Supplementary Material for: Histologic Clearance of a Giant Cutaneous Squamous Cell Carcinoma with Imiquimod 5% Cream: A Case Report

INTRODUCTION Cutaneous squamous cell carcinoma (cSCC) is one of the most common skin cancers, with an increasing incidence worldwide. Chronic sun exposure is a major risk factor and lesions are usually seen on sun-exposed areas such as the face, neck, scalp, and hands. Imiquimod cream, an immune response modifier, has shown promising results in the management of selected cases of cSCC. CASE REPORT A 70-year-old, Filipino male presented with 3-year history of a slow growing erythematous plaque on the abdomen. Physical examination revealed a solitary, well- defined, erythematous plaque measuring 5cm on the left lower quadrant of the abdomen. Histopathologic examination revealed cSCC. The patient declined surgery and opted for topical treatment with imiquimod 5% cream, applied over 24 weeks for a total of 104 applications. Serial biopsies taken at multiple follow-up points and anatomic sites confirmed complete histologic clearance. CONCLUSION This case highlights one of the few documented instances of histologic cure in a >5cm cSCC treated solely with imiquimod cream. It underscores the potential of imiquimod as a non-surgical alternative and expands current treatment for patients who may not be suitable candidates for conventional surgical excision.【引言】皮肤鳞状细胞癌（cutaneous squamous cell carcinoma, cSCC）是最常见的皮肤恶性肿瘤之一，全球发病率呈逐年上升态势。长期日光暴露是其主要危险因素，皮损多好发于面部、颈部、头皮及手部等日光暴露部位。咪喹莫特（imiquimod）乳膏作为一类免疫应答调节剂，在部分经筛选的cSCC病例治疗中已展现出可观的应用前景。 【病例报告】1例70岁菲律宾男性患者，因腹部出现缓慢生长的红斑斑块且病史长达3年前来就诊。体格检查显示，患者腹部左下腹象限存在单发、边界清晰的红斑斑块，尺寸约5cm。经组织病理学检查，确诊为cSCC。患者拒绝手术治疗，选择采用5%咪喹莫特乳膏进行外用治疗，疗程共计24周，累计用药104次。在多个随访节点及不同解剖部位开展的连续活检结果证实，皮损已实现完全组织学清除。 【结论】本案例为为数不多经文献记录的、仅采用咪喹莫特乳膏治疗的直径＞5cm cSCC实现组织学治愈的病例之一。该研究凸显了咪喹莫特作为非手术治疗替代方案的潜力，为不适宜接受传统手术切除的患者拓展了现有治疗选择。