Introduction The clinical effect of imiquimod stems from cytokine-induced activation of the immune system. A randomised study was conducted to study the efficacy and safety of daily applications of 5% imiquimod cream in female patients with external genital warts and MC.

Methods Patients were randomised to receive daily applications of 5% imiquimod cream for a maximum of 16 weeks. Before bedtime patients rubbed the study cream into clean, dry, lesional skin until it disappeared and washed the area with soap and water 8 ± 2 h after application. To investigate wart and MC recurrence, patients who had complete clearance of their baseline lesions at any time during the treatment period stopped treatment and entered a 12-week treatment free follow-up period. Patients were evaluated weekly for the first 4 weeks and every 2 weeks thereafter for the remainder of the 16-week treatment period as well as during the 12-week follow-up period.

Results The clearance rate of lesions was 75% in genital MC patients and 50% in patients with genital warts. Erythema was the commonest adverse reaction seen 24% patients with the use of 5% imiquimod. Other side effects were excoriation seen in 16% patients, erosions in 10% patients, excoriation in 6% patients and pain was seen in 4% patients.

Conclusions Nonspecific inflammation and dermatitis can occur during use of imiquimod for genital warts and molluscum.Fortunately, after completion of the therapy, the skin often heals with barely any scarring.

Disclosure of interest Nil.