Clinical effect of imiquimod 5% cream in the treatment of actinic keratosis
Clinical effect of imiquimod 5% cream in the treatment of actinic keratosis
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DOI：
10.1067/mjd.2002.123492
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发表时间：
2002-10-01
影响因子：
13.8
通讯作者：
Lebwohl, MG
中科院分区：
文献类型：
--
作者：
Persaud, AN;Shamuelova, E;Lebwohl, MG
背景：光化性角化病（AK）是鳞状细胞癌最早的临床表现。在美国，每年因非黑色素瘤皮肤癌导致 1300 至 2300 例死亡，其中大部分是由转移性鳞状细胞癌引起的。最近的研究表明，病灶内注射干扰素可成功用于治疗AK。 目的：咪喹莫特是一种免疫反应调节剂，目前已被批准用于治疗尖锐湿疣。局部应用的免疫反应调节剂通过在应用部位上调干扰素和参与细胞介导的免疫反应的其他细胞因子来发挥作用。目的是确定 5% 咪喹莫特乳膏治疗 AK 的有效性和安全性。 方法：22 名 AK 病变患者接受 5% 咪喹莫特乳膏治疗，最初每周 3 次，持续 8 周，或直至病变完全清除。患者在身体一侧的病变部位涂抹咪喹莫特，在另一侧涂抹媒介霜。共有 17 名完成治疗的患者在治疗前和治疗开始后第 2、4、6 和 8 周评估皮损数量和不良反应。治疗后 4 周和 8 周还评估了 AK 病变。结果：使用咪喹莫特治疗的患者观察到每位患者的平均病变数量显着减少。最常见的治疗反应是红斑、瘙痒和结痂。然而，所有不良事件均为轻度至中度。结论：5% 咪喹莫特乳膏可能是 AK 的一种有前途的治疗方法。
Background: Actinic keratosis (AK) is the earliest clinical manifestation of squamous cell carcinoma. Metastatic SCC causes the majority of the 1300 to 2300 deaths attributed to nonmelanoma skin cancer in the United States each year. Recent studies have shown that intralesional administration of interferon can be used successfully in the treatment of AK.Objective: Imiquimod is an immune response modifier, currently approved for the treatment of genital warts. The topically applied immune response modifier acts by up-regulating interferon and other cytokines involved in the cell-mediated immune response at the site of application. The aim of this was to determine the efficacy and safety of imiquimod 5% cream for the treatment of AK.Methods: Twenty-two patients with AK lesions were treated with imiquimod 5% cream, initially at 3 times per week for 8 weeks, or until total clearance of lesions. Patients applied imiquimod to lesions on one side of the body and vehicle cream to the other side. A total of 17 patients who completed treatment were evaluated for number of lesions and adverse reactions before treatment and at weeks 2, 4, 6, and 8 after initiation of treatment. AK lesions were also assessed 4 and 8 weeks after treatment.Results: A significant reduction in the average number of lesions per patient was observed for patients treated with imiquimod. The most frequent reactions to treatment were erythema, itching, and scabbing; however, all adverse events were mild to moderate.Conclusion: Imiquimod 5% cream may be a promising treatment for AK.