Imiquimod 5% Cream in Plaque-Type Morphea: A Pilot, Prospective Open-Label Study

Localized scleroderma or morphea is a fibrotic disease, imiquimod induces cytokines which inhibit fibrotic activity . We propose that topical imiquimod 5% cream is efficacious and safe in treating plaque-type morphea. Twenty adults will be enrolled for a pilot study. A screening and baseline clinic visit will be required for each patient enrolled in the study. Each visit will involve completing a medical history, skin examination, digital pictures, histologic examination if the patient consents and an ultrasonographic score. One morphea plaque will be treated with topical imiquimod 5% cream, and another morphea lesion with vehicle cream. Patients will be asked about side effects (local and systemic). Patients will be followed up in the clinic at 3, 6 and 9 months of therapy, and 3 months following end of treatment period (month 12).

Inclusion Criteria:

• Adults and children > 6 years with plaque-type morphea
• Subject has not participated in previous study involving imiquimod for three months
• In the investigator's judgement, imiquimod treatment may benefit the patient over conventional treatment
• Subject has provided informed written consent
• Female subjects of childbearing potential have a pregnancy urine test that is negative prior to treatment
• Sexually active subjects agree to practice effective birth control throughout the duration of the study

Exclusion Criteria:

• Patients with a non-morphea skin disorder in the region of interest
• Subjects previously undergoing morphea therapy within four weeks of the study
• Subjects have a known hypersensitivity to imiquimod or component of the cream preparation
• Subjects who are pregnant or nursing