Skip to main content
SpringerLink
Log in

Use of Imiquimod Cream 5% in the Treatment of Localized Morphea

  • Case Report
  • Published:
Journal of Cutaneous Medicine and Surgery: Incorporating Medical and Surgical Dermatology

Abstract

Fibrosis is characterized by the increased deposition of collagen and other matrix components by fibroblasts. This process occurs as a reaction to inflammation and is mediated by numerous cytokines including transforming growth factor β (TGF-β). Localized cutaneous scleroderma or morphea is characterized by fibrosis. Current treatment for morphea includes topical, intralesional, or systemic corticosteroids, vitamin D analog (calcitriol and calcipotriol), photochemotherapy, laser therapy, antimalarials, phenytoin, D-penicillamine, and colchicine, all with varying degrees of success. In this case report, imiquimod cream 5% (Aldara®), which induces interferon and in turn inhibits TGF-β, was employed to treat morphea.

Sommaire

Les fibroses se caractérisent par le dépôt excessif de collagène et autres composés matriciels sécrétés par les fibroblastes. Ce processus apparaît en réaction à une inflammation et est facilité par les nombreuses cytokines, dont le TGF-β. La sclérodermie localisée, ou morphée, est caractérisée par des fibroses. Parmi les traitements actuels, notons les corticostéroïdes topiques, intralésionnels ou systémiques, les analogues de la vitamine D (calcitriol et calcipotriène), la photochimiothérapie, le traitement au laser, les antipaludiques, la phénytoïne, le D-pénicillamine et la colchicine, qui présentent tous différents degrés de réussite. Dans le présent rapport de cas, l’imiquimod (AldaraMD 5% crème) qui stimule 1’interféron et inhibe TGF-β a été utilisé dans le traitement de la morphée.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
Figure 7
Figure 8

Similar content being viewed by others

References

  1. RW Simms JH. Korn (2002) ArticleTitleCytokine directed therapy in scleroderma: rationale, current status, and the future. Curr Opin Rheumatol 14 IssueID6 717–722 Occurrence Handle10.1097/00002281-200211000-00015 Occurrence Handle1:CAS:528:DC%2BD38XosFegurg%3D Occurrence Handle12410097

    Article  CAS  PubMed  Google Scholar 

  2. Y Naiki Y Maeda K Matsuo et al. (2003) ArticleTitleInvolvement of TGF-ss signal for peritoneal sclerosing in continuous ambulatory peritoneal dialysis. J Nephrol 16 IssueID1 95–102 Occurrence Handle10.1159/000070123 Occurrence Handle1:CAS:528:DC%2BD3sXmtVamsrg%3D Occurrence Handle12649540

    Article  CAS  PubMed  Google Scholar 

  3. H. Ihn (2002) ArticleTitlePathogenesis of fibrosis: role of TGF-[beta] and CTGF. Curr Opin Rheumatol 14 IssueID6 681–685 Occurrence Handle10.1097/00002281-200211000-00009 Occurrence Handle1:CAS:528:DC%2BD38XosFeguro%3D Occurrence Handle12410091

    Article  CAS  PubMed  Google Scholar 

  4. VN Sehgal G Srivastava AK Aggarwal et al. (2002) ArticleTitleLocalized scleroderma/morphea. Int J Dermatol 41 IssueID8 467–475 Occurrence Handle10.1046/j.1365-4362.2002.01469.x Occurrence Handle12207760

    Article  PubMed  Google Scholar 

  5. T Kawakami Y Soma T Baba et al. (2002) ArticleTitleImmunohistochemical analysis of transforming growth factor beta 3 expression in solitary morphoea profunda with histological membranocystic changes. Br J Dermatol 146 IssueID1 171–173 Occurrence Handle10.1046/j.1365-2133.2002.4513_7.x Occurrence Handle1:STN:280:DC%2BD387hvFSrsQ%3D%3D Occurrence Handle11852924

    Article  CAS  PubMed  Google Scholar 

  6. M Kubo H Ihn K Yamane et al. (2002) ArticleTitleUpregulated expression of transforming growth factor-beta receptors in dermal fibroblasts of skin sections from patients with systemic sclerosis. J Rheumatol 29 IssueID12 2558–2564 Occurrence Handle1:CAS:528:DC%2BD3sXntFym Occurrence Handle12465152

    CAS  PubMed  Google Scholar 

  7. H. Ihn (2002) ArticleTitleThe role of TGF-beta signaling in the pathogenesis of fibrosis in scleroderma. Arch Immunol Ther Exp (Warsz) 50 IssueID5 323–331

    Google Scholar 

  8. MK. Connolly (2001) ArticleTitleScleroderma. Dermatol Ther 14 81–94 Occurrence Handle10.1046/j.1529-8019.2001.014002081.x

