A 36-month clinical experience of the effectiveness of curettage and imiquimod 5% cream in the treatment of basal cell carcinoma.

Background: Electrodesiccation and curettage is commonly used for the treatment of basal cell carcinomas (BCCs). Does the addition of imiquimod 5% cream improve clearance rates and cosmetic outcomes?

Objective: To evaluate a 3-year clinical experience of the effectiveness of curettage combined with imiquimod cream in the treatment of BCC.

Methods: Patients were enrolled into the study in the first 10 months of 2003. All patients had biopsy-confirmed BCCs and were treated with curettage followed by imiquimod 5% cream 5 times weekly for 6 weeks.

Results: Ninety patients with 101 tumors were treated; a clearance rate of 96% was obtained. Twenty-five sites were rebiopsied at 6 weeks after therapy, regardless of clinical findings. Two of these biopsies showed persistent BCC. The remaining 76 sites were followed clinically and only rebiopsied for clinical signs of reoccurrence. Two additional BCCs reoccurred at 23 months and 25 months, respectively. All patients were followed a minimum of 13 month with an average of 36 months. There were minimal cutaneous side effects and no systemic side effects.

Conclusions: Curettage followed by the application of imiquimod 5% cream resulted in clearance rates of 96% at an average 36 months follow-up. The treatment was well-tolerated and appears to produce a favorable cosmetic outcome.