Patients Being Treated for Superficial Basal Cell Carcinoma (sBCC)

Dosing is 5 times per week for a full 6 weeks, unless otherwise directed by the physician. Can you buy imiquimod 5% cream over the counter However, the treatment period should not be extended beyond 6 weeks due to missed doses or rest periods .

It is recommended that the treatment area be washed with mild soap and water 8 hours following ALDARA Cream application .

Most patients using ALDARA Cream for the treatment of sBCC experience erythema, edema, induration, erosion, scabbing/crusting, and flaking/scaling at the application site with normal dosing .

Use of sunscreen is encouraged, and patients should minimize or avoid exposure to natural or artificial sunlight (tanning beds or UVA/B treatment) while using ALDARA Cream .

The clinical outcome of therapy can be determined after resolution of application site reactions and/or local skin reactions.

Patients with sBCC treated with ALDARA Cream should have regular follow-up to re-evaluate the treatment site .

Surgical excision is the standard treatment for superficial BCC

Excisional surgery is the standard method for managing non-melanoma skin cancer. 8,9 Compared with non-surgical methods, surgery has the advantage that it provides a complete specimen to confirm the diagnosis and adequacy of excision. 8 The 5-year cumulative recurrence rate of primary basal cell carcinoma (across all types) after surgical excision is estimated to be about 5% 10 , although the actual rate may be higher or lower, depending on the skill of the surgeon.

What is it?

Imiquimod (Aldara) is an immune response modifier that promotes NF-kappa-B-mediated secretion of pro-inflammatory cytokines, chemokines and other mediators. These immune responses produce cytotoxic effects that are antiproliferative and anti-tumour, with indirect antiviral effects against some viral infections (e.g. human papillomavirus).1

Imiquimod cream (50 mg/g ) is supplied in a pump that contains 2 g of cream, or as single-use sachets that contain 250 mg.2

Where does it fit?

The aim for treatment of BCC is to eradicate the tumour in a manner likely to result in a cosmetic outcome that is acceptable to the patient.3 For most BCC lesions the most effective treatment is excisional surgery, which offers the most prognostically reliable control rates with the advantage of a complete specimen for histological confirmation of tumour clearance,3,4 and low 5-year recurrence when complete excision is achieved.5,6 Surgery also delivers good cosmetic results, particularly when excision and wound repair are performed by experienced practitioners.3

Although surgical excision is often the most effective treatment for BCC there are other alternatives, including:

There is a lack of evidence comparing these different treatment modalities.7

Although field treatment for SK lesions on the face and scalp is not a PBS-subsidised indication, imiquimod is TGA approved and RPBS subsidised for this use. http://www.ncbi.nlm.nih.gov/pubmed/19110735 SK lesions may require treatment for cosmetic reasons or because of irritation or the potential for progression to cancer.4,8 No data are available assessing imiquimod as a therapy to prevent squamous cell carcinoma (SCC)-related adverse health outcomes. Although SK has the potential to progress to SCC, the risk of progression is low with no way of determining the risk factor for individual lesions.9 As most lesions do not progress and up to 26% of lesions regress spontaneously,10 the decision to treat depends on clinical judgement. Where treatment is provided, most SK lesions are cleared with cryotherapy, 5-fluorouracil (5-FU) cream or surgery.4 For people with multiple SK lesions, field-directed therapies (e.g. topical) are recommended to allow treatment of clinical and subclinical lesions (i.e. those not yet visible) within the treatment area.11