[Solar keratosis: from precancerous lesion to pre-invasive squamous cell carcinoma--therapeutic approach with a...

Solar keratoses are precancerous lesions in chronically UV-damaged skin with histological features consistent with pre-invasive squamous cell carcinoma. They require therapeutic intervention in order to prevent progression towards invasive carcinoma. Treatment options include topical medications and destructive methods. We report on a new approach--topical bioinductive therapy with imiquimod 5% cream.

In a prospective case series, 7 patients with solar keratoses have been treated with topical imiquimod 5%. The cream was applied 5 days/week over 2 weeks. After end of treatment, the outcome was assessed at regular control visits and, in some cases, histologically confirmed. One patient was followed up as untreated control.

In 6 of the 7 treated patients, the lesions cleared completely; one patient did not respond. The patients did not show new solar keratoses during a follow-up period of about 2 years. The untreated patient showed spontaneous clearance of his keratoses. Local skin reactions during treatment included erythema, oedema and erosions in varying degrees, all of which completely resolved.

Bioinductive therapy with imiquimod 5% cream represents a promising therapeutic approach for cutaneous precancerous lesions such as solar keratoses.