Efficacy and Tolerability of Imiquimod 5% Cream to Treat Periocular Basal Cell Carcinomas

PURPOSE: To assess the efficacy and safety of nonsurgical treatment with imiquimod (IMQ) 5% cream in patients with periocular nodular basal cell carcinoma (BCC). METHODS: Fifteen patients with clinical and histopathological diagnosis of nodular BCC on the eyelid were treated with IMQ 5% cream once daily, 5 days/week for 6 weeks. Three patients had tumor persistence after photodynamic therapy and 1 patient had failed cryotherapy. RESULTS: All tumors showed histopathological remission within 3 months of starting IMQ, and sustained clinical remission was documented in each patient after 24-28 months' follow-up. Treatment tolerability was bad in 7 patients with local effects being most problematic, but all symptoms disappeared when treatment ended. CONCLUSIONS: IMQ therapy is effective for treating periocular BCCs with a cure rate similar to that of surgery. Aesthetic results were rated as excellent. IMQ is a useful alternative to surgery in patients with periocular BCCs when other therapies have failed or are not possible.