Topical imiquimod treatment of cutaneous vascular disorders in pediatric patients: clinical evaluation on the efficacy and safety

Abstract

To evaluate the clinical effect of topical imiquimod treatment on cutaneous vascular disorders in pediatric patients. A retrospective investigation was conducted in 25 pediatric patients with cutaneous vascular disorders, including 19 infantile hemangiomas (IHs) (12 superficial/7 mixed type), 5 nevus flammeus (NF), and 1 pyogenic granuloma (PG). Imiquimod 5% cream was applied every other day for 4 to 16 weeks (average 9.6 weeks). Of the 19 IHs treated, an overall efficacy of 52.6% was achieved, with a clinical resolution rate of 15.8%, excellent rate of 26.3%, and moderate rate of 10.5%. The superficial type responded the best at 66.7%, while the mixed type showed only 28.6% effectiveness, which was predominantly from their superficial parts. No obvious response was noted in the 5 patients with NF. Side effects were observed in 78.9% of the patients, mostly mild to moderate local irritations and occasionally severe reactions such as thick crusting and ulceration. Systemic side events were observed in 4 IH patients including fever and digestive tract reactions. No recurrence was observed during the follow-up examination. Topical imiquimod could be an alternative option for the treatment of uncomplicated superficial IHs with satisfactory tolerability.