By Gary M. White, MD
This ear is inflamed from the treatment of AKs with 5% Imiquimod.
Caution: Facts about drugs changes frequently. The latest research, package insert and FDA information should be consulted before prescribing.
- Genital and perianal warts.
- Actinic Keratoses
- Superficial basal cell carcinoma
- Local skin irritation
- Case report of angioedema.
- Flu-like symptoms, e.g. headache, malaise.
External Genital Warts
- Apply a small amount of cream to wart and rub in till disappears. Do not occlude.
- For three times a week application, Aldara can be applied on Monday, Wednesday and Friday or Tuesday, Thursday and Saturday.
- Sexual contact is to be avoided when medication is on the skin.
- Wash area with soap and water 6-10 hours after applying Aldara. Rarely, headache may occur.
- Treatment with Aldara should continue until the warts are completely gone. Aldara should not be used for more than 16 weeks at a time.
- It usually takes 8-10 weeks for your warts to disappear but warts may clear as early as 4 weeks.
For external genital/perianal warts, Aldara is to be applied three days a week (e.g. MWF) for up to 16 weeks.
Dosing for AKs is twice weekly for 16 weeks.
Superficial Basal Cell Carcinoma
The target tumor should be a biopsy-proven superficial BCC, have a maximum diameter of no more than 2 cm and be located on the trunk (excluding anogenital skin), neck, or extremities (excluding hands and feet).
For superficial basal cell carcinomas, Aldara is to be applied once daily for five consecutive days per week for 6 weeks. Sufficient cream should be applied to cover the tumor and one centimeter of skin surrounding the tumor. Treatment should continue for 6 weeks unless your doctor tells you otherwise.
Aldara is supplied in single use tubes which are sufficient to cover 20 cm2.
Pregnancy Category C
Note that a few recent reports have recommended imiquimod for both basal cell carcinoma and Bowen's Disease.
Cutaneous T Cell Lymphoma
Treatment of AKs with imiquimod had induced changes of the skin which histologically mimic CTCL [JAMA Derm 2014;150;1236]
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