25044
document
Pilot study of imiquimod 5 % cream as adjunctive therapy to curettage and electrodesiccation for nodular basal cell carcinoma . BACKGROUND Curettage and electrodesiccation ( C & D ) is a widely used method to treat nodular basal cell carcinoma ( BCC ) . However , residual tumor is present immediately after the procedure in approximately 20 to 40 % of cases . Imiquimod , a topical immune response modifier that targets Toll-like receptor 7 , is currently approved for superficial BCC . OBJECTIVE In a double-blind , vehicle-controlled study , the administration of imiquimod after C & D was investigated to determine if the combination regimen would reduce the frequency of residual tumor compared with C & D alone in patients with nodular BCC . METHODS Twenty patients received three cycles of C & D followed by imiquimod 5 % or vehicle cream once daily for 1 month as adjunctive therapy . The primary end point was the frequency of residual tumor . The secondary end points included the time to heal and cosmetic appearance . RESULTS Twenty patients were randomized to the imiquimod ( n = 10 ) or vehicle ( n = 10 ) treatment group . At 8 weeks , the proportion of patients with residual tumor was substantially decreased with imiquimod therapy ( 10 % ) compared with vehicle ( 40 % ) . Wounds in the vehicle group healed more quickly than those in the imiquimod group , although by 8 weeks , all excision sites were healed . The majority of scars in the control group were atrophic and hypopigmented , whereas most scars in the imiquimod group were flat and slightly pink . CONCLUSION Imiquimod 5 % cream once daily for 1 month as adjunctive therapy after C & D substantially reduced the frequency of residual tumor and improved the cosmetic appearance compared with C & D alone . These preliminary results suggest that further studies to investigate imiquimod adjunctive therapy are warranted .
25045
Intervention_Pharmacological
imiquimod 5 % cream
25046
Intervention_Pharmacological
adjunctive therapy
25047
Intervention_Surgical
curettage
25048
Intervention_Physical
electrodesiccation
25049
Intervention_Surgical
Curettage
25050
Intervention_Physical
electrodesiccation
25051
Intervention_Physical
C & D
25052
Intervention_Pharmacological
imiquimod
25053
Intervention_Surgical
C & D
25054
Intervention_Pharmacological
C & D
25055
Intervention_Pharmacological
imiquimod
25056
Intervention_Pharmacological
vehicle cream
25057
Intervention_Pharmacological
adjunctive therapy
25058
Intervention_Pharmacological
imiquimod
25059
Intervention_Control
vehicle
25060
Intervention_Pharmacological
imiquimod
25061
Intervention_Control
vehicle
25062
Intervention_Pharmacological
imiquimod
25063
Intervention_Pharmacological
Imiquimod
25064
Intervention_Surgical
C & D
25065
Intervention_Surgical
C & D
25066
Intervention_Pharmacological
imiquimod adjunctive therapy
25067
Outcome_Physical
proportion of patients with residual tumor
25068
Participant_Condition
nodular basal cell carcinoma
25069
Participant_Condition
nodular basal cell carcinoma
25070
Participant_Condition
BCC
25071
Participant_Condition
nodular BCC
25072
Participant_Sample-size
Twenty