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Topical Treatment of Skin Cancers and the Risks of ‘Fighting Fire with Fire’

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Clinical Cases in Skin Cancer Surgery and Treatment

Part of the book series: Clinical Cases in Dermatology ((CLIDADE))

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Abstract

While surgical excision remains the mainstay of managing non-melanoma skin cancers, many authors have published successful topical or non-surgical options for treating non-melanoma skin cancers [1]. A recent review article compared the efficacy of topical 5-fluorouracil (5FU), topical imiquimod 5 % cream, intralesional 5FU, intralesional methotrexate (MTX), intralesional bleomycin, and intralesional interferon (IFN) for non-melanoma skin cancers [2].

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References

  1. Kirby JS, Miller CJ. Intralesional chemotherapy for nonmelanoma skin cancer: a practical review. J Am Acad Dermatol. 2010;63:689–702.

    Article  CAS  PubMed  Google Scholar 

  2. Chitwood K, Etzkorn K, Cohen G. Topical and intralesional treatment of nonmelanoma skin cancer: efficacy and cost comparisons. Dermatol Surg. 2013;39:1306–16.

    Article  CAS  PubMed  Google Scholar 

  3. Klein E, Milgrom H, Helm F, Ambrus J, Traenkle HL, Stoll HL. Tumors of the skin: effects of local use of cytostatic agents. Skin (Los Angeles). 1962;1:81–7.

    CAS  Google Scholar 

  4. Maltusch A, Rowert-Huber J, Matthies C, Lange-Asschenfeldt S, Stockfleth E. Modes of action of diclofenac 3 %/hyaluronic acid 2.5 % in the treatment of actinic keratosis. J Dtsch Dermatol Ges. 2011;9:1011–7.

    PubMed  Google Scholar 

  5. Lebwohl M, Swanson N, Anderson LL, Melgaard A, Xu Z, Berman B. Ingenol mebutate gel for actinic keratosis. N Engl J Med. 2012;366:1010–9.

    Article  CAS  PubMed  Google Scholar 

  6. Rosen RH, Gupta AK, Tyring SK. Dual mechanism of action of ingenol mebutate gel for topical treatment of actinic keratoses: rapid lesion necrosis followed by lesion-specific immune response. J Am Acad Dermatol. 2012;66:486–93.

    Article  CAS  PubMed  Google Scholar 

  7. Micali G, et al. Topical pharmacotherapy for skin cancer. J Am Acad Dermatol. 2014;70(6):979.e1–e12.

    Google Scholar 

  8. Harrison CJ, Jenski L, Voychehovski T, Bernstein DI. Modification of immunological responses and clinical disease during topical R-837 treatment of genital HSV-2 infection. Antiviral Res. 1988;10:209–24.

    Article  CAS  PubMed  Google Scholar 

  9. Gerster JF, Lindstrom KJ, Miller RL, et al. Synthesis and structure-activityrelationships of 1H-Imidazo[4,5-c]quinolines that induce interferon production. J Med Chem. 2005;48:3481–91.

    Article  CAS  PubMed  Google Scholar 

  10. Salasche SJ, Levine N, Morrison L. Cycle therapy of actinic keratoses of the face and scalp with 5 % topical Imiquimod cream: an open label trial. J Am Acad Dermatol. 2002;47(4):571–7.

    Article  PubMed  Google Scholar 

  11. Beutner KR, Geisse JK, Helman D, Fox TL, Ginkel A, Owens ML. Therapeutic response of basal cell carcinoma to the immune response modifier imiquimod 5 % cream. J Am Acad Dermatol. 1999;41:1002–7.

    Article  CAS  PubMed  Google Scholar 

  12. Smyth E, Flavin M. Treatment of locally recurrent mucosal melanoma with topical imiquimod. J Clin Oncol. 2011;29(33):809–11.

    Article  Google Scholar 

  13. Gagnon L. Imiquimod advantage. Dermatology Times. 2011;32(9):86–9.

    Google Scholar 

  14. Stanley MA. Imiquimod and the imidazoquinolones: mechanism of action and therapeutic potential. Clin Exp Dermatol. 2002;27:571–7.

    Article  CAS  PubMed  Google Scholar 

  15. Gibson SJ, Lindh JM, Riter TR, et al. Plasmacytoid dendritic cells produce cytokines and mature in response to the TLR7 agonists, imiquimod and resiquimod. Cell Immunol. 2002;218:74–86.

    Article  CAS  PubMed  Google Scholar 

  16. Kaisho T, Akira S. Toll-like receptor function and signaling. J Allergy Clin Immunol. 2006;117:979–87.

    Article  CAS  PubMed  Google Scholar 

  17. Tomai MA, Imbertson LM, Stanczak TL, et al. The immune response modifiers imiquimod and R-848 are potent activators of B lymphocytes. Cell Immunol. 2000;203:55–65.

