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Erick M. Macedo, Rachel C. Carneiro, Breno G. Silva, Suzana Matayoshi; Evaluation Of Local Side Effects Of Topical Immunotherapy In The Treatment Of Periocular Nodular Basal Cell Carcinoma. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1030.
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During topical immunotherapy, local inflammation is the main agent responsible not only for the cure of the lesion but also for the main side effects of the medication. The objective of the study was to evaluate the main local side effects of topical immunotherapy with 5% imiquimod cream in the treatment of periocular nodular basal cell carcinoma.
Prospective study involving 19 patients with primary periocular nodular basal cell carcinoma confirmed by biopsy. All patients were submitted to treatment with 5% imiquimod cream once a day, five times a week, for 8-16 weeks. Side effects were quantified at semimonthly ophtalmologic follow-up visits, based on visual acuity, biomicroscopy and photographic documentation analyzed with the software ImageJ v. 1.42
Histological cure of the lesion was confirmed in 89.5% of the patients. The peak of skin inflammation occurred during the first eight weeks of treatment in 68% of the patients, and 95% developed ulceration in this period. Reactional conjunctivitis affected 79% of the patients, keratitis 68%, deterioration of visual acuity 42%, and ectropion 32%. The distance from the lesion to the eyelid margin was significantly smaller in patients presenting ectropion during treatment (p=0.045).
Local side effects of topical immunotherapy with imiquimod were most prevalent during the first eight weeks of treatment and regressed thereafter. Lesions near the eyelid margin were at greater risk of developing ectropion during treatment.
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