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Vol. 223, No. 4, 2011
Issue release date: March 2012
Section title: Original Paper
Dermatology 2011;223:363–369
(DOI:10.1159/000335560)

Topical Imiquimod 5% Cream for Pediatric Plaque Morphea: A Prospective, Multiple-Baseline, Open-Label Pilot Study

Pope E. · Doria A.S. · Theriault M. · Mohanta A. · Laxer R.M.
aSection of Dermatology, bDepartment of Diagnostic Imaging and cDivision of Rheumatology, The Hospital for Sick Children, University of Toronto, and dCancer Care Ontario, Toronto, Ont., Canada

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 10/18/2011 8:16:05 AM
Accepted: 12/4/2011
Published online: 2/8/2012

Number of Print Pages: 7
Number of Figures: 6
Number of Tables: 0

ISSN: 1018-8665 (Print)
eISSN: 1421-9832 (Online)

For additional information: http://www.karger.com/DRM

Abstract

Background/Aims: Therapeutic options for the treatment of plaque morphea are limited. We explored the efficacy and safety of imiquimod cream in children with plaque morphea. Methods: Prospective, open-label, double-baseline study, using imiquimod 5% cream topically for 9 months. The primary outcome measure was improvement in the thickening of morphea plaques using a visual analog scale (VAS) and the DIET score (dyspigmentation/induration/erythema/telangiectasia). Secondary outcome measures were clinicoradiographic correlations and frequency of adverse events. Results: Nine patients, 89% females, with a mean age of 11.33 years (SD = 3.52) were enrolled. At 36 weeks, the mean VAS had decreased from 48.08 (SD = 18.85) to 22.7 (SD = 12.9) (p < 0.0001), and the mean DIET score from 4.38 (SD = 1.2) to 3.06 (SD = 1.39) (p = 0.23). There was very good interrater reliability between DIET score assessments (intraclass correlation coefficient, ICC = 0.75) and VAS (ICC = 0.59) and moderate agreement between parent and investigator VAS (ICC = 0.5). Ultrasonographically measured dermis thickness changed from 1.05 (SD = 0.34) to 0.95 (SD = 0.19) (p = 0.001). One patient experienced ulceration that required temporary discontinuation of intervention. Conclusions: This proof of concept study revealed that imiquimod 5% cream is effective in decreasing the thickening of plaque morphea and safe for pediatric use. Further prospective studies are warranted.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 10/18/2011 8:16:05 AM
Accepted: 12/4/2011
Published online: 2/8/2012

Number of Print Pages: 7
Number of Figures: 6
Number of Tables: 0

ISSN: 1018-8665 (Print)
eISSN: 1421-9832 (Online)

For additional information: http://www.karger.com/DRM


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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