DERMATOLOGISTS' CASE FILES
Immune Response Modifier Therapy Used With Good Results in Recalcitrant Warts and Photoaging

A supplement to Skin & Allergy News, supported by a restricted educational grant from 3M Pharmaceuticals and recognized by the American Academy of Dermatology (AAD) for AAD continuing medical education (CME) credit.

•Topics
•Faculty
•Target Audience
•Educational Needs
•Learning Objectives
•CME Recognition

To view the supplement, click the image above.

Topics

• Introduction

• Photodamage in a 46-Year-Old Woman

• Man With a Large Plantar Wart

• Recalcitrant Periungual Warts in a 12-Year-Old Boy

Faculty

Cheryl L. Effron, MD
Private Practice
Anaheim Hills, Calif.
Dr. Effron is on the Speaker's Bureau and the Aldara Advisory Panel at 3M Pharmaceuticals. She refers to a discussion elsewhere in this supplement of the unlabeled use of imiquimod for the prevention of AKs and for the treatment of plantar and periungual warts.

Albert M. Kligman, MD, PhD
Professor Emeritus of Dermatology
University of Pennsylvania School of Medicine
Philadelphia
Dr. Kligman has no financial disclosures. He discusses the unlabeled use of imiquimod for the prevention of AKs.

Robert B. Skinner, Jr., MD
Professor of Medicine (Dermatology)
The University of Tennessee
Health Science Center
Memphis
Dr. Skinner is on the Speaker's Bureau and the Aldara Advisory Panel at 3M Pharmaceuticals. He discusses the unlabeled use of imiquimod for the treatment of plantar and periungual warts.

Target Audience

This activity has been developed for dermatologists and other health care professionals involved in the diagnosis and treatment of skin conditions for which immune response modifier (IRM) therapy may be considered.

Educational Needs

Actinic keratoses (AKs) and common warts are lesions that are difficult to eliminate. Traditional therapies—surgical and topical chemical modalities—can be effective, but none of these has been shown to produce remission in all patients.

IRM therapy is a relatively recent approach to eliminating AKs and lesions caused by human papillomavirus (HPV). In both cases, topical imiquimod—the first agent in the class of IRMs—causes an upregulation of several mechanisms that control local immune system function.

To date, imiquimod has been approved by the US Food and Drug Administration for the treatment of anogenital warts, superficial basal cell carcinoma, and AKs of the face and balding scalp. In the cases presented here, imiquimod was used investigationally as a potential prophylactic treatment for AKs in patients with photodamaged facial skin who, by definition, are at increased risk for AKs and, possibly, subsequent squamous cell carcinoma. In the cases of common warts, imiquimod was used based on the efficacy of this agent in treating anogenital warts, also caused by infection with HPV.

The results of well-controlled clinical trials form the foundation of any evidence-based approach to medical treatment. In treating individual patients, however, clinicians also receive valuable knowledge from their own experience and that of their colleagues. Using case studies as a basis, this supplement offers the clinical experiences of experts who have used imiquimod in a variety of skin diseases.

Learning Objectives

By reading and studying this supplement, participants should be able to:

• Briefly summarize what is currently understood about the antiviral and antitumor properties and mechanism of action of imiquimod.

• Describe the experience of a clinician who treated a patient enrolled in a study involving the use of imiquimod to prevent the emergence of subclinical AKs.

• Discuss the experience of a clinician who used imiquimod to treat two patients with recalcitrant warts—one with a plantar wart and one with periungual warts of the fingers.

CME Recognition

This Skin & Allergy News supplement is recognized by the American Academy of Dermatology (AAD) for 1 hour of AAD Category 1 CME credit and may be used toward the American Academy of Dermatology's Continuing Medical Education Award.

This program was developed in accordance with the Accreditation Council for Continuing Medical Education guidelines.

Term of Approval: June 2006–May 31, 2007.

Copyright © 2006 Elsevier Inc.

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