14-06-2006

Dos cosas novedosas sobre Imiquimod, he leído en DERMLIST, la estupenda lista de correos brasilera, que ponemos en Asocolderma.

1-Disminuir el tamaño previo de un tumor con imiquimod, antes de hacer cirugía: "quanto ao uso pré-op. do Imiquimod que eu sugeri no chat de oncologia da SBD, para diminuir o Tu antes da cirurgia, seria uma estratégia de ação sinérgica para diminuir o trauma cirúrgico e deformidade decorrente de exérese de Tu maior" (Dr Joao Handro)

2-Que el imiquimod, puede poner en evidencia lesiones satélites, no visibles de un tumor.

"existiria algum tropismo para lesoes perifericas  pois observa-se que mesmo aplicando so em um ponto basico, ha elementos indicativos que o Imiquimod agiu em lesoes satelites, na vizinhanca deste ponto (Dr Geoge Barros Leal)" 

El Dr Leal buscó biliografía y encontró:

" Dermatology. 2003;206(4):357-60.

Nudging epidermal field cancerogenesis by imiquimod.

Uhoda I, Quatresooz P, Pierard-Franchimont C, Pierard GE.
Department of Dermatopathology, University Medical Center of Liege, Belgium.

BACKGROUND: The coexistence of malignancies close to each other on the skin has been occasionally reported. The concept of fieldcancerogenesis applies to such cases. Given the purported mechanism of action of imiquimod, it should not be surprising that this treatment could inhibit epidermal field cancerogenesis. AIM: To assess the effect of imiquimod applied twice weekly on incipient bowenoid changes disclosed in the vicinity of basal cell carcinomas. MATERIALS AND METHOD: Biopsies were taken before treatment and after 4-6 weeks and 12 weeks of imiquimod treatment. RESULTS: Large atypical bowenoid keratinocytes and dyskeratotic cells were cleared in time while factor-XIIIa-positive dermal dendrocytes appeared boosted and admixed with a brisk lymphocytic infiltration. CONCLUSION: Epidermal field cancerogenesis appears to be controlled by imiquimod. Dermal dendrocytes might play a pivotal role in this regression phenomenon."

Parece que e' um conceito novo, apesar do trabalho ser de 2003.
Nao ha muitas referencias envolvendo o termo "epidermal field
cancerogenesis", acho que por isto a vasta maioria dos trabalhos sobre o imiquimod nao refere este interessante efeito.
Dr George Barro Leal

Jairo Mesa Cock