Videodermatoscopy of lentigo maligna treated with imiquimod

Area of Science:

• Dermatology
• Oncology
• Dermatopathology

Background:

• Lentigo maligna (LM) is an early-stage melanoma often found on sun-exposed skin, posing treatment challenges due to size and facial location.
• Surgical excision, the traditional treatment for LM, can be disfiguring and poorly tolerated by patients.
• Imiquimod 5% cream, an immune response modifier, is explored as an off-label topical therapy for LM.

Observation:

• Two female patients (39 and 48 years old) with nasal LM were treated with imiquimod 5% cream, applied five times weekly for four months.
• Videodermatoscopy, a noninvasive imaging technique, was utilized for diagnosis and monitoring treatment efficacy.
• Both patients achieved complete lesion clearance by the end of the treatment period, confirmed via videodermatoscopy.

Findings:

• Complete clinical clearance of lentigo maligna was observed in both patients post-treatment.
• Videodermatoscopy confirmed the absence of residual lesions after four months of imiquimod therapy.
• A 30-month follow-up revealed no signs of recurrence or significant changes in the treated areas.

Implications:

• Topical imiquimod presents a potentially valuable, non-invasive therapeutic option for lentigo maligna.
• This approach may offer an alternative for patients who are not candidates for or prefer to avoid surgery.
• Further clinical trials are warranted to establish imiquimod as a standard treatment for LM.