Successful treatment of vulvar intraepithelial neoplasia with topical imiquimod 5% cream in a lung transplanted patient.

Sir, Imiquimod, an immune response modi® er, has been successful in the treatment of external genital and perianal warts caused by low-risk HPV, usually types 6 or 11 (1). The drug’s antiviral and antitumour properties are thought to be due to its induction of cytokines, which stimulate a T-helper 1 or cell-mediated immune response. Recently, it has been shown that imiquimod may potentially be effective in treating genital intraepithelial neoplasia caused by high-grade HPV (2, 3). We report the case of a 27-year-old woman who presented with recurrent genital warts and later found to have cervical intraepithelial neoplasia (CIN) 2 and vulvar intraepithelial neoplasia (VIN) 3. Two separate courses of topical imiquimod cream 5% were used with clearing of the lesions. Topical imiquimod cream 5% may therefore be an effective medical treatment for genital intrapepithelial neoplasia.