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Treatment of multiple, multiform actinic keratoses on the head with imiquimod 5% cream


European Journal of Dermatology. Volume 19, Number 4, 355-9, July-August 2009, Therapy

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Author(s) : Eggert Stockfleth, Claas Ulrich, Bernhard Lange-Asschenfeldt, Hans-Joachim Kremer, Ulrike Drecoll, Joachim Maus, Joachim Röwert-Huber

Summary : The objective of this non-controlled interventional clinical study was to evaluate the efficacy of imiquimod in the treatment of fields with multiple, multiform AK. 180 office-based dermatological practices in Germany participated. Patients with clinically typical, visible AK lesions on the head were treated with 5% imiquimod cream 3 times per week for 4 weeks followed by a 4 week treatment pause. If lesions were still present, a second treatment course of treatment (COT) was given. Complete clearance rate, i.e. no clinically visible AK lesions in the treatment area, was the main outcome measure. 829 patients were enrolled. The complete clearance rate was 40.5% after the first COT and 68.9% overall. Altogether, 85.4% of the 7,427 baseline lesions were cleared. Patients with hyperkeratotic/hypertrophic lesions showed comparable responses. Local skin reactions were the most commonly reported adverse effects, causing discontinuation in only 4 patients. Severity of the local skin reactions was a strong predictor of the outcome. Patients with multiple multiform AK on the head can be successfully and safely treated with topical imiquimod in daily practice. Assurance of patient understanding that treatment success is closely correlated to proper drug administration is important.

Keywords : imiquimod, actinic keratoses

 

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