Early Treatment with Imiquimod 5% Cream of Periungual Warts in Vietnam: The Poorer, the Better

AIM: To evaluate the efficacy of imiquimod 5% in periungual wart treatment. MATERIAL AND METHODS: A group of 40 patients were recruited to apply imiquimod 5 % cream once daily for 5 consecutive days per week in 8 weeks. They were classified into 3 levels: Mild (the total lesion area ≤ 25 mm(2)), moderate (25 mm(2) <total lesion area ≤ 50 mm(2)), severe (total lesion area > 50 mm(2)). The outcome was evaluated at the 4(th) and the 8(th) week. The result was graded as excellent (complete clearance), good (≥ 50% clearance) and poor (< 50% clearance). RESULTS: The total area of the wart lesion got decreased significantly from the beginning to the 4(th) and the 8(th) week (36.7 mm(2) vs 16.8 mm(2), p = 0.0001 and 16.8 mm(2) vs 8.8 mm(2), p = 0.01). The complete clearance rate at the 4th week was lower than that at the 8th week significantly (22.5% vs 72.5%, p = 0.04). The clearance rate of patients suffering severe warts was lower significantly than that of mild/moderate patients (82.8% vs 45.5%, p = 0.03). The duration of the disease in people who responded completely to imiquimod was shorter than that of patients partially responded (10.2 ± 14.1 months vs 22.3 ± 14.3 months, p = 0.02). Adverse effects were not common, mild and local only. Recurrence rate after 6 months of follow up was 3.5%. CONCLUSION: In conclusion, Imiquimod 5% cream is a safe and effective drug in the treatment of periungual warts.