Preliminary communication: imiquimod in mixed capillary/lymphatic malformation

Abstract

The present authors reported a 14-year-old white boy who visited the present authors' dermatology department in January 2004. Physical examination revealed multiple translucent and hemorrhagic vesicles and skin-colored nodules on the chin. The lesion had grown slowly in size over the previous 7 years. The objective of this study is to estimate the exact mechanism of action of topical imiquimod on mixed capillary/lymphatic malformation. After 4 weeks of therapy the lesions were less protuberant. At the follow-up examination after a further 2 months of therapy, there was partial clinical regression of the capillary component with a return to normal skin color. One month after termination of therapy the lesions had completely regressed and there was no evidence of recurrence of the hemangiomatous section. The present authors' case suggests the efficacy of the use of topical imiquimod and this therapeutic modality may be of particular benefit in superficial type of capillary/lymphatic malformation, in which the destructive intervention may be undesirable.

Imiquimod 5% Cream for an Annular Plaque with Progressive Pain on the Right Distal Arm in the Cubital Fossa: Acquired Tufted Angioma

“… 8 , 9 The antiproliferative and apoptotic effects on vascular and lymphatic vessels were supposed to be the curative mechanism for imiquimod. 10 , 11 So, we decided to try off-label use of imiquimod 5% cream for TA in this patient. Surprisingly, as a result, her pain disappeared and the whole plaque was significantly improved without obvious side effects in an unexpectedly short period, which was shorter than that in reported cases of superficial infantile hemangioma whose regression occurred after approximately six weeks of treatment.…”

“…Complete blood cell count was also performed and revealed a normal platelet count, which excluded Kasabach-Merritt syndrome. Because imiquimod, an immunomodulator, is supposed to have antiproliferative and apoptotic effects on vascular and lymphatic vessels and has a good curative efficacy in cutaneous lymphangioma and infantile hemangiomas, [8][9][10][11] we tried off-label use of imiquimod 5% cream for TA (three times per week). Surprisingly, this alternative therapy resulted in an excellent response, her pain was relieved after one week, and almost disappeared after one month without any analgesics, and the lesion was also gradually getting softer.…”

“…In consideration of the annular appearance of the entity, surgical excision might not be suitable. In addition, imiquimod is supposed to have antiproliferative and apoptotic effects on vascular and lymphatic vessels and has a good curative efficacy in cutaneous lymphangioma and infantile hemangiomas, [8][9][10][11] we tried imiquimod 5% cream as an alternative therapy for her. To our surprise, her pain disappeared and the whole plaque was significantly improved after a four-month treatment of imiquimod 5% cream.…”