Background: Vulval intraepithelial neoplasia (VIN) is a precancerous condition that may progress to invasive malignancy. VIN is associated with human papillomavirus (HPV) infection in most cases, and with inflammatory skin disorders in a smaller proportion of patients. Treatment of VIN has traditionally been surgical excision; however, topical treatments, including imiquimod cream, are becoming increasingly used. Patient factors influencing response to imiquimod therapy, in particular smoking, have not yet been published.
Aim: To assess the impact of smoking and other patient characteristics that may influence the treatment response to topical imiquimod for VIN.
Methods: This was a retrospective cohort study of 46 women treated with topical imiquimod for VIN in a single centre dermatology unit from January 2011 to July 2017.
Results: Complete clinical resolution of VIN was observed in 28 of 46 patients (61%), but was significantly reduced in the smoking cohort.
Conclusions: Smoking may impair response to imiquimod for VIN, and should be considered when discussing VIN treatment options with patients.
© 2019 British Association of Dermatologists.