Treatment of various types of basal cell carcinoma with topical 5% imiquimod in the elderly who refused surgical intervention: a case series.

Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer in the elderly population, causing significant local destruction and image deformities. Although surgical excision is the primary treatment modality, preservation of functions, cosmetic concerns and patient's age, as well as tumor prognostic factors, aid in treatment selection. Topical imiquimod provides immunomodulatory effects by increasing the release of proinflammatory cytokines, and is currently approved and funded for pathologically diagnosed superficial BCC. We report herein the successful results of topical imiquimod in four cases of BCC, nodular and large superficial types, all of whom refused surgical intervention. The lesions regressed in all except one in whom more than one BCC of superficial type was present. She is still on follow-up for intermittent cryotherapy sessions. Imiquimod is a good alternative to surgery in elderly patients who have unwillingness to surgery and are often poor candidates for surgery.