Vehicle-controlled, double-blind, randomized study of imiquimod 5% cream applied 3 days per week in one or two courses of treatment for actinic keratoses on the head

BackgroundA shorter dosing regimen of imiquimod for the treatment of actinic keratosis may be effective, with long-term clinical benefits.ObjectiveImiquimod in one or two shorter courses of treatment was evaluated.MethodsPatients with actinic keratosis lesions on the head applied imiquimod or vehicle cream 3×/wk for 4 weeks (course 1). Patients with remaining lesions received another course of treatment. Complete and partial clearance rates were evaluated after course 1, after course 2 (overall), and 1 year later.ResultsComplete clearance rates were 26.8% (course 1) and 53.7% (overall). Partial clearance rates were 36.6% (course 1) and 61.0% (overall). One-year follow-up recurrence rates were 39% (imiquimod) and 57% (vehicle).LimitationsBlinded investigators may have been biased toward patients treated with imiquimod identified by treatment site reactions.ConclusionImiquimod 3×/wk in one or two courses of treatment appears to be effective for the treatment of actinic keratoses on the head, providing long-term clinical benefits. Some recurrences do occur, so long-term follow-up is recommended.