Lip

INTRODUCTION

Cutaneous squamous cell carcinoma (SCC) is the second most common skin cancer. It usually occurs in the sun exposed areas of elderly people who have a light skin color tone. The important risk factors are UV irradiation, chronic inflammation, chemical carcinogens and human papilloma virus. It is considered a key etiology of SCC that UV irradiation induces mutation of genes which are in charge of chromosomal repair and cell apoptosis. The SCC usually arises from precancerous lesions like Bowen’ disease or actinic keratosis in the photo-damaged skin which may then progress to invasive SCC in 3-26% of untreated cases. The treatment of choice for invasive SCC is radical surgery. However, cancers in the cosmetically-sensitive areas may leave unwanted scarring after surgical treatment, and this could be as distressful to the patients as the cancer itself. The goal of the treatment for skin cancer should be complete eradication of the disease with minimal morbidity. Topical imiquimod has shown antiviral and anti-tumor effects in animal experi­ments by potentiating both the innate immune response and the acquired immune response which is mainly Thl cell mediated. Many case reports and studies have revealed the effectiveness of topical imiquimod in the treatment of condyloma accumi- nata, molluscum contagiosum, actinic keratosis,Bowen’ disease, basal cell carcinoma, squamous cell carcinoma, mycosis fungoides, Paget disease, extra- mammary Paget disease and malignant melano­ma. We used imiquimod 5% cream on invasive SCC of the lower lip, before resorting to surgical eradication and we obtained both good cosmetic result and disease cure. We report this case as a good example which has shown successful size-reductive, neo-adjuvant immunotherapy using imiquimod in invasive SCC. canadian antibiotics