Successful treatment of invasive squamous cell carcinoma using topical imiquimod.

A 65-year-old man with a history of renal transplantation, chronic renal insufficiency after graft failure, and hemodialysis presented with a red palpable lesion on his right temple that had developed over a 3-year period (Figure 1A). The 4 3-cm erythematous hyperkeratotic plaque was located at the hair rim. On palpation, some induration and several papules were noted. Histologic examination of a 5-mm punch biopsy specimen showed tumor cells with variably irregular nuclei and several atypic mitoses that extended into the dermis (Figure 2A). The patient’s medical history was remarkable for metastatic prostate cancer and 5 years of hemodialysis because of chronic renal failure. Because of prostate cancer that had been diagnosed in 1998 and had metastasized to the seventh right rib, the patient was not undergoing chemotherapy. His most recent prostate-specific antigen level was within normal limits. His current medications were furosemide, simvastatin, and epoetin alfa.