Source:

Journal of the Dermatology Nurses' Association

April 2009, Volume 1 Number 2 , p 148 - 148 [FREE]

Author

  • Raymond M. Shulstad MS, ARNP-C, BC, DNC

Abstract

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This prospective case series will show the responsiveness of recurrent or inoperable squamous cell carcinomas to treatment with imiquimod 5% cream. The data points are prior, immediately following, and 6 months after treatment.

 

Patients were selected based on surgical contraindications and refusal of surgical interventions following previously failed surgical interventions. Imiquimod 5% cream was applied five times per week for 6 weeks. Patients were seen following treatment to assess reactions, then again at 1 month and 6 months after treatment to observe for clinical evidence of recurrence.

 

Three patients completed 6 weeks of therapy. Inflammation, scabbing and ulcerations were noted at the sites of application for all at the initial follow-up. Two of the patients had postinflammatory hyperpigmentation, while one had postinflammatory hypopigmentation. At 6 months, there were no clinical signs of recurrent squamous cell carcinoma in these patients.

 

Imiquimod 5% cream may prove to be effective in treating inoperable or recurrent squamous cell carcinomas. This treatment is promising for elderly patients or those who are poor surgical candidates to receive efficacious treatment.

 

Knowledge of alternative treatments for skin cancers when traditional measures are contraindicated or refused by patients is important for all practitioners.

INTRODUCTION

This prospective case series will show the responsiveness of recurrent or inoperable squamous cell carcinomas to treatment with imiquimod 5% cream. The data points are prior, immediately following, and 6 months after treatment.

METHODS

Patients were selected based on surgical contraindications and refusal of surgical interventions following previously failed surgical interventions. Imiquimod 5% cream was applied five times per week for 6 weeks. Patients were seen following treatment to assess reactions, then again at 1 month and 6 months after treatment to observe for clinical evidence of recurrence.

RESULTS

Three patients completed 6 weeks of therapy. Inflammation, scabbing and ulcerations were noted at the sites of application for all at the initial follow-up. Two of the patients had postinflammatory hyperpigmentation, while one had postinflammatory hypopigmentation. At 6 months, there were no clinical signs of recurrent squamous cell carcinoma in these patients.

CONCLUSIONS

Imiquimod 5% cream may prove to be effective in treating inoperable or recurrent squamous cell carcinomas. This treatment is promising for elderly patients or those who are poor surgical candidates to receive efficacious treatment.

NURSING IMPLICATIONS

Knowledge of alternative treatments for skin cancers when traditional measures are contraindicated or refused by patients is important for all practitioners.