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A Review of Topical Imiquimod in the Management of Basal Cell Carcinoma, Actinic Keratoses, and Other Skin Lesions

Authors: Jubin Ryu and F. Clarissa Yang
Publication Date: 03 Nov 2009
Clinical Medicine: Therapeutics 2009:1 1557-1575

Jubin Ryu1 and F. Clarissa Yang2

1Harvard Medical School, Boston, MA 02115. 2Brigham and Women’s Hospital, Department of Dermatology, 221 Longwood Avenue, Boston, MA 02115.

Abstract

Imiquimod (trade name Aldara™) is a small molecule of the imidazoquinoline family, a group of nucleoside analogs that were first synthesized as potential antiviral agents. It has since been discovered to activate both innate and adaptive immunity, as well as apoptosis. Clinically, it has been approved for three indications thus far: external genital warts, actinic keratosis, and superficial basal cell carcinoma. In addition to these applications, a number of off-label uses have been reported in the literature. In this review, we summarize and discuss the literature describing imiquimod’s mechanism of action, its approved and off-label clinical uses, and its safety and tolerability.