No abstract available.
Aminoquinolines

Desmoplastic trichoepithelioma is a rare benign adnexal tumor. Although it is a benign lesion, patients often want to treat it due to cosmetic concerns when it occurs in an easily visible site. For our two cases, topical 5% imiquimod was an attractive treatment option as it is applied by the patients themselves and it has minimal side effects, including leaving no scar. However, the lesions recurred after clinical remission. To the best of our knowledge, this is the only report on utilizing imiquimod to treat a benign adnexal tumor, and especially desmoplastic trichoepithelioma.
Aminoquinolines ; Cicatrix ; Cosmetics ; Humans ; Recurrence

No abstract available.
Aminoquinolines ; Hypopigmentation ; Paget Disease, Extramammary

Keratoacanthoma (KA) is a benign epidermal tumor, characterized by rapid and abundant growth, a tendency toward spontaneous regression and histopathologic similarity to squamous cell carcinoma (SCC). Because KA can be easily misdiagnosed as SCC, surgery is considered the treatment of choice. Recently, regression of KAs following application of 5% imiquimod cream (Aldara(R)) has been reported. We present 4 cases of KA treated with topical imiquimod, applied 3 to 4 times a week. Obvious improvement was observed after 4 to 6 weeks of application and the lesions were almost cleared leaving scars after 9 to 11 weeks. These results show that topical imiquimod can be an effective option for the conservative management of KA as previously reported. We also suggest that lesions treated with imiquimod cream should be considered for biopsy to judge histopathological remission after 5 to 8 weeks of application to shorten the duration of the treatment.
Aminoquinolines ; Biopsy ; Carcinoma, Squamous Cell ; Cicatrix ; Keratoacanthoma

Infantile hemangiomas are the most common benign tumors of infancy and they can occur on any part of the body. However, their presentation as a perianal ulcer prior to the development of a clinical hemangioma is extremely rare. A 5-week-old girl presented with painful ulcerated lesions on the perianal area, which developed about 10 days after her birth. Histopathologic examination showed the proliferation of dilated vessels in the upper dermis. The patient was treated with combined approach using topical steroid, 5% imiquimod cream and triamcinolone intralesional injection. Clinical improvement was observed. We herein report on a case of infantile hemangioma that presented with perianal ulcers.
Aminoquinolines ; Dermis ; Hemangioma ; Humans ; Injections, Intralesional ; Parturition ; Triamcinolone ; Ulcer

BACKGROUND: Although molluscum contagiosum (MC) resolves spontaneously, there are several reasons to treat this dermatological disorder. OBJECTIVE: To evaluate the safety and efficacy of 5% imiquimod cream versus 10% potassium hydroxide (KOH) solution in treating MC, and to propose the mechanism of cure by observing the histological findings. METHODS: Imiquimod or KOH were applied by the patient or a parent 3 days per week until all lesions cleared. The number of MC lesions was counted and side effects were evaluated at 5 points during the treatment (the initial visit, week 2, week 4, week 8, and week 12). Histological changes were compared between 2 patients of each group, before and after the 2 weeks of application. RESULTS: In both group, the mean lesion counts decreased all through to week 12, and the reduction in number of lesions were statistically significant in both groups (p <0.005). Over 40% of each group developed local side effects, and no systemic side effects were noted in either group. Before treatment, histological findings showed little or no dermal infiltrates. After treatment, specimens showed dense lymphocytic infiltrates, especially T cells, around the lesions which had resolved. CONCLUSION: Both 10% KOH solution and 5% imiquimod cream are effective and safe treatment of MC.
Aminoquinolines ; Humans ; Hydroxides ; Molluscum Contagiosum ; Parents ; Potassium ; Potassium Compounds ; T-Lymphocytes

