What is the role of imiquimod in the treatment of infantile hemangiomas?

Updated: Feb 06, 2019
  • Author: Richard J Antaya, MD; Chief Editor: William D James, MD  more...
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Answer

Only a few case reports and two small, open-label, uncontrolled trials suggest some minimal efficacy for the treatment of infantile hemangiomas. [95, 96, 97] This treatment should be considered experimental until placebo-controlled trials are performed and therapy is determined safe for infants. Imiquimod cream is the only medication in this new class. It purportedly works by stimulation of toll-like receptor 7 (TLR-7) and increases local interferon-alpha and interferon-gamma, through which it may exert antiangiogenic effects. In a mouse model, imiquimod-treated vascular tumors showed decreased tumor cell proliferation, increased tumor apoptosis, and increased expression of tissue inhibitor of matrix metalloproteinase-1, with decreased activity of matrix metalloproteinase-9, both of which are observed in the natural involution of infantile hemangiomas.


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