Imiquimod: A Review

Abstract

Beyond its established use, there are case reports and preliminary studies suggesting the effectiveness of imiquimod 5% cream in the treatment of nongenital human papillomavirus warts, molluscum contagiosum, actinic keratosis, basal cell carcinoma, squamous cell carcinoma, Bowen's disease, nongenital human papillomavirus infection, and vulvar intraepithelial neoplasia.

Topical treatment of actinic keratosis with imiquimod 5% cream

“…Despite the adverse effects reported (Grupta et al, 2002) during the use of the medicine in this case, significant side effects have not been observed. The intensification of the inflammatory reaction in the beginning is plausible, considering the action mechanism of the medicine.…”

“…It usually occurs in regions of lower fur density and lesser pigmentation such as the nose, pinnae and periocular region (Rodaski and Werner, 2009). In mammals, the causes and pathogenetic mechanisms of the disease are very similar to others involved in actinic keratosis (Festa-Neto, 2002), a dysplasia of keratinocytes (Kagy and Amonette, 2000) that is usually a consequence of solar dermatitis (Festa-Neto, 2002;Grupta et al, 2002).…”

“…However, most authors agree that the scheme must be kept until the injury disappears completely or for a maximum treatment period of 16 weeks (Cutler et al, 2000;Grupta et al, 2002). In the case presented here, it was decided that Imiquimod 5% cream should be used in a regimen of three consecutive applications everyday with a fourday interval, according to the protocol adopted by Peters-Kennedy et al (2008) in the same species.…”

“…It is also used with variable success in basal cell carcinoma, Bowen's disease (squamous cell carcinoma in situ), squamous cell carcinoma, epitheliotropic lymphoma and keratoacanthoma (Smith et al, 2004). The adverse effects that are considered possible or are probably related to the use of the drug include disorders at the application site (red skin, scaling skin, skin erosion, excoriation, edema, hypopigmentation, pain, burning, itch); reactions in some remote areas of the skin (bleeding, tenderness, pain, burning, itch) and systemic reactions (fatigue, fever, symptoms similar to those of flu, disorders of the central and peripheral nervous system -headache, gastrointestinal signs and myalgia) (Grupta et al, 2002).…”

Uso de imiquimode tópico no tratamento da infecção anal pelo papilomavírus humano

“…Além disso, induz apoptose e ativa os linfócitos B, potencializando a resposta imunológica contra as células alteradas pelo HPV. (3)(4)(5)(6)(7)(8)(9)(10)(11) Aprovado para tratamento de condiloma anogenital em 1997, (12) foi liberado no Brasil pela Agên-cia Nacional de Vigilância Sanitária (ANVISA) para uso em maiores de 12 anos e recomendado para aplicação externa. Porém, há descrição na literatura de uso em criança de nove anos com regressão completa da lesão condilomatosa.…”