Successful treatment of persistent melanoma in situ with 5% imiquimod cream

Five percent imiquimod cream, a topically applied immune response modifier with potent antiviral and antitumor activity, has been reported to be effective in the management of lentigo maligna and cutaneous metastases from melanoma.

We report a case in which 5% imiquimod cream was effective in the management of a persistent melanoma in situ.

Five percent imiquimod cream was applied to the affected area twice to three times a week, as tolerated.

After 4 months of treatment, repeated biopsies of the previously affected areas showed complete regression of the melanoma.

Treatment of melanoma in situ of sun-damaged areas with 5% imiquimod cream certainly appears warranted in selected cases where surgical procedures have failed or are not feasible owing to factors such as size and/or localization of the lesion, advanced age, or deteriorated medical status of the patient. Rigorous posttreatment follow-up is mandatory, because long-term recurrence rates after treatment of melanoma in situ with imiquimod are yet unknown.