Revista de Dermatologia e Doenças Dermatológicas

Efficacy Of Zyclara Cream (3.75% Imiquimod) Once A Day For One Week In Actinic Keratosis Of The Face: Results From A Non-randomized, Open-label, Prospective Study

Abstract

Natalee Schors*, Pouria Keshoofy and Maryam Shayesteh Alam

Scope: Actinic keratoses are premalignant lesions of the epidermis that result from ultraviolet radiation exposure and can advance into squamous cell carcinoma. 3.75% imiquimod cream, available as Zyclara, is an immune response modifier that has been demonstrated to be an effective alternative to conventional treatment for actinic keratosis. The objective of this study was to collect data on ten patients with multiple non-hypertrophic facial actinic keratoses following the daily week long topical application Zyclara cream, in order to analyze its effectiveness and safety in a shorter treatment duration than standard approaches.

Methodology: This non-randomized, open-label, prospective study enrolled ten participants 18 years of age or older with actinic keratoses presenting on their face or scalp and were instructed to apply topical Zyclara cream once daily for seven days. All patients were examined by the study dermatologist at the end of treatment to record adverse effects and treatment ease of use. Follow-up patient visits took place at 4 weeks, 8 weeks, 6 months, and 12 months to track possible actinic keratosis recurrence and side effects.

Findings: All patients described relatively easy treatment use with 70% reporting very easy use. At 8 weeks following treatment, 37.5% of patients demonstrated complete clearance, while 62.5% showed partial clearance. At 12 months, 14.3% of patients demonstrated complete clearance, 71.4% showed partial clearance, and 14.3% had no clearance. Adverse events were minor with localized erythema and other cutaneous reactions being most common. No serious adverse events were reported.

Conclusion: These findings suggest that daily, week long imiquimod application in the form of 3.75% Zyclara cream is a safe and well-tolerated treatment that can decrease the recurrence of actinic keratoses.

Limitations: Three main limitations of the study were noted. Non-randomization increased the impact of patient and investigator bias, leading to a potential overexaggeration of reported results. Extraneous variables could not be accounted for due to the lack of a comparator group. Finally, there was diminished accuracy in AK recurrence rate from the small sample size and having follow-up data only until 12 months post-treatment.