ABSTRACT
BACKGROUND: It has been reported that topical application of imiquimod 5% cream induces interferon-alpha, an antifibrotic cytokine. OBJECTIVE: To determine the tolerability and effectiveness on the cosmetic outcome of the application of imiquimod to postsurgical excision sites. MATERIALS AND METHODS: A prospective, double-blinded, randomized, vehicle-controlled trial was conducted among 20 patients with two skin lesions clinically diagnosed as melanocytic nevi. Imiquimod 5% cream was applied to one of the sutured surgical wounds starting the night of the excision nightly for a period of 4 weeks. The second sutured excision site was treated with vehicle cream. Scar cosmesis, erythema, pigmentary alterations, induration, tenderness, and pain were assessed using a visual analogue scale 2, 4, and 8 weeks after surgery. RESULTS: Eighteen subjects completed the study, with a total of 36 excision sites; no wound site dehisced, and no signs of infection were noted. Surgical wounds treated with imiquimod had more erythema, pigmentary alterations, and lower cosmesis rated by the investigator compared with wounds treated with placebo, both becoming nonsignificant in further evaluations. For pigmentary alterations, induration, and cosmesis rated by the patients, no statistically significant difference between treatment groups was observed at week 8. CONCLUSION: Treatment of surgical excision-site wounds with imiquimod was well tolerated and without serious adverse events. Evaluations for cosmesis of placebo-treated surgical sites were better than imiquimod-treated sites at week 8, becoming nonsignificant later.
Subject(s)
Aminoquinolines/therapeutic use , Cicatrix/drug therapy , Interferon Inducers/therapeutic use , Nevus, Pigmented/surgery , Skin Neoplasms/surgery , Adolescent , Adult , Aminoquinolines/administration & dosage , Child , Double-Blind Method , Esthetics , Female , Humans , Imiquimod , Interferon Inducers/administration & dosage , Male , Middle Aged , Ointments , Prospective Studies , Treatment OutcomeABSTRACT
Therapeutic interventions to augment tumor antigenicity or increase the host's immune response against cancer cells include recombinant cytokines, immune modulators, vaccination with tumor antigens, T cell-based immunotherapy, and gene therapy. We describe the current role of the immunomodulators (up-regulators of the immune response) in the therapy of skin cancer (non melanoma skin cancer, melanoma, lymphoma, Kaposi sarcoma, and extramammary Paget's disease).
Subject(s)
Aminoquinolines/therapeutic use , Antineoplastic Agents/therapeutic use , Bowen's Disease/drug therapy , Immunologic Factors/therapeutic use , Interferons/therapeutic use , Lymphoma/drug therapy , Melanoma/drug therapy , Paget Disease, Extramammary/drug therapy , Sarcoma, Kaposi/drug therapy , Skin Neoplasms/drug therapy , Clinical Trials as Topic , Humans , Imiquimod , Treatment OutcomeABSTRACT
Numerous treatments have been described for the treatment and prevention of scars, but the optimal management strategy is yet to be defined. In this article we present and evaluate new opportunities for the treatment and prevention of hypertrophic scars, keloids, and atrophic scars. Clinical, animal, and in vitro studies reporting novel techniques for the treatment and prevention of scarring were identified primarily from the MEDLINE/PubMed database. We found that a variety of new treatments exist with potential effectiveness for the treatment of hypertrophic scars and keloids, including interferon, imiquimod 5% cream, tacrolimus, botulinum toxin, 5-fluorouracil, bleomycin, and verapamil. For atrophic scars, different types of lasers represent modern treatment modalities with satisfactory results. Several agents have been reported to be effective in reducing scarring in vitro and in animal studies, representing potential opportunities for scarring management. We conclude that several novel modalities may be potential therapies for scarring.
