Topical Imiquimod for Bowen's Disease of the Head and Neck

Interventional study Enrolling Inclusion criteria: Military beneficiaries with histologically proven Bowens disease, located on the head and neck, defined as any area superior to the clavicle and anterior to the posterior triangle of the neck Exclusion Criteria: * Previous treatment of biopsied lesion Recurrent lesions from previous biopsy-proven Bowen's disease * Patients younger than 18 years of age * Pregnancy * Immunosuppression, including HIV, transplant patients on immune suppressive medications, cancer patients on chemotherapy, and hematologic malignancies (e.g., lymphoma, leukemia) * Mucous membrane involvement * Lesions larger than 2 cm * Methods: Pts randomized to treatment group (6 weeks of Mon-Friday Imiquimod to Bowens site) or vehicle group (same treatment regimen). All patients undergo surgical excision (Mohs or simple excision) of site where disease is either visible or was present and tissue examined for histologic evidence of residual Bowens disease