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Periocular Melanoma In Situ Treated With Imiquimod
Maxwell D Elia1, Sara E Lally, Allison M Hanlon
1*Department of Ophthalmology and Visual Sciences, Yale School of Medicine, New Haven, Connecticut; †Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania; ‡Department of Dermatology, Yale School of Medicine, New Haven, Connecticut; and §Oculofacial Plastic Surgeons of Georgia, Atlanta, Georgia, U.S.A.
Topical 5% imiquimod cream effectively treated periocular melanoma in situ (lentigo maligna) in most patients. This treatment option showed high clearance rates with manageable side effects for this sensitive ocular area.
Area of Science:
- Dermatology
- Ophthalmology
- Oncology
Background:
- Periocular melanoma in situ, also known as lentigo maligna, presents unique treatment challenges due to the sensitive anatomical location.
- Standard treatments may involve surgical excision, which can lead to functional and cosmetic deficits in the periocular region.
Purpose of the Study:
- To assess the efficacy of topical 5% imiquimod cream for treating periocular melanoma in situ.
- To evaluate imiquimod as a primary or adjunctive therapy in this specific patient population.
Main Methods:
- A retrospective case series involving 12 patients with periocular melanoma in situ.
- Patients received daily topical 5% imiquimod cream for a mean of 3.9 months.
- Treatment outcomes were assessed via post-treatment biopsy for histologic clearance.
Main Results:
- Eleven of twelve patients achieved complete histologic clearance of atypical melanocytes.
- The most common side effects were local reactions such as redness, discomfort, and swelling.
- No systemic side effects were reported, and the median follow-up was 1.5 years.
Conclusions:
- Topical 5% imiquimod cream demonstrates significant efficacy as both a primary and adjunctive treatment for periocular melanoma in situ.
- It offers a viable, less invasive therapeutic option for managing this condition in the delicate periocular area.
