Effect of dicarboxylic acids on lentigo maligna

Area of Science:

• Dermatology
• Oncology
• Biochemistry

Background:

• Lentigo maligna is a premalignant melanocytic lesion.
• Dicarboxylic acids show in vitro tyrosinase inhibition.
• Azelaic acid is a C9 dicarboxylic acid.

Purpose of the Study:

• To evaluate the efficacy of a 15% azelaic acid cream for treating lentigo maligna.
• To investigate the histological and ultrastructural effects of azelaic acid on lentigo maligna.

Main Methods:

• Clinical and histological assessment of 3 lentigo maligna cases treated with 15% azelaic acid cream for 90 days.
• Electron microscopy monitoring of one case during treatment.
• Long-term follow-up for up to 2 years post-treatment.

Main Results:

• Remarkable clinical and histological improvement observed in all cases.
• Sustained remission for up to 2 years after treatment cessation.
• Electron microscopy showed elimination of abnormal melanocytes and restoration of normal melanogenesis and epidermal structure.
• Diminution of inflammatory response (lymphocyte response).

Conclusions:

• Dicarboxylic acids, specifically azelaic acid, exhibit direct inhibitory and cytotoxic effects on abnormal melanocytes in lentigo maligna.
• Azelaic acid treatment leads to significant clinical and histological resolution of lentigo maligna.
• Further research is needed to elucidate the precise mechanism of action and factors influencing melanocyte susceptibility.