Imiquimod as an effective treatment method of advanced basal cel carcinoma affecting 100-year-old man - case report with literature review.

INTRODUCTION: Basal cell carcinoma (BCC) is the most common skin cancer with increasing prevalence in the last years. The most important risk factor for development of BCC is exposure to UV radiation. Surgical excision remains the first line treatment, but there are some non-surgical methods of treatment. The aim of this study is to present a case of 100-year-old patient with advanced BCC in temporal area who refused surgical treatment. The noninvasive treatment with imiquimod was successful.

CASE PRESENTATION: The 100-year-old male patient was admitted to the dermatological outpatient clinic with an ulceration within the forehead, which had been increasing in size for 3 years. Physical examination revealed shallow irregular ulceration with erythematous pearly-shaped borders in the right temporal area measuring ca. 1.5 cm × 2 cm. Dermatoscopic examination of the lesion showed arborising vessels on the semitransparent background, white structureless area and numerous erosions, leading to an initial diagnosis of BCC. Patient refused any surgical interventions within the lesion including skin biopsy. Consequently, treatment with 5% imiquimod was initiated with cream application for 8 weeks, once daily 5 times a week. 8 months after termination of treatment there were no clinical and dermoscopic signs of recurrence of BCC. The patient remains under dermatological follow-up.