Topical Imiquimod 5% Cream for Treatment of Cutaneous Neurofibromas in Adults With Neurofibromatosis 1

Inclusion Criteria: * Patients must have a diagnosis of NF1 based on NIH criterial with two or more of the following characteristics: * six or more cafe-au-lait macules (1.5cm or greater in size) * skin fold freckling in the axilla or groin * optic pathway glioma * two or more Lisch nodules of the iris * distinctive bony lesions such as dysplasia of the sphenoid wing or of a long bone such as the tibia * two or more neurofibromas of any type of 1 or more plexiform neurofibroma * first degree relative with NF1 * Participants must have at least four cutaneous neurofibromas on skin exam with the following qualities: * the lesion must be discrete by clinical exam and must not be contact with another skin tumor * the lesion must be amenable to measurement with calipers with minimum dimension of 5mm and maximum dimension of 30mm * the lesions must be located on the trunk, neck, or extremities (excluding the hands and feet) and must be located in an area that can be photographed * histologic confirmation of tumor type is not required in the setting of compatible clinical setting * No treatment with an investigation agent for cutaneous neurofibromas within the last 3 months * 18 years of age or older Exclusion Criteria: * Pregnant and nursing women * Patients who have had chemotherapy or radiotherapy within 6 weeks prior to entering the study or those who have not recovered from adverse events due to agents administered more than 6 weeks earlier * Patients may not be receiving any other investigational agents * History of allergic reactions attributed to compounds of similar chemical or biologic composition to imiquimod * Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.