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04-11-2015 | Non-melanoma skin cancer | Case report | Article

Imiquimod 5% as Adjuvant Therapy for Incompletely Excised Infiltrative Nodular Basal Cell Carcinoma and Dermoscopy to Monitor Treatment Response

Journal: Dermatology and Therapy

Authors: Rodrigo Roldán-Marín, Sonia Toussaint-Caire

Publisher: Springer Healthcare

Abstract

Introduction

A relatively novel application for dermoscopy is its use in the monitoring of topical treatment response for non-melanoma skin cancer. Basal cell carcinoma (BCC) is the most frequent type of skin cancer in humans. Surgical excision is still considered the “gold-standard” of treatment. However, a number of topical therapies are now available for the treatment of different types of basal cell carcinoma.

Case Report

This case report exemplifies the usefulness of dermoscopy in the monitoring of residual disease after incomplete surgical excision and also in the monitoring of topical treatment response. Imiquimod 5% cream acts as a topical immune response modifier promoting a Th-1 immune response enhancing the removal of neoplastic cells and has proven to reduce deregulated Hedgehog (HH)/GLI signal strength independent of Toll-like receptor signaling, which makes it a valuable adjuvant topical therapy for the treatment of basal cell carcinoma.

Conclusion

Imiquimod 5% cream is a valuable adjuvant therapy for the treatment of incompletely excised BCC. This case report adds further evidence to the usefulness of dermoscopy in the assessment and monitoring of treatment outcome.
Literature
1.
Vestergaard ME, Macaskill P, Holt PE, Menzies SW. Dermoscopy compared with naked eye examination for the diagnosis of primary melanoma: a meta-analysis of studies performed in a clinical setting. Br J Dermatol. 2008;159:669–76.PubMed
2.
Lallas A, Argenziano G, Zendri E, Moscarella E, Longo C, Grenzi L, Pellacani G, Zalaudek I. Update on non-melanoma skin cancer and the value of dermoscopy in its diagnosis and treatment monitoring. Expert Rev Anticancer Ther. 2013;13:541–58.CrossRefPubMed
3.
Zalaudek I, Lallas A, Moscarella E, Longo C, Soyer HP, Argenziano G. The dermatologist’s stethoscope-traditional and new applications of dermoscopy. Dermatol Pract Concept. 2013;3:67–71.PubMedCentralPubMed
4.
Apalla Z, Lallas A, Tzellos T, Sidiropoulos T, Lefaki I, Trakatelli M, Sotiriou E, Lazaridou E, Evangelou G, Patsatsi A, Kyrgidis A, Stratigos A, Zalaudek I, Argenziano G, Ioannides D. Applicability of dermoscopy for evaluation of patients’ response to nonablative therapies for the treatment of superficial basal cell carcinoma. Br J Dermatol. 2014;170:809–15.CrossRefPubMed
5.
Cuellar F, Vilalta A, Puig S, Palou J, Zaballos P, Malvehy J. Dermoscopy of early recurrent basal cell carcinoma. Arch Dermatol. 2008;144:1254.PubMed
6.
Farhi D, Dupin N, Palangié A, Carlotti A, Avril MF. Incomplete excision of basal cell carcinoma: rate and associated factors among 362 consecutive cases. Dermatol Surg. 2007;33:1207–14.PubMed
7.
Thissen MR, Kuijpers DI, Krekels GA. Local immune modulator (imiquimod 5% cream) as adjuvant treatment after incomplete Mohs micrographic surgery for large, mixed type basal cell carcinoma: a report of 3 cases. J Drugs Dermatol. 2006;5:461–4.PubMed
8.
Bath-Hextall F, Ozolins M, Armstrong SJ, Colver GB, Perkins W, Miller PS, Williams HC. Surgery versus imiquimod for nodular superficial basal cell carcinoma (SINS) study group. Surgical excision versus imiquimod 5% cream for nodular and superficial basal-cell carcinoma (SINS): a multicentre, non-inferiority, randomised controlled trial. Lancet Oncol. 2014;15:96–105.CrossRefPubMed
9.
Gruber W, Frischauf AM, Aberger F. An old friend with new skills: imiquimod as novel inhibitor of Hedgehog signaling in basal cell carcinoma. Oncoscience. 2014;1:567–73.PubMedCentralCrossRefPubMed
10.
Kaçar SD, Özuğuz P, Erkan F, Karaca Ş. Treatment of various types of basal cell carcinoma with topical 5% imiquimod in the elderly who refused surgical intervention: a case series. J Dermatolog Treat. 2015;26:165–7.CrossRefPubMed
11.
de Macedo EM, Carneiro RC, de Lima PP, Silva BG, Matayoshi S. Imiquimod cream efficacy in the treatment of periocular nodular basal cell carcinoma: a non-randomized trial. BMC Ophthalmol. 2015;15:35. doi:10.​1186/​s12886-015-0024-0.PubMedCentralCrossRefPubMed