The Effects of 5% Imiquimod Cream on Bowen's Disease

Ko, Hyun Chang; Oh, Chang Keun; Kim, Sung Jun; Kim, Byung Soo; Jang, Bong Seok; Kim, Moon Bum; Kwon, Kyung Sool

Abstract

BACKGROUND: Imiquimod is an immune response modifier which works as a Toll-like receptor 7 agonist which induces interferon and other cytokines through the innate immune system and stimulates cell-mediated immunity through T cells. Imiquimod has been shown to be efficacious as a topical treatment for variable cutaneous neoplasms including Bowen's disease.
OBJECTIVE
The purpose of this study was to evaluate the efficacy and safety of 5% imiquimod cream for the treatment of Bowen's disease.
METHODS
Thirty one lesions from 13 patients with Bowen's disease were treated with 5% imiquimod cream, 3 times per week at night, until complete clearance of lesions had occurred. During the follow-up period, the duration of therapeutic response, clearance rate, side effects and recurrence were recorded. Biopsy specimens from five patients after treatment completion were obtained to confirm tumor clearance.
RESULTS
Complete clinical response was obtained in 30 lesions (96.8%) from 12 patients, and a partial clinical response was observed in a palmar lesion of 1 patient. The duration of complete response ranged from 4 to 24 weeks, and mean duration was 11.8 weeks. All patients showed mild to moderate local skin reactions such as erythema, erosion, crusting, itching, burning, and pain. No-one experienced systemic adverse effects during topical application. After 3 to 26 months follow-up of the patients who had shown complete clearance, no-one encountered recurrence.
CONCLUSION
5% imiquimod cream appears to be safe and effective for the treatment of Bowen's disease, and so therefore may be promising future treatment for this condition.