Also Known As: Imiquimod, Aldara, Zyclara, Beselna, R-837

Imiquimod (INN) is a prescription medication that acts as an immune response modifier. It is marketed by Meda ABGraceway Pharmaceuticals, and iNova Pharmaceuticals under the trade names Aldara and Zyclara, and by Mochida as Beselna. It is also referred to as R-837. Due to the bankruptcy of Graceway in 2011, Medicis Pharmaceutical Corporation is the current owner of these products.

Imiquimod is a patient-applied cream used to treat certain diseases of the skin, including skin cancers (basal cell carcinomaBowen's disease,[1]superficial squamous cell carcinoma, some superficial malignant melanomas, and actinic keratosis) as well as genital warts (condylomata acuminata). However, Imiquimod is generally secondary to surgery, because surgery has a better chance to effectively treat at least some forms of skin cancer.[2]

Imiquimod has been tested for treatment of molluscum contagiosum. Two large randomized controlled trials, however, found no evidence of effectiveness of imiquimod in treating children with molluscum contagiosum, and concerning adverse effects were also noted.[3]

Imiquiomd has also been tested for treatment of vulvar intraepithelial neoplasia, common warts that have proven difficult to treat,[4] and vaginal intraepithelial neoplasia.[5]

Outstanding cosmetic result has resulted from the treatment of both large superficial basal cell carcinoma and squamous cell carcinoma in-situ, but the morbidity and discomfort of the treatment can be severe, and can very occasionally result in some degree of permanent[citation needed] mild scarring. Focal recurrence of tumor has been seen after imiquimod treatment, but appear to be amenable to surgical excision.

Imiquimod can also cause subclinical lesions to become visible and to be killed by the immune system. Photographs of actinic keratosis and superficial basal cell carcinomas before, during and after treatment show the unmasking of subclinical disease.[6] The more-concentrated (5%) Imiquimod cream needs to be applied on and off for 4 months, while the less concentrated (3.75%) Imiquimod cream needs to be applied on and off for a number of months to be determined by the doctor.[7]

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