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October 2003

Imiquimod: A Topically Applied Link Between Innate and Acquired Immunity

Arch Dermatol. 2003;139(10):1347-1350. doi:10.1001/archderm.139.10.1347

IMIQUIMOD IS a topically applied imidazoquinoline immunomodulator that has been shown to have efficacy in a wide range of infectious and neoplastic dermatologic conditions. This has generated some skepticism about how any single drug can work for so many indications. In 1997, it was approved for treating external perianal and genital warts.1 In addition, there are open-label trials and case reports showing success in treating of other virus-related conditions including flat warts2 and molluscum contagiosum.3 There are similar reports demonstrating successful treatment of intraepithelial neoplasms including Bowen disease,4 lentigo maligna,5 and extramammary Paget disease.6 A recent case report showed efficacy in treating cutaneous T-cell lymphoma.7 Imiquimod has also been used to effectively treat other neoplastic conditions such as actinic keratosis8 and superficial basal cell carcinoma.9

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