Oster-Schmidt Claus, Altmeyer Peter, Markus Stücker
J Dtsch Dermatol Ges. 2003 Oct;1(10):790-6. doi: 10.1046/j.1439-0353.2003.03723.x.
Solar keratoses are precancerous lesions in chronically UV-damaged skin with histological features consistent with pre-invasive squamous cell carcinoma. They require therapeutic intervention in order to prevent progression towards invasive carcinoma. Treatment options include topical medications and destructive methods. We report on a new approach--topical bioinductive therapy with imiquimod 5% cream.
In a prospective case series, 7 patients with solar keratoses have been treated with topical imiquimod 5%. The cream was applied 5 days/week over 2 weeks. After end of treatment, the outcome was assessed at regular control visits and, in some cases, histologically confirmed. One patient was followed up as untreated control.
In 6 of the 7 treated patients, the lesions cleared completely; one patient did not respond. The patients did not show new solar keratoses during a follow-up period of about 2 years. The untreated patient showed spontaneous clearance of his keratoses. Local skin reactions during treatment included erythema, oedema and erosions in varying degrees, all of which completely resolved.
Bioinductive therapy with imiquimod 5% cream represents a promising therapeutic approach for cutaneous precancerous lesions such as solar keratoses.
日光性角化病是长期紫外线损伤皮肤中的癌前病变，其组织学特征与原位鳞状细胞癌一致。为防止进展为浸润性癌，需要进行治疗干预。治疗选择包括局部用药和破坏性方法。我们报告一种新方法——使用5%咪喹莫特乳膏进行局部生物诱导治疗。
在一项前瞻性病例系列研究中，7例日光性角化病患者接受了5%咪喹莫特局部治疗。乳膏每周使用5天，共2周。治疗结束后，定期复诊评估疗效，部分病例进行了组织学确认。1例患者作为未治疗对照进行随访。
7例接受治疗的患者中，6例病变完全清除；1例患者无反应。在约2年的随访期内，患者未出现新的日光性角化病。未治疗的患者其角化病自发清除。治疗期间的局部皮肤反应包括不同程度的红斑、水肿和糜烂，所有这些反应均完全消退。
5%咪喹莫特乳膏生物诱导治疗是一种治疗日光性角化病等皮肤癌前病变的有前景的治疗方法。
