Lmax and imiquimod 3.75% in daily clinical practice. (January 2015)

• Record Type: Journal Article
• Authors: Gupta, G.
• Is Part Of: Journal of the European Academy of Dermatology and Venereology. Volume 29(2015)Supplement 1
• Page Start: 15
• Page End: 18
• Publication Date: 2015-01
• Subjects: Dermatology -- Periodicals; Sexually transmitted diseases -- Periodicals; 616.5
• DOI: 10.1111/jdv.12829
• Languages: English
• ISSNs: 0926-9959

Abstract

Abstract: Background: Lmax, the maximum lesion count during treatment, is a new concept for evaluating the efficacy of field‐directed treatments for actinic keratosis (AK) against clinical and subclinical lesions. Imiquimod 3.75% is a field‐directed AK treatment, which can detect and clear clinical and subclinical lesions across an entire sun‐exposed field such as the full face or balding scalp. Objectives: To evaluate the importance of integrating Lmax into daily clinical practice by describing the clinical features and outcomes obtained in the first 10 patients who were treated with imiquimod 3.75% in a UK dermatology department. Methods: Ten AK patients were treated with imiquimod 3.75% in two 2‐week treatment cycles separated by a 2‐week treatment‐free interval. Lesions were counted before, during and 2 months after treatment was completed. Patients compared the imiquimod 3.75% regimen with their previous AK therapies in terms of treatment duration and side‐effect profile. Results: All 10 patients in this cohort had used two or more prior AK treatments including 5‐flurouracil, diclofenac, imiquimod 5% and photodynamic therapy. The patients had a median of 10 AK lesions on clinical presentation and a median Lmax of 14. The median lesion count was zero 2 months after treatment was completed. All patients thought that imiquimod 3.75% was easy‐to‐use and that the duration of treatment was better than that of previous AK therapies. Seven of the patients considered the side‐effect profile of imiquimod 3.75% to be better than that of their prior AK treatments. Conclusions: Imiquimod 3.75% in daily clinical practice enables dermatologists to detect and clear clinical and subclinical AK lesions across a large sun‐exposed area. Patients generally find imiquimod 3.75% easy‐to‐use with a better side‐effect profile than other AK treatments.