Clinical and histologic features associated with lentigo maligna clearance after imiquimod treatment. Journal Article

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Authors: Kwak, R; Joyce, C; Werchniak, AE; Lin, JY; Tsibris, HC
Article Title: Clinical and histologic features associated with lentigo maligna clearance after imiquimod treatment.
Abstract: BACKGROUND: Imiquimod cream may be used as a non-surgical treatment for lentigo maligna or as adjuvant therapy following excision to decrease the risk of recurrence. OBJECTIVES: To evaluate histologic and clinical factors associated with clinical clearance of lentigo maligna treated with imiquimod. METHODS: We performed a retrospective review of all patients diagnosed with lentigo maligna and treated with imiquimod between 1997 and 2019 at our academic institution. RESULTS: We observed clinical clearance in 93% (66/71) of participants who received adjuvant imiquimod following surgery and 79% (19/24) in the primary non-surgical treatment group over a median of 38?months of follow-up. In the adjuvant therapy group, positive surgical margins were associated with a decreased rate of clinical clearance when compared to cases with close (1?mm) margins or background melanocytic dysplasia (83.3 100%, ?=?.01). The presence of an inflammatory response during treatment was associated with increased clearance (94.1 66.7%, ?=?.02). CONCLUSIONS: Adjuvant imiquimod treatment may decrease LM recurrence rates in cases with background melanocytic dysplasia or close margins. LM cases with positive surgical margins need close clinical follow-up given higher recurrence rates.
Journal Title: The Journal of dermatological treatment
Publisher: Unknown  
Date Published: 2021