    Article  Google Scholar 

  9. S Karrer C Abels M Landthaler et al. (2000) ArticleTitleTopical photodynamic therapy for localized scleroderma. Acta Derm Venereol 80 IssueID1 26–27 Occurrence Handle10.1080/000155500750012469 Occurrence Handle1:STN:280:DC%2BD3c7osVymsQ%3D%3D Occurrence Handle10721828

    Article  CAS  PubMed  Google Scholar 

  10. Y Uziel BM Feldman BR Krafchik et al. (2000) ArticleTitleMethotrexate and corticosteroids therapy for pediatric localized scleroderma. J Pediatr 136 IssueID1 91–95 Occurrence Handle10.1016/S0022-3476(00)90056-8 Occurrence Handle1:CAS:528:DC%2BD3cXhtVWhsbw%3D Occurrence Handle10636981

    Article  CAS  PubMed  Google Scholar 

  11. NG Caca-Biljanovska MT Vlckova–Laskoska DV Dervendi et al. (1999) ArticleTitleTreatment of generalized morphea with oral 1,25-dihydroxyvitamin D3. Adv Exp Med Biol 455 299–304 Occurrence Handle1:STN:280:DC%2BD3c%2FmslCltA%3D%3D Occurrence Handle10599359

    CAS  PubMed  Google Scholar 

  12. AN Sapadin R. Fleischmajer (2002) ArticleTitleTreatment of scleroderma. Arch Dermatol 138 IssueID1 99–105 Occurrence Handle10.1001/archderm.138.1.99 Occurrence Handle1:CAS:528:DC%2BD38XhtFWqurg%3D Occurrence Handle11790173

    Article  CAS  PubMed  Google Scholar 

  13. DJ. Eedy (2002) ArticleTitleImiquimod: a potential role in dermatology? Br J Dermatol 147 IssueID1 1–6 Occurrence Handle10.1046/j.1365-2133.2002.04945.x Occurrence Handle1:CAS:528:DC%2BD38XmsVansbc%3D

    Article  CAS  Google Scholar 

  14. MV. Dahl (2002) ArticleTitleImiquimod: a cytokine inducer. J Am Acad Dermatol 47 IssueID4 Suppl S205–S208 Occurrence Handle10.1067/mjd.2002.126586 Occurrence Handle12271278

    Article  PubMed  Google Scholar 

  15. GW Pearson RGB. Langley (2001) ArticleTitleTopical imiquimod. J Dermatol Treat 12 IssueID1 37–40 Occurrence Handle10.1080/095466301750163572 Occurrence Handle1:CAS:528:DC%2BD3MXjvVCnsro%3D

    Article  CAS  Google Scholar 

  16. TL Wagner CL Ahonen AM Couture et al. (1999) ArticleTitleModulation of TH1 and TH2 cytokine production with the immune response modifiers, R-848 and imiquimod. Cell Immunol 191 IssueID1 10–19 Occurrence Handle10.1006/cimm.1998.1406 Occurrence Handle1:CAS:528:DyaK1MXpvF2quw%3D%3D Occurrence Handle9918682

    Article  CAS  PubMed  Google Scholar 

  17. AN Sapadin R. Fleischmajer (2002) ArticleTitleTreatment of scleroderma. Arch Dermatol 138 IssueID1 99–105 Occurrence Handle10.1001/archderm.138.1.99 Occurrence Handle1:CAS:528:DC%2BD38XhtFWqurg%3D Occurrence Handle11790173

    Article  CAS  PubMed  Google Scholar 

  18. M. Selman (2002) ArticleTitleFrom anti-inflammatory drugs through antifibrotic agents to lung transplantation: a long road of research, clinical attempts, and failures in the treatment of idiopathic pulmonary fibrosis. Chest 122 IssueID3 759–761 Occurrence Handle10.1378/chest.122.3.759 Occurrence Handle12226006

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

The authors wish to thank Drs. J. Liao and Vladimir Migounov for useful discussion of the case, and 3 M Pharmaceuticals (especially Mr. Scott Connell) for providing Aldara cream and funding for the color photographs in this publication.

Author information

Authors and Affiliations

  1. Division of Dermatology, University of Alberta, T6G 2G3, Edmonton, Alberta, Canada

    Jeremy Man & Marlene T. Dytoc

Authors
  1. Jeremy Man
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marlene T. Dytoc
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marlene T. Dytoc.

About this article

Cite this article

Man, J., Dytoc, M.T. Use of Imiquimod Cream 5% in the Treatment of Localized Morphea. JCMS 8, 166–169 (2004). https://doi.org/10.1007/s10227-003-0112-2

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10227-003-0112-2

Keywords

Search

Navigation