The patient is a 64 yo man who received a renal transplant x years ago and is maintained on prednisone and Prograf. He presented with a 4 cm biopsy proven superficial squamous cell carcinoma on the left parietal scalp. This lesion would have necessitated a large micrographic surgical procedure with a graft.
An attempt was made to treat with topical chemotherapy. Imiquimod was inititiated, but there was only minimal response after two weeks. Five fluorouracil was then added and this achieved a moderate response. The combination of imiquimod/5FU was continued for a total of six weeks, then stopped. One month later there appears to be a clinical cure. He will be followed closely.
There is a possibility that this combination therapy can help selected transplant patients with low risk superficial nonmelanoma skin cancers.
Clinical Photos:
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| After Six Weeks Imiquimod/5FU |
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| One month after Stopping Imiquimod/5FU |
Comment: This treatment made me a little nervous, but the surgical approach would have been major for a lesion that had only a small chance of of metastasizing. The benefits and risks were discussed with the patient; however, his oncologist was unhappy about this approach.
