Use of Imiquimod Cream 5% in the Treatment of Localized Morphea

Abstract

Fibrosis is characterized by the increased deposition of collagen and other matrix components by fibroblasts. This process occurs as a reaction to inflammation and is mediated by numerous cytokines including transforming growth factor beta (TGF-beta). Localized cutaneous scleroderma or morphea is characterized by fibrosis. Current treatment for morphea includes topical, intralesional, or systemic corticosteroids, vitamin D analog (calcitriol and calcipotriol), photochemotherapy, laser therapy, antimalarials, phenytoin, D-penicillamine, and colchicine, all with varying degrees of success. In this case report, imiquimod cream 5% (Aldara), which induces interferon and in turn inhibits TGF-beta, was employed to treat morphea.

Topical Imiquimod 5% Cream for Pediatric Plaque Morphea: A Prospective, Multiple-Baseline, Open-Label Pilot Study

“…Systemic absorption of topically applied imiquimod is minimal, with less than 0.9% of the drug being detected in the urine and feces and 0% in the serum [16], making it an attractive therapeutic option for pediatric patients. Man and Dytoc [13] have previously reported on the clinical response in 12 adult patients with morphea plaques who were treated with 5% imiquimod cream 3–5 times a week for a total of 6 months. Both clinical and pathological improvement (in 4/12, there was decreased dermal thickness and inflammation) was noted.…”

“…To date, there is only anecdotal evidence that any of the listed therapies are effective. Man and Dytoc [13] and Dytoc et al [14] explored the potential efficacy of 5% imiquimod cream applied 3–5 times a week for a total of 6 months in 12 adult patients. Improvement was noted in all patients, particularly with respect to thickening and erythema.…”

Viral and Nonviral Uses of Imiquimod: A Review

“…107 The cause of morphea is chiefly unknown, but it has been proposed to have an autoimmune etiology. 108 Given the etiology of morphea and the immunomodulatory effects of imiquimod, this agent was administered 3 times weekly to treat this condition resulting in significant improvement of the lesion at the 6-week followup.…”

“…108 Given the etiology of morphea and the immunomodulatory effects of imiquimod, this agent was administered 3 times weekly to treat this condition resulting in significant improvement of the lesion at the 6-week followup. 107 Current investigations are underway tp determine the role of imiquimod in the treatment of morphea and analyze the cytokines responsible for its efficacy in this condition. 107 Tattoo Removal Tattoo removal is frequently requested in dermatologic practices.…”

“…107 Current investigations are underway tp determine the role of imiquimod in the treatment of morphea and analyze the cytokines responsible for its efficacy in this condition. 107 Tattoo Removal Tattoo removal is frequently requested in dermatologic practices. However, traditional tattoo removal may result in undesirable dermal damage, disfiguring scar, and pigmentary changes.…”