Imiquimod 5% tópico como terapia alternativa en carcinoma basocelular periocular en 2 pacientes con contraindicación quirúrgica / Topical imiquimod 5% as an alternative therapy in periocular basal cell carcinoma in two patients with surgical contraindication

CASO CLÍNICOS: Presentamos los casos de dos pacientes con carcinoma basocelular periocular palpebral, que recibieron imiquimod tópico al 5%, con buena respuesta. Ambos presentaban un estado funcional que desaconsejaba el tratamiento quirúrgico. CONCLUSIÓN: La crema de imiquimod al 5% ha demostrado ser una alternativa eficaz al tratamiento quirúrgico de tumores basocelulares perioculares, especialmente en aquellos casos en los que la cirugía no es posible

CLINICAL CASE: The cases are presented of two patients with periocular basal cell carcinoma of the eyelid who received topical imiquimod 5%, with a good response. Both had a functional state that contraindicated surgical treatment. CONCLUSION: Imiquimod cream 5% was shown to be an effective alternative to surgical treatment of periocular basal cell carcinoma, especially in those cases where surgery is not possible

Topical imiquimod 5% as an alternative therapy in periocular basal cell carcinoma in two patients with surgical contraindication. / Imiquimod 5% tópico como terapia alternativa en carcinoma basocelular periocular en 2 pacientes con contraindicación quirúrgica.

CLINICAL CASES: The cases are presented of two patients with periocular basal cell carcinoma of the eyelid who received topical imiquimod 5%, with a good response. Both had a functional state that contraindicated surgical treatment. CONCLUSION: Imiquimod cream 5% was shown to be an effective alternative to surgical treatment of periocular basal cell carcinoma, especially in those cases where surgery is not possible.

Neoadjuvant chemotherapy in the management of sebaceous gland carcinoma of the eyelid with regional lymph node metastasis.

A 55-year-old Asian Indian woman who had recurrent sebaceous gland carcinoma of the left lower eyelid with orbital extension and regional lymph node metastasis was treated with neoadjuvant chemotherapy, using a combination of carboplatin and 5-fluorouracil. Eyelid-sparing orbital exenteration was performed after 3 cycles of chemotherapy, followed by radiotherapy to the regional lymph nodes. Subsequently, 3 cycles of adjuvant chemotherapy were administered. Significant eyelid and orbital tumor volume reduction was achieved with neoadjuvant chemotherapy, making eyelid-sparing orbital exenteration possible. Chemotherapy also spared the patient from radical neck dissection. The patient had limited morbidity and was free of local, regional, and systemic disease at 26 months of follow-up.

Oral capecitabine plus subcutaneous interferon alpha in advanced squamous cell carcinoma of the skin.

PURPOSE: Squamous cell carcinoma of the skin (SSC) is a UV-damage-related skin tumor. The first-line treatment is surgery, which has a high cure rate. In advanced cases, however, the established treatment is often not curative and shows a high rate of side effects. Improved treatment modalities are necessary. METHODS: Oral capecitabine plus subcutaneous interferon alpha were used in a prospective case series in advanced SSC of the skin at an academic teaching hospital for dermatology. Four patients with advanced SCC were included. Capecitabine 950 mgm(-2) body surface on days 1 to 14 was combined with interferon alpha 3x3 mioU s.c. three times a week. The chemotherapy was repeated on day 22. Clinical response, histology, monitoring of side effects and health performance status were assessed. RESULTS: Four patients (two females and two males) with advanced SCC were included (age range: 19 to 75 years). Complete remission (CR) was obtained in two and partial response (PR) in two. The final outcome was CR in two and progressive disease in one. One patient died of an unknown cause. Side effects were mild. Adjuvant treatment was unnecessary. Health performance status was not affected by the treatment. CONCLUSIONS: The treatment protocol with a combination of capecitabine and interferon alpha seems to be effective and well tolerated in patients with advanced SCC. Controlled trials are necessary to prove the benefit we observed in this case series.

Topical treatment of periocular basal cell epithelioma with solcoderm.

25 patients with 29 histologically confirmed periocular basal cell epitheliomas were treated by topical application of Solcoderm, a solution of organic and inorganic acids and ions. The cure rate of the 29 lesions, which were followed for a mean period of 32 months, was 80%. The overall cure rate following second Solcoderm treatment of the 6 recurrent lesions was 96.7%. The cosmetic and functional results were excellent and there were no serious complications and side effects.