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Detailed Overview

New warts may develop during therapy, as imiquimod is not considered a cure. https://aldara-cream.today/buy-aldara-cream Recurrences appear in up to 20 % of patients. The safety of imiquimod during pregnancy is not established and thus its use is contraindicated in pregnancy.

The side effects of imiquimod are generally mild or moderate. Erythema, erosion, swelling, changes in skin color, itching, burning, pain/ tenderness, thickening/ hardening of the skin, peeling/ flaking/ scabbing/ crusting may occur with this treatment. In some few cases in which the skin reaction is severe (bleeding, formation of sores/ blisters/ ulcers), imiquimod may need to be temporarily stopped so that the skin can heal. Other side effects may include headache, loss of appetite, dizziness, diarrhea, nausea or back pain. Imiquimod acts by stimulating a cell-mediated response against human pappiloma virus.

Abstract

Objective: Since imiquimod, a nucleoside analogue of the imidazoquinoline family, has shown efficacy against many tumour entities, its mode of action has become a focus of scientific interest.

Results: The major biologic effects of imiquimod are mediated through agonistic activity towards toll-like receptors (TLR) 7 and 8, and consecutively, activation of nuclear factor-kappa B (NF-kappaB). The result of this activity is the induction of pro-inflammatory cytokines, chemokines and other mediators leading to activation of antigen-presenting cells and other components of innate immunity and, eventually, the mounting of a profound T-helper (Th1)-weighted antitumoral cellular immune response. Several secondary effects on the molecular and cellular level may also be explained, at least in part, by the activation of NF-kappaB. Moreover, independent of TLR-7 and TLR-8, imiquimod appears to interfere with adenosine receptor signalling pathways, and the compound causes receptor-independent reduction of adenylyl cyclase activity. This novel mechanism may augment the pro-inflammatory activity of the compound through suppression of a negative regulatory feedback mechanism which normally limits inflammatory responses. Finally, imiquimod induces apoptosis of tumour cells at higher concentrations. The pro-apoptotic activity of imiquimod involves caspase activation and appears to depend on B cell lymphoma/leukemia protein (Bcl)-2 proteins.

Conclusions: Overall, imiquimod acts on several levels, which appear to synergistically underlie the profound antitumoral activity of the compound.

Dermatologic

Very common (10% or more): Excoriation/flaking/scaling/dryness (up to 87%), erythema (up to 69%), scab/crusting (up to 64%), erosion/ulceration (up to 54%), skin exfoliation, skin edema, skin ulcer, skin hypopigmentation

Common (1% to 10%): Dermatitis

Uncommon (0.1% to 1%): Pruritus, folliculitis, rash erythematous, eczema, rash, sweating increased, urticaria, actinic keratosis

Frequency not reported: Skin infection, alopecia, erythema multiforme, Stevens-Johnson syndrome, skin hyperpigmentation, cutaneous lupus erythematosus