PubMed2003
AIM: The clinical effects of home-therapy with 5% imiquimod cream in the treatment of cutaneous anogenital warts are evaluated. METHODS: From March 2000 to January 2002, 57 women presenting clinical cutaneous external genital and perianal warts were selected in the base-population observed at our clinical of vulvar pathology and sexually transmitted diseases, AIED Rome. The patients were divided into 2 groups: Group A, with new cutaneous viral lesions and Group B with recurrent anogenital warts pre-treated with CO2-laser therapy. A total of 36% (20) of all patients presented contemporaneous HPV lesions of cervix and/or vaginal wall. The follow-up was carried out at 4 weeks, 3 months and 6 months, evaluating the safety, clinical efficacy and tolerance of women. The Pearson chi2 test was used to evaluate trends significance. All lesions were photo-documented. RESULTS: Sixty-four per cent (64%) of the patients had complete clearance of anogenital warts within 16 weeks, for 3 times per week self-application of imiquimod, with clinical remission at short term (6/8 weeks) (chi2=1.42; p<0.05); 12% had partial clearance (<50%) and 20% had a clearance of about 75%. The coexistent lesions of cervix and/or vaginal walls had a high remission (>50%) and required surgical additional therapy with CO2-laser; 28% of patients (16/57) experienced mild to moderate drug-related side effects. There was a significant increase in the severity of local skin reactions due to the increased time and number of applications. CONCLUSION: These data confirm that imiquimod cream at the dose regimen of 3 times per week, is effective and well tolerated in the treatment of cutaneous external warts and is associated to a reduction of coexistent mucous viral lesions due to enhancement of local immune response.