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E. M. S. Macedo, R. C. Carneiro, S. Matayoshi; Efficacy and Safety of Topical Immunotherapy in the Treatment of Periocular Nodular Basal Cell Carcinoma. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3518.
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Imiquimod is an immune response modifier for topical administration. The objective of this study was to evaluate the efficacy and safety of imiquimod cream 5% in the treatment of periocular nodular basal cell carcinoma (BCC).
Fifteen subjects with primary nodular BCC of the eyelid were recruited and all lesions were confirmed by 2 mm punch biopsy. Subjects applied Imiquimod cream 5 times per week for 8 - 16 weeks. At semimonthly ophthalmological follow-up visits patients were submitted to biomicroscopy and visual acuity testing until complete resolution of lesions. Twelve weeks after treatment completion a second 2 mm punch biopsy was performed.
Of a total of fifteen lesions, thirteen resolved clinically and histologically and have remained asymptomatic. The average follow-up time was 20 months. No damage to the eye or permanent loss of visual acuity was observed during the study period. The main side effects of the treatment were keratitis punctata and conjunctivitis, both of which resolved spontaneously after treatment completion. Patients presented local reactions such as erythema, itching, ulceration, bleeding and burning to a varying degree during treatment.
Topical immunotherapy with imiquimod was shown to be an attractive alternative to surgical treatment of periocular nodular BCC. Future studies with larger samples and longer follow-up periods are expected to provide more accurate information on the efficacy and safety of the drug.
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