BACKGROUND: Extramammary Paget disease (EMPD) is an uncommon malignant neoplasm affecting apocrine gland-bearing skin which usually occurs in the anogenital area of patients older than 50 years. Although Mohs micrographic surgery (MMS) is recommended for the treatment of EMPD, wide local excision has also been performed by many other surgeons including dermatosurgeons. However, the extent of an adequate resection margin is still under debate. OBJECTIVE: The efficacy of minimal surgical therapy consisting of a wide excision combined with preoperative multiple scouting biopsies and postoperative topical imiquimod was investigated for the treatment of EMPD in Korean patients. METHODS: Between 2006 and 2012, 10 patients with primary EMPD were treated with wide surgical excision, with a surgical margin of less than 2.5 cm. Multiple preoperative scouting biopsies and postoperative topical imiquimod were also performed to delineate the lesional boundaries and to reduce the recurrence rate. RESULTS: During the 6-year follow-up period, complications and recurrences were not observed. CONCLUSION: Minimal surgical therapy may be an effective alternative when MMS is unavailable.
Aminoquinolines ; Biopsy ; Follow-Up Studies ; Humans ; Mohs Surgery ; Paget Disease, Extramammary ; Recurrence ; Skin

BACKGROUND: Keloids are slow-growing neoplasms that are characterized by a benign proliferation of fibroblasts in the setting of an altered cytokine profile. The traditional treatment modalities for external ear keloids are often associated with high recurrence rates. OBJECTIVE: The purpose of this study is to investigate the efficacy and safety of applying imiquimod 5% cream after parallel shave excision for the treatment of external ear keloids. METHODS: Twenty-two keloids from 19 patients were treated with parallel shave excision and this was followed by daily application of imiquimod 5% cream for 8 weeks. The patients were examined every 2 weeks for up to 24 weeks for recurrence of the keloids and any side effects. RESULTS: At the end of the 24-week follow-up period, 15 keloids (68.2%) remained recurrence free. Seven of these have remained recurrence free for a period ranging from 29 to 131 weeks. The common local side effects were burning (59.1%), pain (36.4%) and itching (27.3%), but there were no severe systemic side effects. Most of the patients experienced erythema (90.9%) and crust (77.3%) at the application sites and 3 patients (13.6%) reported transient hyperpigmentation on the surrounding areas. CONCLUSION: The application of imiquimod 5% cream after parallel shave excision can be an effective treatment modality for external ear keloids with mild and acceptable side effects.
Aminoquinolines ; Burns ; Ear, External ; Erythema ; Fibroblasts ; Follow-Up Studies ; Humans ; Hyperpigmentation ; Keloid ; Pruritus ; Recurrence

Condyloma acuminatum is an uncommon disease but there is an increased incidence reported in recent years in prepubertal children. Anal and perianal condyloma accuminatum in children may suggest sexual abuse and treatment should include the thorough social evaluation as well as medical treatment. A 25 month old girl presented with multiple sessile nodules around her anal and perianal area, Biopsy confirmed the diagnosis of condyloma accuminatum. There was no definite evidence of sexual abuse, but her father had condyloma accuminatum involving his penis. The patient's lesions were excised totally. At three week follow up there was no anal stricture but there were newly developed small lesions around perianal area. Imiquimod onit was applied for 2 weeks and the recurred lesion disappeared completely. At postoperative 5 month, the operative area was fully epithelialized without recurrence.
Aminoquinolines ; Biopsy ; Child ; Constriction, Pathologic ; Fathers ; Follow-Up Studies ; Humans ; Incidence ; Male ; Penis ; Recurrence ; Sex Offenses

Verrucous carcinoma is a slow-growing, well-differentiated, low grade squamous cell carcinoma with little tendency to metastasize. The best treatment for verrucous carcinoma is excision, and Mohs microsurgery may also be a helpful technique. But some people can not undergo surgical excision because of poor general condition of the site and the size of the tumor. Herein, we report a case of verrucous carcinoma treated by 5% imiquimod cream. A 71-year-old male patient presented with a large hyperkeratotic verrucous plaque on the Rt. buttock. Diagnosis of verrucous carcinoma was based on typical clinical and histologic features. Surgical excision could not be performed due to the size of the tumor. Treatment with 5% imiquimod cream, a topical immune response modifier, applied every other day for 16 weeks, led to tumor regression. Four weeks after the end of treatment, the lesion was evaluated by punch biopsy. The histology just showed scar tissue change. This case demonstrates that the imiquimod cream might be an alternative treatment option for verrucous carcinoma.
Aged ; Aminoquinolines ; Biopsy ; Buttocks ; Carcinoma, Squamous Cell ; Carcinoma, Verrucous ; Cicatrix ; Humans ; Male ; Microsurgery