Two cases of bowen disease of the eyelid treated with imiquimod
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Bowen's disease
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Photodynamic therapy (PDT) has been shown to be useful and effective in the treatment of actinic keratosis, Bowen disease, and basal cell carcinoma. We present a series of 13 Bowen disease lesions treated using PDT. Complete responses were achieved in 11 (84%) of the lesions after 3 months of treatment; at 18 months, complete responses were seen in 9 (70%) of the lesions. Patients who presented a partial response or recurrence were treated with topical 5% imiquimod and achieved complete responses. The lesions that presented partial response or recurrence were the largest lesions, between 3 and 5 cm in diameter. PDT in monotherapy or combined sequentially with imiquimod is an excellent and well-tolerated therapeutic option for Bowen disease. The treatment has few adverse effects and shows satisfactory results, particularly in multiple large lesions in areas of difficult surgical reconstruction or in elderly patients with a high surgical risk. La terapia fotodinámica (TFD) ha demostrado ser un tratamiento útil y eficaz en queratosis actínicas, enfermedad de Bowen (EB) y carcinoma basocelular. Presentamos una serie de 13 lesiones de EB tratados con TFD. A los 3 meses del tratamiento 11/13 (84%) lesiones presentaron respuesta completa. A los 18 meses la respuesta completa fue de 9/13 (70%) lesiones. Los pacientes que presentaron respuesta parcial o recidiva fueron tratados con imiquimod tópico al 5%, con la consiguiente respuesta completa. Las lesiones con respuesta parcial o recidiva fueron las de mayor tamaño: entre 3 y 5 cm de diámetro. La TFD en monoterapia o combinada secuencialmente con imiquimod es una excelente opción terapéutica para la EB, bien tolerada, con mínimos efectos secundarios y unos resultados satisfactorios, y sobre todo indicada en lesiones de gran tamaño, múltiples, en áreas de difícil reconstrucción quirúrgica o en pacientes ancianos con riesgo quirúrgico elevado.
Imiquimod
Bowen's disease
Actinic keratosis
Actinic Keratoses
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乳房以外的佩吉特氏症是一種罕見的表皮腺癌，多見於汗腺豐富的區域。約60%的乳房以外的佩吉特氏症發生於外陰部，而外陰部佩吉特氏症約占外陰部惡性腫瘤的1%。一位95 017２０１歲的女性於過去兩年多的期間，飽受外陰部紅腫、結痂、滲液的困擾，在本院皮膚科門診時也在外陰部發現一顆一公分大的結節。經切片後證實為佩吉特氏症。考慮到她高齡及獨居的狀況，決定不以手術切除而採放射治療。原訂以6 MeV電子至少照射25次至50 Gy劑量。但因放射性皮膚炎而於20 Gy時中止。改採imiquimod 5%乳膏治療，每兩日塗抹於病灶及其邊緣外加2公分之範圍。三週後已見到病灶明顯縮小。後因她行動不便而未前來接受治療，療程僅維持共五週。六個月後回診，原本的結節已消失，大部分病灶也均消失，但仍有部分紅色斑塊疑似殘存腫瘤。
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A 61-year-old male presented with 20 x 15 mm diffuse, hyperpigmented lesion that covered the right upper eyelid and which had been present for 2 years.Lesion was diagnosed as actinic keratosis (AK).Since the patient refused surgery and reconstruction, he was treated with imiquimod (IMQ) 5% cream once a day, 5 times per week for 6 weeks.Lesion gradually reduced in size and no clinically evident residual keratosis was observed after treatment.No post-therapy excision was performed to assess histological clearance of AK for cosmetic reasons.Although surgery is first-line treatment for these lesions, in case of refusal to undergo surgery, when lesion is superficial and diffuse and in region where reconstruction would be difficult, treatment with IMQ may be preferred.
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Imiquimod
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Bowen's disease is a cutaneous squamous cell carcinoma (SCC) in situ with a potential risk of progression to invasive SCC. Despite the high number of approved treatments, elderly patients with extensive lesions of critical sites may represent a therapeutical challenge, especially in cases of treatment failure or recalcitrant disease. Here, we report the successfully use of topical Imiquimod 3.75% to treat an extensive Bowen's disease of the cheek in an elderly.
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Bowen's disease
Cheek
Carcinoma in situ
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Imiquimod
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61歳，女性。肛門近傍の褐色局面を主訴に受診した。皮膚生検を施行したところ，表皮肥厚，異型角化細胞の増殖，核分裂像，clumping cellが認められ，Bowen病と診断した。HPV抗体染色は陰性であった。5％イミキモドクリーム外用を開始したところ，8週間後には肉眼的に病変が消失した。中止後約3ヵ月半の時点で再度皮膚生検を施行し，組織学的に表皮異型細胞は消失していた。
Bowen's disease
Imiquimod
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Imiquimod
Bowen's disease
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Topical 5% imiquimod cream is an FDA-approved treatment for superficial basal cell carcinomas. It has also been utilized in the treatment of Bowen's disease (squamous cell in situ). The current literature on this subject, however, is scant, and this treatment is only validated by case reports and two small open label studies.The objective was to assess the efficacy of topical 5% imiquimod cream in the treatment of squamous cell in situ in a larger open-label case series. METHODS A retrospective study of 49 patients was performed.Forty-two of the 49 (86%) patients in the study had a complete response with topical imiquimod. The remaining 7 (14%) failed therapy and required additional treatments. The mean follow-up duration was 19 months, with a range of 1 to 44 months.Topical 5% imiquimod cream appears to be clinically beneficial in the treatment of Bowen's disease and should be considered as a treatment option.
Imiquimod
Bowen's disease
Cosmetic Techniques
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Imiquimod
Vulvar intraepithelial neoplasia
Bowen's disease
Cryotherapy
Curettage
Curette
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