Long-term outcome after treatment with 5% topical imiquimod cream in patients with basal cell carcinoma of the eyelids

Basal cell carcinoma (BCC) is the most common malignancy of the skin and of the eyelid in the Caucasian population. Our study evaluated the long-term results of 5% imiquimod cream therapy for nodular BCC of the eyelid as an alternative to surgical approaches. Five patients suffering from histologically proven nodular BCC of the eyelid who had refused surgical treatment were included in this interventional off-label use study. The patients applied 5% imiquimod cream topically five times a week for 6 weeks at the site of the tumorous lesion. Patients were followed up regularly for up to 7 years to check for tumor disappearance or recurrence, and for local and systemic side-effects. Complete long-term clinical clearance was obtained in four of the five patients, with no tumor recurrence after 7 years of follow-up. Cosmetic results were excellent. One patient refused to continue the treatment 2 weeks after therapy onset, due to significant subjective discomfort. No serious local side-effects, and no systemic side-effects at all were observed following treatment. Imiquimod cream (5%) provides an effective alternative therapy for the treatment of nodular BCC of the eyelid, although surgical treatment remains the gold standard at the present time. This study is the first to assess the long-term efficacy and safety of this approach. Trial studies are necessary.