Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/61466
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Type: Journal article
Title: The ophthalmic side-effects of imiquimod therapy in the management of periocular skin lesions
Author: Cannon, P.
O'Donnell, B.
Huilgol, S.
Selva-Nayagam, D.
Citation: British Journal of Ophthalmology, 2011; 95(12):1682-1685
Publisher: British Med Journal Publ Group
Issue Date: 2011
ISSN: 0007-1161
1468-2079
Statement of
Responsibility: 
Paul S. Cannon, Brett O’Donnell, Shyamala C. Huilgol, Dinesh Selva
Abstract: Aim: To describe the ophthalmic side-effects of topical imiquimod for periocular actinic keratoses, squamous cell carcinoma in situ and basal cell carcinoma. Method: A retrospective study was carried out in two centres of all patients who underwent topical imiquimod therapy between January 2004 and January 2009. Imiquimod was applied three times weekly for 4–6 weeks. Diagnosis of the lesions, complications, clinical resolution and long-term ophthalmic side-effects was recorded. Patients on therapy were reviewed fortnightly and then every 6 weeks following completion of treatment. Results: 47 patients were identified; the mean age was 74 years. 37 patients had actinic keratoses, seven patients had Bowen disease, and three patients had BCC. The lower lid was the commonest site involved (68%). Application site erythema occurred in all patients. Conjunctivitis occurred in 15 patients, and six patients complained of ocular stinging on application of imiquimod. One patient had a staphylococcal keratitis, which responded to topical antibiotic and steroid therapy. Two patients required oral antibiotics for preseptal cellulitis. Three patients had delayed conjunctivitis at a mean of 2.3 weeks. Nine patients discontinued imiquimod due to ocular irritation and conjunctivitis, of whom four patients recommenced and finished the treatment after a rest period. At a mean follow-up of 16 weeks, 34 patients had clinical resolution of the periocular lesions and no patient had any residual ophthalmic side-effects from imiquimod. Conclusion: Conjunctivitis and ocular stinging were the commonest ophthalmic side-effects encountered with the application of imiquimod for periocular skin lesions. These effects were temporary and resolved on terminating the imiquimod therapy.
Keywords: Humans; Carcinoma, Basal Cell; Bowen's Disease; Skin Neoplasms; Conjunctivitis; Erythema; Aminoquinolines; Antineoplastic Agents; Treatment Outcome; Administration, Topical; Retrospective Studies; Aged; Female; Male; Keratosis, Actinic
Description: Published Online First 10 August 2010
Rights: Copyright © 2010 by the BMJ Publishing Group Ltd.
RMID: 0020100608
DOI: 10.1136/bjo.2009.178202
Appears in Collections:Opthalmology & Visual Sciences publications

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