Uses
Imiquimod is a patient-applied cream used to treat certain diseases of the skin, including skin cancers (basal cell carcinoma, Bowen's disease, superficial squamous cell carcinoma, some superficial malignant melanomas, and actinic keratosis) as well as genital warts (condylomata acuminata). However, Imiquimod is generally secondary to surgery, because surgery has a better chance to effectively treat at least some forms of skin cancer.
It has also been tested for treatment of molluscum contagiosum, vulvar intraepithelial neoplasia, common warts that have proven difficult to treat, and vaginal intraepithelial neoplasia.
Outstanding cosmetic result has resulted from the treatment of both large superficial basal cell carcinoma and squamous cell carcinoma in-situ, but the morbidity and discomfort of the treatment can be severe, and can very occasionally result in some degree of permanent mild scarring. Focal recurrence of tumor has been seen after imiquimod treatment, but appear to be amenable to surgical excision.
Imiquimod can also cause subclinical lesions to become visible and to be killed by the immune system. Photographs of actinic keratosis and superficial basal cell carcinomas before, during and after treatment show the unmasking of subclinical disease. Somewhat counter-intuitively, the more-concentrated (5%) Imiquimod cream needs to be applied on and off over the course of a longer period (4 months), while the less concentrated (3.75%) Imiquimod cream only needs to be applied on and off over the course of a shorter period (1 month).
Imiquimod is more likely to cure skin disease that is identified earlier.
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