5% Imiquimod Cream and Reflectance-Mode Confocal Microscopy as Adjunct Modalities to Mohs Micrographic Surgery for Treatment of Basal Cell Carcinoma

Torres, Abel; Niemeyer, Agnieszka; Berkes, Beatrice; Marra, Diego E.; Schanbacher, Carl F.; González, Salvador; Owens, Mary; Morgan, Blaine

doi:10.1111/j.1524-4725.2004.30504.x

Cited by 63 publications

(26 citation statements)

References 16 publications

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“…Its mode of action implies the induction of the innate immunity resulting in a selective antitumoral immune response through the activation of dendritic cells, cytotoxic T lymphocytes and proinflammatory cytokines. RCM has been used for monitoring and evaluation of treatment efficacy of basal cell carcinoma and lentigo maligna melanoma during topical IMIQ therapy [36,37,38]. To our knowledge, no systematic RCM evaluation of treatment response of AK to IMIQ has been performed.…”

Section: Discussionmentioning

confidence: 99%

Reflectance Confocal Microscopy for Noninvasive Monitoring of Therapy and Detection of Subclinical Actinic Keratoses

et al. 2009

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Background: Actinic keratoses (AK) represent cutaneous carcinoma in situ and have previously been evaluated by reflectance confocal microscopy (RCM). Treatment of AK with imiquimod (IMIQ) 5% cream has been shown to ‘highlight’ subclinical lesions. Objective: The aim of this study was to test the applicability of RCM for noninvasive monitoring of actinic field cancerization and detection of subclinical AK. Subjects and Methods: AK and surrounding skin sites with no apparent AK of 11 volunteers were selected for imaging and subsequently classified as ‘clinical’ and ‘subclinical’ AK. IMIQ was used 3 times weekly for 4 weeks. Results: RCM was able to detect morphologic features of AK in both clinical and subclinical AK; features were more pronounced in clinical lesions. The immunomodulatory response induced by IMIQ was visualized by RCM. Conclusion: Our findings indicate that RCM allows noninvasive monitoring of treatment response in vivo and permits early detection of subclinical AK, thus substantiating the incentive for therapy.

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Section: Discussionmentioning

confidence: 99%

Reflectance Confocal Microscopy for Noninvasive Monitoring of Therapy and Detection of Subclinical Actinic Keratoses

et al. 2009

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“…RCM has been used to monitor the treatment efficacy of imiquimod for actinic keratoses, 22 BCC, 23 and lentigo maligna, 24 and the effect of cryotherapy for superficial BCCs. 25 When BCCs were treated with imiquimod, RCM revealed tumor clearance or a reduction in tumor size, with results corresponding well to histopathologic findings.…”

Section: Fundamentals Of Reflectance Confocal Microscopymentioning

confidence: 99%

“…25 When BCCs were treated with imiquimod, RCM revealed tumor clearance or a reduction in tumor size, with results corresponding well to histopathologic findings. 23 Again, caution should be taken when interpreting a negative result on RCM, because neoplastic aggregates may be present deeper than the imaging range of RCM. Regular follow-up skin examinations are indicated to assess for recurrent neoplasms.…”

Section: Fundamentals Of Reflectance Confocal Microscopymentioning

confidence: 99%

Through the looking glass: Basics and principles of reflectance confocal microscopy

Que

Fraga‐Braghiroli

Grant‐Kels

et al. 2015

Journal of the American Academy of Dermatology

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“…RCM revealed intense inflammation, but after three weeks, there were no clinical signs of BCC. In 2004, another study used RCM to determine the effect of imiquimod treatment on BCC prior to Mohs microsurgery [29]. The area of the lesion was treated five times/week for two, four or six weeks, then Mohs microsurgery was performed two to four weeks after completion of imiquimod treatment.…”

Section: Applications Of Reflectance Confocal Microscopy For Dynamic mentioning

confidence: 99%

The use of reflectance confocal microscopy for monitoring response to therapy of skin malignancies

Ulrich

Lange‐Asschenfeldt

González

2012

Dermatol Pract Concept

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SummaryReflectance confocal microscopy (RCM) is a new non-invasive imaging technique that enables visualizing cells and structures in living skin in real-time with resolution close to that of histological analysis. RCM has been successfully implemented in the assessment of benign and malignant lesions. Most importantly, it also enables monitoring dynamic changes in the skin over time and in response to different therapies, e.g., imiquimod, photodynamic therapy, and others. Given the often traumatic nature of skin cancer that affects both the physiology and the psychology of the patients, it is crucial to have methods that enable monitoring the response to treatment but that minimize the distress and discomfort associated with such process. This article provides a very brief overview of the fundamentals of RCM and then focuses on its recent employment as a monitoring tool in skin cancer and other pathologies that may require frequent follow-up.

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5% Imiquimod Cream and Reflectance-Mode Confocal Microscopy as Adjunct Modalities to Mohs Micrographic Surgery for Treatment of Basal Cell Carcinoma

Abstract: Imiquimod improved excision results relative to vehicle when used for treating basal cell carcinoma before Mohs micrographic surgery. Confocal microscopy assessments correlated well with tumor response to therapy, suggesting that confocal microscopy may help determine the need for surgery.

Cited by 63 publications

References 16 publications

Reflectance Confocal Microscopy for Noninvasive Monitoring of Therapy and Detection of Subclinical Actinic Keratoses

Reflectance Confocal Microscopy for Noninvasive Monitoring of Therapy and Detection of Subclinical Actinic Keratoses

Through the looking glass: Basics and principles of reflectance confocal microscopy

The use of reflectance confocal microscopy for monitoring response to therapy of skin malignancies

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