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Background and Design: Intralesional recombinant interferon alfa-2b has been shown to be effective in the treatment of actinic keratoses and basal cell carcinomas. This open-label study was designed to evaluate the effectiveness and cosmetic result of this therapy on actinically induced, primary cutaneous squamous cell carcinomas. Thirty-six squamous cell carcinomas (28 invasive lesions and 8 in situ lesions) ranging in size from 0.5 to 2.0 cm in the longest dimension were treated with interferon alfa-2b 1.5 million units injected intralesionally three times per week for 3 weeks. Eighteen weeks following therapy, the treatment sites were excised and examined for histologic evidence of remaining tumor., Results: Thirty-three (97.1%) of 34 evaluable lesions revealed an absence of squamous cell carcinoma histologically after therapy, although three biopsy specimens (8.8%) obtained after treatment showed actinic keratoses, for an overall complete response rate of 88.2%. The lesion not eliminated after treatment was an invasive squamous cell carcinoma. The investigators and patients independently judged 93.9% of cases to have a very good or excellent cosmetic result. Adverse reactions were limited to those influenzalike symptoms well recognized to occur with interferon therapy and these were well tolerated. Only one patient discontinued therapy due to side effects., Conclusions: This trial demonstrates that intralesional interferon is effective in the treatment of small sun-induced squamous cell carcinomas with well-tolerated side effects and a highly acceptable cosmetic result.

Although it is important to medical school faculty that they publish articles, little has been done to study the process of submitting manuscripts to journals. Specifically, the authors of this study surveyed authors in nine journals read by family medicine teachers to see if their published articles previously had been rejected by other journals. Based on 517 responses from 541 authors (96% response rate), the authors learned that the New England Journal of Medicine had the highest "not previously rejected" rate of 98% and the Journal of the American Medical Association had the lowest rate of 68%. Overall, 11% of the articles published in the eight other journals in the study previously had been rejected by NEJM. It might be interesting for an author whose manuscript is rejected to know the rates of rejection and publication of various journals.