{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T18:10:13Z","timestamp":1694542213667},"reference-count":13,"publisher":"Wiley","issue":"s1","license":[{"start":{"date-parts":[[2014,12,3]],"date-time":"2014-12-03T00:00:00Z","timestamp":1417564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Meda Pharma GmbH & Co. KG"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Lmax, the maximum lesion count during treatment, is a new concept for evaluating the efficacy of field\u2010directed treatments for actinic keratosis (<jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content>) against clinical and subclinical lesions. Imiquimod 3.75% is a field\u2010directed <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> treatment, which can detect and clear clinical and subclinical lesions across an entire sun\u2010exposed field such as the full face or balding scalp.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the importance of integrating Lmax into daily clinical practice by describing the clinical features and outcomes obtained in the first 10 patients who were treated with imiquimod 3.75% in a <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> dermatology department.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ten <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> patients were treated with imiquimod 3.75% in two 2\u2010week treatment cycles separated by a 2\u2010week treatment\u2010free interval. Lesions were counted before, during and 2\u00a0months after treatment was completed. Patients compared the imiquimod 3.75% regimen with their previous <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> therapies in terms of treatment duration and side\u2010effect profile.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All 10 patients in this cohort had used two or more prior <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> treatments including 5\u2010flurouracil, diclofenac, imiquimod 5% and photodynamic therapy. The patients had a median of 10 <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> lesions on clinical presentation and a median Lmax of 14. The median lesion count was zero 2 months after treatment was completed. All patients thought that imiquimod 3.75% was easy\u2010to\u2010use and that the duration of treatment was better than that of previous <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> therapies. Seven of the patients considered the side\u2010effect profile of imiquimod 3.75% to be better than that of their prior <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Imiquimod 3.75% in daily clinical practice enables dermatologists to detect and clear clinical and subclinical <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> lesions across a large sun\u2010exposed area. Patients generally find imiquimod 3.75% easy\u2010to\u2010use with a better side\u2010effect profile than other <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> treatments.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.12829","type":"journal-article","created":{"date-parts":[[2014,12,3]],"date-time":"2014-12-03T11:43:06Z","timestamp":1417606986000},"page":"15-18","source":"Crossref","is-referenced-by-count":2,"title":["Lmax and imiquimod 3.75% in daily clinical practice"],"prefix":"10.1111","volume":"29","author":[{"given":"G.","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Dermatology Monklands Hospital Airdrie Lanarkshire UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,12,3]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"227","article-title":"Zyclara (imiquimod) cream, 3.75%","volume":"8","author":"Gupta AK","year":"2010","journal-title":"Skinmed"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.2011.549128"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2009.07.004"},{"key":"e_1_2_6_5_1","first-page":"166","article-title":"Imiquimod 2.5% and 3.75% for the treatment of actinic keratoses: two phase 3, multicenter, randomized, double\u2010blind, placebo\u2010controlled studies","volume":"13","author":"Swanson N","year":"2014","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_6_6_1","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1684\/ejd.2014.2265","article-title":"Reduction in lesions from Lmax: a new concept for assessing efficacy of field\u2010directed therapy for actinic keratosis. Results with imiquimod 3.75%","volume":"24","author":"Stockfleth E","year":"2014","journal-title":"Eur J Dermatol"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2007.07942.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2007.01.047"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1111170"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2002.04561.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-4362.2001.01324.x"},{"key":"e_1_2_6_12_1","unstructured":"AlomarA.Efficacy of imiquimod 3.75% from Lmax in patients with and without rest periods during treatment. Poster presented at EADV 2013 Abstract P0536."},{"key":"e_1_2_6_13_1","first-page":"165","article-title":"Complete clearance is sustained for at least 12\u00a0months after treatment of actinic keratoses of the face or balding scalp via daily dosing with imiquimod 3.75% or 2.5% cream","volume":"10","author":"Hanke CW","year":"2011","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_6_14_1","first-page":"193","article-title":"Physicians\u2019 concerns towards prescription adherence and treatment effectiveness in the clinical management of actinic keratosis","volume":"149","author":"Peris K","year":"2014","journal-title":"G Ital Dermatol Venereol"}],"container-title":["Journal of the European Academy of Dermatology and Venereology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjdv.12829","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjdv.12829","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdv.12829","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T17:45:33Z","timestamp":1694454333000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdv.12829"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,12,3]]},"references-count":13,"journal-issue":{"issue":"s1","published-print":{"date-parts":[[2015,1]]}},"alternative-id":["10.1111\/jdv.12829"],"URL":"https:\/\/doi.org\/10.1111\/jdv.12829","archive":["Portico"],"relation":{},"ISSN":["0926-9959","1468-3083"],"issn-type":[{"value":"0926-9959","type":"print"},{"value":"1468-3083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,12,3]]}}}