LOCAL THERAPY WITH IMIQUIMOD AS A POSSIBLE MEDICAL TREATMENT OF VULVAR INTRAEPITHELIAL NEOPLASMS

Abstract

Imiquimod is a local immunomodulator with antiviral effects. Vulvar intraepithelial neoplasia is a chronic precancerous condition of the skin of the vulva, with different malignant potential and clinical course. The aim of the paper was to determine therapeutic effects of Imiquimod in treating different types and grades of vulvar intraepithelial neoplasms. The study enrolled 17 patients with vulvar pre-cancerous conditions of different grade and histological type. The patients were treated with combined medical therapy oral systemic immunomodulatory and antiviral drug inosine acedoben dimepranol and 5% Imiquimod cream locally applied to the lesion area using cotton swabs. Complete remision (CR) had 41.18% of patients, partial remission (PR) was seen in 47.06%, and 11.76% of patients had no response (NR). Out of these patients, response distribution for usual type was: CR 80%, 20% NR, and for differentiated type the response distribution was: 8.3% NR, 66.67% PR, while 25% of patients had CR. The use of imiquimod for conservative treatment of vulvar intraepithelial neoplasia is a beneficial alternative to surgical treatment. The best results of imiquimod treatment are achieved in younger patients with usual type of vulvar neoplasia, while the treatment effects are limited to partial response in older patients with differentiated VIN. Acta Medica Medianae 2019;58(1):05-10.