles primarily by directly or indirectly enhancing innate and acquired immune responses, which result in the recognition and killing of tumor cells or virus-infected cells [ 11 ]. As a synthetic Toll-like receptor (TLR) agonist, imiquimod can bind to TLR7 and, to a lesser degree, to TLR8 on antigen-presenting cells, which leads to the activation of nuclear factor kappa-B (NF-κB) via the myeloid differentiation factor 88 (MyD88)-dependent pathway, ultimately promoting target cell maturation and increasing the levels of various proinflammatory cytokines, such as tumor necrosis factor (TNF)-α, interferon (IFN)-α, interleukin (IL)-6, IL-8, and IL-12, as well as chemokines, including CCL2, CCL3, and CCL4 [ 8 , 12 ].…”