Photodamage

Question 1

Topical treatments can be used for actinic (solar) keratoses. ______________ can be used as part of the management regimen for dry, sun-damaged elderly skin although the direct effect is unclear; addition of urea or salicylic acid may provide benefit

Answer 1

An emollient

Question 2

_____________ gel may be suitable for the treatment of superficial lesions in mild actinic (solar) keratoses

Answer 2

Diclofenac sodium

Question 3

_____________ can be used for lesions on the face and scalp when cryotherapy or other topical treatments cannot be used to treat actinic keratosis

Answer 3

Imiquimod

Question 4

In the treatment of actinic keratosis, Fluorouracil and imiquimod produce a more marked ______________ than diclofenac sodium but lesions resolve faster

Answer 4

inflammatory reaction

Question 5

Imiquimod and topical fluorouracil are licensed for treating _______________ carcinomas

Answer 5

superficial basal cell

Question 6

Are patients with suspected basal cell carcinoma referred for review routinely or urgently (down the suspected cancer pathway)?

Answer 6

Routine referral UNLESS there are concerns that delay may have a significant impact due to lesion factors such as size and site

Question 7

Photodynamic therapy in combination with methyl-5-aminolevulinate cream is used in specialist centres for treating _______________ carcinomas when other treatments are unsuitable.

Answer 7

thin nodular basal cell; may also be used for superficial basal cell carcinomas, particularly for multiple and large-area lesions, cosmetically sensitive sites, and lesions located at sites of poor healing

Question 8

What is the mechanism of action of imiquimod?

Answer 8

Stimulates innate and acquired immune responses which ultimately leads to inflammatory cell infiltration within the field of drug application followed by apoptosis of diseased tissue

Question 9

What are the indications of imiquimod? (3)

Answer 9

1. Warts (external genital and perianal)
2. Superficial basal cell carcinoma
3. Actinic keratosis

Question 10

What additional precautions should be taken when considering imiquimod and contraception?

Answer 10

Imiquimod cream may damage latex condoms and diaphragms