Treatment of patch and plaque stage mycosis fungoides with imiuquimod 5% cream

Background: Systemic interferon is effective in the treatment of mycosis fungoides (MF). Imiquimod is effective in the treatment of some epidermal neoplasms and induces localized interferon production. Objective. To evaluate the safety and efficacy of topical imiquimod 5% cream for the treatment of patch and plaque stage MF. Methods: Six patients with stage IA to IIB MF were treated with topical imiquimod 5% cream 3 times per week for 12 weeks in this open label pilot study. index lesions were biopsied pre- and post- treatment, and up to 4 additional treated lesions were monitored for 16 weeks. Results. Three of 6 patients had histologic clearance of disease in index lesions, and also demonstrated significant improvement in the clinical scores for all treated lesions. A fourth patient had 2 of 4 lesions respond clinically. Application site reactions were limited to those patients responding to treatment. Conclusion: In this preliminary open label study topical imiquimod 5% cream was well tolerated and associated with a histologic and clinical response rate of 50%.