    Article  CAS  PubMed  Google Scholar 

  18. Goh MS. Invasive squamous cell carcinoma after treatment of carcinoma in situ with 5 % imiquimod cream. Australas J of Dermatol. 2006;47:186–8.

    Article  Google Scholar 

  19. Campelani E, Holden CA. Keratoacanthoma associated with the use of topical imiquimod correspondence. Clin Exp Dermatol. 2013;38:553–8.

    Article  Google Scholar 

  20. Chapman MS, Spencer SK, Brennick JB. Histologic resolution of melanoma in situ (lentigo maligna) with 5 % imiquimod cream. Arch Dermatol. 2003;139:943–4.

    PubMed  Google Scholar 

  21. Kamin A, Eigentler TK, Radny P, et al. Imiquimod in the treatment of extensive recurrent lentigo maligna. J Am Acad Dermatol. 2005;52(2 Suppl 1):51–2.

    Article  PubMed  Google Scholar 

  22. Aspord C, Tramcourt L, et al. Imiquimod inhibits melanoma development by promoting pDC cytotoxic functions and impeding tumor vascularization. J Investig Dermatol. 2014. (Advance online publication).

    Google Scholar 

  23. Bong AB, Bonnekoh B, Franke I, et al. Imiquimod, a topical immune response modifier, in the treatment of cutaneous metastases of malignant melanoma. Dermatology. 2002;205:135–8.

    Article  CAS  PubMed  Google Scholar 

  24. Ashton KJ, Weinstein SR, Maguire DJ, Griffiths LR. Chromosomal aberrations in squamous cell carcinoma and solar keratosis revealed by genomic hybridization. Arch Dermatol. 2003;139(7):876–82.

    CAS  PubMed  Google Scholar 

  25. Brash DE, Zeigler A, Jonason AS, Simon JA, Kunala S, Leffell DJ. Sunlight and sunburn in human skin: p53, apoptosis and tumor promotion. J Investig Dermatol Symp Proc. 1996;19(2):136–42.

    Google Scholar 

  26. McGillis ST, Fein H. Topical treatment strategies for Non-melanoma skin cancer and precursor lesions. Semin Cutan Med Surg. 2004;23:174–83.

    Article  PubMed  Google Scholar 

  27. Akkilic-Materna M, Massone C, Komericki P. Imiquimod and lymphatic field clearance: a New hypothesis based on a remote immune action on skin cancer. Acta Derm Venereol. 2011;91(4):432–435(4).

    Article  CAS  PubMed  Google Scholar 

  28. Skaria AM. Facial basal cell carcinomas recurring after imiquimod therapy correspondence. Dermatology. 2013;226:13–4.

    Article  CAS  PubMed  Google Scholar 

  29. Fernández-Vozmediano J, Armario-Hita J. Infiltrative squamous cell carcinoma on the scalp after treatment with 5 % imiquimod cream. J Am Acad Dermatol. 2005;52:716–7.

    Article  PubMed  Google Scholar 

  30. Leroy B, Wolf F, Descotes J, Vial T. Imiquimod and pulmonary embolism: a case report. Fundamental and Clinical Pharmacology. 2012;26 Suppl 1:375.

    Google Scholar 

  31. LAPRESTA A, GARCÍA-ALMAGRO D, SEJAS AG. Amelanotic lentigo maligna managed with topical imiquimod. J Dermatol. 2012;39:503–5.

    Article  CAS  PubMed  Google Scholar 

  32. O'Neill J, Ayers D, Kenealy J. Periocular lentigo maligna treated with imiquimod. J Dermatol Treat. 2011;22(2):109–12.

    Article  Google Scholar 

  33. Ventura F, et al. Topical imiquimod treatment of lentigo maligna. Case Rep Dermatol. 2009;1:78–81.

    Article  PubMed Central  PubMed  Google Scholar 

  34. Cotter M, et al. Treatment of lentigo maligna with imiquimod before staged excision. Dermatol Surg. 2008;34(2):147–51.

    Article  CAS  PubMed  Google Scholar 

  35. Schön M, Bong AB, Drewniok C, et al. Tumor-selective induction of apoptosis and the small-molecule immune response modifier imiquimod. J Natl Cancer Inst. 2003;95:1138–49.

    Article  PubMed  Google Scholar 

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Correspondence to Sharad P. Paul MD, MPhil .

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Paul, S.P. (2016). Topical Treatment of Skin Cancers and the Risks of ‘Fighting Fire with Fire’. In: Paul, S., Norman, R. (eds) Clinical Cases in Skin Cancer Surgery and Treatment. Clinical Cases in Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-20937-1_11

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  • DOI: https://doi.org/10.1007/978-3-319-20937-1_11

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-20936-4

  • Online ISBN: 978-3-319-20937-1

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