Imiquimod Cream 5% for the Treatment of Arsenic-Induced Cutaneous Neoplasms

Long-term exposure to arsenic has been linked to the development of numerous cutaneous neoplasms including arsenical keratoses, basal cell carcinomas (BCCs), and squamous cell carcinomas (SCCs). We report a patient with a remote history of psoriasis treated with arsenic who subsequently developed more than 40 nonmelanoma skin cancers as well as arsenical keratoses. This patient had a remarkable response to imiquimod cream 5% applied once daily to affected areas for 6 weeks with complete resolution of all cutaneous neoplasms and no evidence of recurrence in more than 3 years of clinical surveillance.