Imiquimod 5% cream in the treatment of Bowen's disease and invasive squamous cell carcinoma

BackgroundImiquimod has been successfully used for treatment of various epithelial cutaneous neoplasms.ObjectiveOur aim was to evaluate the efficacy and tolerability of imiquimod 5% cream for treatment of Bowen's disease and invasive squamous cell carcinoma (SCC) in patients who were unsuitable candidates for surgery.MethodFive Bowen's disease lesions and 7 invasive SCC lesions on 10 patients were treated with imiquimod once daily 5 times a week for a maximum of 16 weeks.ResultsAfter 8 to 12 weeks of treatment, 4 of 5 Bowen's disease lesions (80%) and 5 of 7 invasive SCCs (71.4%) showed complete clinicopathologic regression. The remaining 3 lesions showed partial regression after 16 weeks of treatment. No recurrence has been detected after a follow-up period of 24 to 38 months (mean, 31 months).LimitationsThe study is an open-label clinical trial on a small number of selected patients, with lack of excision with serial step sections.ConclusionTopical application of imiquimod 5% cream might represent an alternative topical treatment to surgery in selected cases of Bowen's disease and invasive SCC.