BACKGROUND: There is limited direct comparative data on imiquimod versus cryotherapy to treat actinic keratoses. OBJECTIVE: Compare lesion response through 12 months post-initial treatment. METHODS:Patients with ≥ 10 lesions on the face or scalp were randomized to cryotherapy (up to 10 lesions per session, up to 4 sessions, every 3 months) or imiquimod (3-times-per-week for 3-4 weeks, up to 2 courses) with repeat treatment depending on response. RESULTS: In 36 patients assigned to cryotherapy and 35 to imiquimod, lesion complete response rates were 85.0 percent (306/360) and 66.9 percent (234/350) for cryotherapy and imiquimod, respectively (P<0.0002). For completely cleared lesions, global skin quality was excellent in 82 percent (250/306) versus 100 percent (234/234) for cryotherapy and imiquimod, respectively (P<0.0001). More cryotherapy than imiquimod patients had hypopigmentation (54.8% versus 24.0%, P=0.0197), as well as blister formation, redness/erythema, flaking/scaling/dryness, and scabbing/crusting (P<0.05). CONCLUSION:12-month lesion complete clearance rate was higher with repeated cryotherapy, but cosmetic outcome was better with imiquimod.
RCT Entities:
BACKGROUND: There is limited direct comparative data on imiquimod versus cryotherapy to treat actinic keratoses. OBJECTIVE: Compare lesion response through 12 months post-initial treatment. METHODS:Patients with ≥ 10 lesions on the face or scalp were randomized to cryotherapy (up to 10 lesions per session, up to 4 sessions, every 3 months) or imiquimod (3-times-per-week for 3-4 weeks, up to 2 courses) with repeat treatment depending on response. RESULTS: In 36 patients assigned to cryotherapy and 35 to imiquimod, lesion complete response rates were 85.0 percent (306/360) and 66.9 percent (234/350) for cryotherapy and imiquimod, respectively (P<0.0002). For completely cleared lesions, global skin quality was excellent in 82 percent (250/306) versus 100 percent (234/234) for cryotherapy and imiquimod, respectively (P<0.0001). More cryotherapy than imiquimod patients had hypopigmentation (54.8% versus 24.0%, P=0.0197), as well as blister formation, redness/erythema, flaking/scaling/dryness, and scabbing/crusting (P<0.05). CONCLUSION: 12-month lesion complete clearance rate was higher with repeated cryotherapy, but cosmetic outcome was better with imiquimod.
Authors: Markus V Heppt; Igor Dykukha; Sara Graziadio; Rafael Salido-Vallejo; Matt Chapman-Rounds; Mary Edwards Journal: J Clin Med Date: 2022-03-16 Impact factor: 4.241