Imiquimod cream
What is it?
Imiquimod is a modifier of the immune response. Studies of saturation binding suggest the existence of a membrane receptor for imiquimod on immune cells that are respond to it. Imiquimod does not have direct antiviral activity but is active on viral infections and acts as an anticancer agent mainly through induction of interferon alpha and other cytokines.
When is this procedure indicated?
Imiquimod cream is indicated for the topical treatment of:
- external genital and perianal condylomata acuminata (condylomata acuminata) in adult patients;
- superficial small basal cell carcinomas (sBCC) in adult patients;
- clinically typical, non-hypertrophic, non-hyperkeratotic actinic keratoses (AK) present on the face and skull, in immunocompetent adult patients, when the size or number of lesions limit the efficacy and/or acceptability of cryotherapy or when other topical therapeutic options are contraindicated or less appropriate.
How is it performed?
The frequency of application and duration of treatment with imiquimod cream varies according to the different indications.
- External genital condylomata in adult patients. Imiquimod cream should be applied 3 times a week (e.g., Monday, Wednesday, Friday or Tuesday, Thursday and Saturday) before going to bed and should remain on the skin for a period of 6-10 hours. Treatment with imiquimod cream should be continued until the disappearance of visible genital or perianal condylomata or for a maximum of 16 weeks per episode of condyloma.
- Superficial basal cell carcinomas in adult patients. Apply imiquimod cream for 6 weeks, 5 times a week (e.g. Monday to Friday) before bedtime and let it work on the skin for about 8 hours.
- Actinic keratosis in adult patients. Imiquimod cream should be applied 3 times a week (e.g. Monday, Wednesday and Friday) for 4 weeks, before going to bed and left on the skin for a period of about 8 hours. A sufficient dose of cream should be applied to cover the area to be treated. Healing of actinic keratosis should be evaluated after the next 4 weeks of treatment withdrawal. If signs of actinic keratosis persist in the treated area, treatment should be repeated for an additional 4 weeks.
Contraindications
Local skin reactions such as erythema, erosions, excoriation/scaling, and edema are common. Other local reactions, such as induration, ulceration, crusting, and vesicles, have also been reported. Some systemic side reactions, such as headache, flu-like symptoms, and myalgia, have also been reported.
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