5% Therapeutic use of imiquimod cream

Abstract

Background: Imiquimod is an immune response modifier that shows antiproliferative and antiviral characteristics through synthesis of multiple cytokines. Although it was originally approved by the Food and Drug Administration for the treatment of anogenital warts, it has also been successfully used to treat various skin conditions. Objective: The aim of this study was to evaluate the current usage of 5% imiquimod cream for the treatment of various skin conditions in dermatologie clinics. Methods: We reviewed the records of 270 patients with various skin conditions who were treated with 5% imiquimod cream. Data was collected through medical records, clinical photographs, and biopsy specimens. Results: Besides anogenital warts, 5% imiquimod cream has been prescribed in more than 20 skin conditions. The most common skin disease was verruca vulgaris. Others, in order of prevalence, were molluscum contagiosum, actinic keratosis, condyloma accuminatum, and verruca plana. Among the 270 patients who were treated with 5% imiquimod cream, more than two-thirds showed clinical response, but only 26 patients (9.7%) achieved clinical complete remission with median clearing time of 7.3 weeks. While applying 5% imiquimod cream, 82 patients (30.4%) experienced local side effects that were generally mild and generally well-tolerated. The most common side effect was erythema and the others, in order of prevalence, were oozing, itching sensation, burning sensation, scabbing, erosion and pain. No systemic side effects were found. Conclusion: Although 5% imiquimod cream is licensed in Korea only for treatment of adult anogenital warts, other skin diseases such as verruca vulgaris are more commonly the treatment target in dermatologie clinics. As the reported therapeutic effects are various, more clinical studies are required to assess the safety and efficacy of imiquimod for the treatment of various skin conditions.