Imiquimod 5% cream as primary or adjuvant therapy for melanoma in situ, lentigo maligna type - 16/05/15
, Frank W. Chen, MD c, David D. Kim, BA c, Barbara M. Egbert, MD bAbstract |
Background |
Surgical resection of lentigo maligna (LM) is complicated by noncontiguous, subclinical extension and actinic melanocytic hyperplasia in sun-damaged skin of older individuals.
Objective |
We sought to determine the long-term effectiveness of imiquimod as primary or adjuvant therapy for LM.
Methods |
Patients were retrospectively identified from January 1, 2003, to December 31, 2013, with LM, early/evolving LM, and LM melanoma who had used topical imiquimod 5% cream for either primary therapy after diagnostic biopsy, or adjuvant therapy after narrow-margin surgical resection or complete clinical but not histologic resection of LM. Follow-up occurred through December 31, 2014.
Results |
In all, 63 cases were identified in 61 patients, mean (SD) age 71.1 (12.4) years; 58 were analyzed for local recurrence. Imiquimod was used as primary therapy in 22 of 63 (34.9%) and adjuvant therapy in 41 of 63 (65.1%) for mean duration of 11.7 (range 2-60) weeks. Fifty cases (86.2%) demonstrated clinical clearance at mean (SD) follow-up of 42.1 (27.4) months: 72.7% primary and 94.4% adjuvant at 39.7 (23.9) and 43.1 (28.9) months, respectively.
Limitations |
Retrospective cohort study and lack of standardized imiquimod application are limitations.
Conclusion |
Imiquimod cream appears to be a viable option for primary or adjuvant treatment of LM in older patients who are poor surgical candidates.
Le texte complet de cet article est disponible en PDF.Key words : adjuvant therapy, imiquimod, inflammatory response, lentigo maligna, lentigo maligna melanoma, melanoma, melanoma in situ, primary therapy
Abbreviations used : AAD, LM, LMM, MIS, NCCN, VAPAHCS, WLE
Plan
| Funding sources: None. |
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| Conflicts of interest: None declared. |
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| Reprints not available from the authors. |
Vol 72 - N° 6
P. 1047-1053 - juin 2015 Retour au numéro
Article précédent
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