Lewis Daniel J, Byekova Yevgeniya A, Emge Drew A, Duvic Madeleine
a School of Medicine , Baylor College of Medicine , Houston , TX , USA.
b Department of Dermatology , The University of Texas MD Anderson Cancer Center , Houston , TX , USA.
J Dermatolog Treat. 2017 Sep;28(6):567-569. doi: 10.1080/09546634.2017.1294728. Epub 2017 Mar 2.
To demonstrate the clinical efficacy of topical 5% imiquimod for mycosis fungoides (MF) tumors.
Treatment of tumor-stage MF represents a therapeutic challenge because of a limited number of effective topical therapies. Single tumors can be treated with localized radiation but may recur. Systemic therapies are also an option but are associated with serious adverse effects. Imiquimod is a topical agent whose efficacy has been documented in treating MF patches and plaques as well as one case of tumor-stage disease.
We present two stage IIB MF patients, including one with large cell transformation, whose tumors were treated with imiquimod 5% cream after failing prior therapies.
The MF tumors in both patients demonstrated a complete response to imiquimod 5% cream without recurrence over 8 years and 2 years of follow-up, respectively. One patient experienced application site irritation and flu-like symptoms as adverse effects.
Our case series is only the second report in the literature demonstrating complete resolution of MF tumors with topical imiquimod. An additional therapeutic option for tumor-stage MF, imiquimod may represent an effective alternative to localized radiation for isolated MF tumors and warrants further investigation in the treatment of various stages of MF.
证明外用5%咪喹莫特治疗蕈样肉芽肿（MF）肿瘤的临床疗效。
肿瘤期MF的治疗是一项治疗挑战，因为有效的局部治疗方法有限。单个肿瘤可用局部放疗治疗，但可能会复发。全身治疗也是一种选择，但会伴有严重的不良反应。咪喹莫特是一种局部用药，其治疗MF斑块和斑片以及一例肿瘤期疾病的疗效已有文献记载。
我们报告了2例IIB期MF患者，其中1例伴有大细胞转化，其肿瘤在先前治疗失败后用5%咪喹莫特乳膏治疗。
两名患者的MF肿瘤对5%咪喹莫特乳膏均表现出完全缓解，分别随访8年和2年无复发。一名患者出现用药部位刺激和流感样症状等不良反应。
我们的病例系列是文献中第二篇证明外用咪喹莫特可使MF肿瘤完全消退的报告。咪喹莫特作为肿瘤期MF的一种额外治疗选择，对于孤立的MF肿瘤可能是局部放疗的有效替代方法，值得在MF各期治疗中进一步研究。
