5% Topical Imiquimod Tolerance in Transplant Recipients

BACKGROUND: Topical imiquimod is a new immunomodulator agent approved for genital warts, actinic keratosis (AK) or carcinoma, occurring in immunocompetent patients. OBJECTIVES: This study aimed to assess the safety and efficacy of imiquimod for the treatment of warts, AK and bowenoid papulosis (BP) in transplant patients. METHODS: 24 transplant patients (18 kidney, 4 kidney-pancreas and 2 heart) were included in this retrospective study conducted between June 2000 and February 2003 at the department of dermatology of 3 hospitals. Imiquimod cream was applied 3 times a week over a median period of 9 weeks. RESULTS: Graft function was not altered under therapy. Local tolerance was excellent. Complete responses were observed in 1 patient (1/12) with cutaneous warts and 1 (1/6) with AK. Two patients of 3 with BP had total clearance of their lesions. Partial responses were observed in 3 of the 6 AK-treated patients, 5 of 12 patients with cutaneous warts and 1 of 2 patients with anogenital warts. CONCLUSIONS: Imiquimod 5% cream is a promising, well-tolerated therapy for warts, AK and BP in transplant recipients.