Imiquimod (Aldara)

Question 1

What is Imiquimod? how does it work?

Answer 1

Activator of Toll Like Receptor 7

Results in secretion of TNF alpha, interferon gamma, IL 6 / 8 /12

Question 2

How do you use imiquimod to treat superficial BCCs?

Answer 2

1/ Ensure the appropriate indication and no contraindications

2/ Apply once daily for 5 days a week (M - F) for 6 weeks

Question 3

What are the PBS requirements to use Imiquimod on sBCCs?

Answer 3

1/ needs to be a biopsy proven sBCC,
2/ the condition must be previously untreated,
3/ the patient must have normal immune function,
4/ The condition must not be suitable for treatment with surgical excision; cryotherapy; OR curettage with diathermy,
5/ The condition must require topical treatment

Question 4

How do you prescribe Imiquimod for Acitinic damage?

Answer 4

1/ Ensure the appropriate indication and no contraindications

2/ Wash hands before and after applying imiquimod cream.

3/ Apply the cream to the affected areas.

2/ Apply 2 - 3 x week for 4 - 6 weeks

Question 5

How do you prescribe Imiquimod for genital warts?

Answer 5

1/ Ensure the appropriate indication and no contraindications

2/ Wash hands before and after applying imiquimod cream.

3/ Apply the cream to the affected areas.

2/ Apply 2 - 3 x week for 6 - 8 weeks

Question 6

What are the side effects of Imiquimod?

Answer 6

1/ Local reaction
- pain, burning, stinging
- redness, crusting, swelling, erosion, flaking, weeping
- rarely scaring

2/ Flu-like symptoms (myalgia, fatigue, fever)

Question 7

Clearance rates of sBCC with imiquimod treatment?

Answer 7

Different studies have slightly different numbers: between 70 - 80%

Question 8

Clearance rates of AK with imiquimod?

Answer 8

2005 systematic review:

Complete clearance occurred in 50% of patients

Partial Clearance in 75% of patients