This is an open-label, single-arm, pilot study on the effects of topical imiquimod treatment
in preventing keloid recurrence after surgical excision. Keloids are abnormal scars that form
in certain genetically predisposed individuals following trauma to the skin. They can be
physically disabling and cause social impairment. Many therapies have been proposed and
trialed for the permanent removal of keloids, but they all have limited efficacy. Topical
imiquimod therapy has been reported to decrease keloid recurrence following keloidectomy in
human patients. Given all previous reports of adjuvant imiquimod therapy to keloidectomy
initiated imiquimod therapy after keloidectomy, the investigators would like to test the
efficacy of topical imiquimod pre-treatment in preventing keloid recurrence after surgical
excision. Therefore, the investigators are initiating an open-label pilot study of 10
patients age 18 or greater with keloids on the trunk and extremities excluding the groin and
hands and feet who present to the dermatology clinic for standard of care keloid excision.
Key exclusion criteria include vulnerable populations, immunocompromised state,
hypersensitivity to study drug components, and keloids outside of specified areas. The main
study intervention will be 6 weeks of treatment with topical 5% imiquimod cream, starting 1
week prior to surgical excision.