19925
document
5 % imiquimod cream and reflectance-mode confocal microscopy as adjunct modalities to Mohs micrographic surgery for treatment of basal cell carcinoma . BACKGROUND Imiquimod is an immune response modifier that up-regulates cytokines and has been shown in clinical studies to reduce or clear basal cell carcinoma tumors when applied topically . OBJECTIVE The objectives were to evaluate the efficacy of 5 % imiquimod cream in treating basal cell carcinoma preceding excision by Mohs micrographic surgery and to determine if reflectance-mode confocal microscopy is useful to establish the need for surgical intervention after imiquimod treatment . METHODS Subjects applied study cream to one biopsy-confirmed basal cell carcinoma tumor 5 x/week for 2 , 4 , or 6 weeks in this vehicle-controlled , double-blind study . Confocal microscopy was used for the 6-week treatment group to examine the target tumor area at each interval visit and immediately before Mohs micrographic surgery . After the Mohs micrographic surgery excision , the tissue was evaluated histologically , and the excision area was measured . Confocal microscopy readings were correlated to the histologic diagnosis . RESULTS Tumors cleared or the target tumor area was reduced in subjects in the 4- and 6-week dosing regimens . Confocal microscopy assessments correlated well with the histologic diagnosis . CONCLUSION 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 .
19926
Intervention_Pharmacological
imiquimod
19927
Intervention_Physical
reflectance-mode confocal microscopy
19928
Intervention_Surgical
Mohs micrographic surgery
19929
Intervention_Pharmacological
Imiquimod
19930
Intervention_Pharmacological
imiquimod
19931
Intervention_Physical
reflectance-mode confocal microscopy
19932
Intervention_Pharmacological
imiquimod
19933
Intervention_Physical
Confocal microscopy
19934
Intervention_Surgical
Mohs micrographic surgery
19935
Intervention_Surgical
Mohs micrographic surgery excision
19936
Intervention_Physical
Confocal microscopy
19937
Intervention_Physical
Confocal microscopy
19938
Intervention_Pharmacological
Imiquimod
19939
Intervention_Surgical
Mohs micrographic surgery .
19940
Outcome_Physical
excision results