BACKGROUND: Verruca plana is a cutaneous human papillomavirus (HPV) infections. Although various treatments such as destructive methods or immunomodulating agents have been used, none are uniformly effective or prevent recurrence. Ideal treatment for verruca plana should target on an increasing local immune response to the HPV infection. Recently, imiquimod, a topical immune- response modifier, has been successfully used in the treatment of external anogenital warts. OBJECTIVE: The aim of this study was to determine the efficacy and safety of 5% imiquimod cream for the treatment of verruca plana. METHOD: Seven patients with verruca plana were treated with 5% imiquimod cream 3 times a week. at night, for 16 weeks or until complete clearance of lesions had occured. During the follow- up period, the onset time of effects, clearance rate, side effects, and recurrence rate were recorded. At 16 weeks after treatment, a clearance rate was determined by a 3 scale rating; complete-100% clearance / partial-less than 100% clearance / failure-no clearance. RESULTS: The onset time of effects ranged from 1 to 4 weeks (mean-1.7 weeks). The clearance rate at 16 weeks after treatment were as follows; complete-4 (57.1%), partial-2 (28.6%), and failure - 1 (14.2%). No patient showed systemic side effects or long-term adverse effects such as pigmentary disorders or scarring. In the subjective local skin reactions, itching was the only symptom and was common (4/7, 57.1%). With objective skin reactions, erythema was the most common (4/7, 57.1%), followed by erosion and scabbing (2/7, 28.6%). In long-term follow-up of those patients who showed complete clearance, no one encountered recurrence. CONCLUSION: This data demonstrates that 5% imiquimod cream is an effective and promising treatment modality for verruca plana. Because it is non-destructive, safe, and easy to use, it resulted in an excellent cosmetic outcome.
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