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Actinic Keratosis Treatment — SCE Dermatology MCQ

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HardSkin CancerActinic Keratosis TreatmentSCE Dermatology

A patient completes imiquimod 5% three times weekly for four weeks for non-hyperkeratotic actinic keratoses on the scalp. Several lesions remain, and inflammation has resolved. Which SmPC schedule is correct?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Take four treatment-free weeks, then repeat the four-week course if needed

Explanation lettering: C = shown as A · D = shown as C · E = shown as D · A = shown as E

D is correct. For actinic keratosis, the Aldara SmPC uses three applications weekly for four weeks, followed by a four-week treatment-free interval. Clearance is then assessed and persistent lesions may receive a second four-week course. Each treatment period should not be extended to compensate for missed applications. The five-times-weekly six-week regimen belongs to superficial BCC, while the longer three-times-weekly schedule belongs to genital warts. Severe local inflammation may justify a temporary interruption, but regimen identity remains indication-specific.

Reference: Aldara 5% cream Summary of Product Characteristics: https://www.medicines.org.uk/emc/product/823/smpc