Imiquimod 5% cream as primary or adjuvant therapy for melanoma in situ, lentigo maligna type  

Oleh:

Swetter, Susan M. ; Frank, W. Chen ; David, D. Kim ; Egbert, Barbara M.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: JAAD: Journal of the American Academy of Dermatology (keterangan: ada di ClinicalKey) vol. 72 no. 06 (Jun. 2015), page 1047–1053 .
Topik: adjuvant therapy; imiquimod; inflammatory response; lentigo maligna; lentigo maligna melanoma; melanoma; melanoma in situ; primary therapy

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Perpustakaan FK Nomor Panggil: J15.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

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.

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