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Imiquimod: A new treatment?
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04/24/06 02:25
Dr. Larry Berryman

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04/24/06 02:25
Dr. Larry Berryman

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Imiquimod: A new treatment?

I recently read an article on using a cream called : Imiquimod....which has anit-fibrotic properties. It is being proposed as a new treatment for Dups. I was curious if anyone had used this cream, and if so, what were the results. I plan on asking Dr. Eaton in person when I have my right hand done on May 5th.

04/24/06 02:36
jim h

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04/24/06 02:36
jim h

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Imiquimod

Interesting. I did some web searching and apparently it was suggested in an article in a dermatology journal in 2004. I do not see any indication that it was actually ever tried on patients. Maybe someone could get a dermatologist to prescribe some as an experiment - it's a common drug with few side effects.

05/02/06 02:25
Graeme

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05/02/06 02:25
Graeme

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Imiquimod

I'm about to start a course of Aldara (Imiquimod) and I will report back on the outcome.

05/03/06 02:32
Dodo

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05/03/06 02:32
Dodo

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Imiquimod

an internet search on Imiquimod and Dupuytren's speaks of an interesting potentional here. Certainly it's worth a trial Graeme. Apart from Med published material I haven't found a personal account of use this product.
Would you mind telling us how much this product costs?

05/03/06 02:06
jim h

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05/03/06 02:06
jim h

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Imiquimod

Thanks Graeme, I look forward to hearing about it.

05/07/06 02:10
Dr. Larry D. Berryman

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05/07/06 02:10
Dr. Larry D. Berryman

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Imiquimod

I too will be starting a course of therapy on my rt. hand using this drug....I will keep everyone posted. I am using it immediately after having NA by Dr. Eaton....my thought is that the post-op inflammation will encourage fibroblast activity which may be inhibited by the drug. Also, the inflammation may encourage absorption into my hand.

05/07/06 02:14
Graeme

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05/07/06 02:14
Graeme

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Imiquimod - Eaton

your post is welcome news Larry. If Eaton is prepared to back Imiquimods use this that adds such weight to this trial. I say trial because I can't find any comprehensive data on any clinical trials - only a few encouraging Med Pub in abstract form.
I had been thinking about the application of Imiquimod immediately after NA and therefore the likelihood of a better result - and providence you pop up!!
You obviously will have photo's of your hand prior to surgery with further to be taken at later stages. I have taken photos but after three applications of Imiquimod.
It will an interesting exercise differentiating between natural imune response after NA and the influence of Imiquimod if any. I guess Eaton will have a good idea of the usual outcomes.
In my case I am applying the cream to my hands and also my feet. There is a difference in the genetic makeup of fribroma material between Ledderhose and Dupuytren and there may be a different outcome.
There have been no side effects after three applications only a very slight redness of the skin. I apply every alternate evening.
Has Eaton put you on a different regime?

05/10/06 02:35
Graeme

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05/10/06 02:35
Graeme

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Imiquimod progress

I have been applying Imiquimod cream for 10 days. For my regime that's 5 sachets. One of the area's of application have been the left hand which is diffuse (spread) in nature. That is, an elongated area MCP running down from the pinky finger towards the wrist and another fresh nodule over to the left lying below the third finger.
The diffuse area was treated with NA by Lermusiaux four months ago and I have had one treatment of Kenalog in between.
No change was noticed in the disease appearance or feel for the first nine days then last night I noticed the newer third finger nodule had shrunk from about 10mm round to 4mm. It is also considerably softer to touch. To illustrate it has gone from a good sized bean to a pimple.
I will process the before and after photo's to see if this adequately shows what I am describing. The in-camera images don't look flash.
Anyway I am cautiously optimistic and my wife is astounded at this development.

05/11/06 02:25
Graeme

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05/11/06 02:25
Graeme

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Progress

sorry no I couldn't Dodo as many more people than myself will be required to use the product and report back their results. I have written to Lermusiaux and advised him what I'm doing and asking if he may be interested in taking this further. Charles Eaton has scripted Larry and if others follow we may have more reliable info in a few months time.

05/11/06 02:45
Keith Denkler

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05/11/06 02:45
Keith Denkler

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Aldara (imiquimod)

What a wonderful discovery and it makes sense. I am going to start using it and I hope it works as an off label use for Dupuytren's.
Aldara is an immune modifier. I have used it successfully for years to treat skin cancers in lieu of surgery.
It was the topic of a TV segment on ABC channel 7 years ago.
Link

http://abclocal.go.com/kgo/story?section=News&id=1226536

It saved this patient from a disfiguring surgery.
In June 2006 her case report will be published in the Journal of Plastic and Reconstructive Surgery as an academic report.

The skin may be key in Dupuytren's. Skin grafts seem to prevent recurrence of Dupuytren's after surgery, so there may be something unhealthy about the skin that Aldara can treat and modify or soften the Dupuytren's underneath.

The potential success of Aldara for Duputyren's has already been postulated in a recent publication by an Iranian physician. I look forward to trying this innovative off-label use and will try to follow it scientifically.

It costs about 10-20 dollars a packet.

Med Hypotheses. 2006;66(5):991-2. Epub 2005 Dec 20.
Imiquimod: a potential weapon against Dupuytren contracture.

Namazi H.

Department of Orthopaedic Surgery, Shiraz University of Medical Sciences, Chamran Hospital, Iran. namazih@sums.ac.ir

Dupuytren disease is a proliferative fibroplasia of the subcutaneous palmar tissue, occurring in the form of nodular and cords. Evidence is certainly accumulating for raised levels in Dupuytren's tissue of growth factors known to stimulate fibroblasts, Interleukin-1, basic fibroblast growth factor, transforming growth factor-beta, prostaglandin-F2, prostaglandin-E2, platelet derived growth factor and connective tissue growth factor have been suggested to have a role. Immune modification of profibrotic cytokines would provide a novel means to treat dupuytren contracture. Imiquimod cream 5% (Aldara) is an immune modifier, that downregulates transforming growth factor-beta and fibroblast growth factor-2 (the two most important cytokine in producing fibrosis). Based on previous mentioned evidence we suggest: imquimod as a potential drug for dupuytren contracture treatment.


Keith

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