Rate of Recurrence of Lentigo Maligna Treated With Off-Label Neoadjuvant Topical Imiquimod, 5%, Cream Prior to Conservatively Staged Excision

JAMA Dermatology
Jessica M DoniganGlen M Bowen

Abstract

Staged excision of lentigo maligna (LM) often requires multiple stages and can result in significant cosmetic morbidity. Imiquimod cream has been used off-label as monotherapy in the treatment of LM and may be used in the neoadjuvant setting prior to staged excision as a strategy to reduce the size of the surgical margins required to confirm negative histologic margins. To examine the rate of recurrence of LM in patients treated with neoadjuvant topical imiquimod, 5%, cream prior to conservatively staged excisions. This was a retrospective medical record review of 334 patients with 345 biopsy-confirmed LM tumors from June 2004 to January 2012 who were treated with imiquimod prior to undergoing staged excisions at the University of Utah Medical Center and Huntsman Cancer Institute, large academic hospitals in Salt Lake City. Patients were treated with off-label imiquimod, 5%, cream 5 nights per week for 2 to 3 months. Those deemed to have an inadequate inflammatory response were also treated with tazarotene, 0.1%, gel twice weekly. Conservatively staged excisions, beginning with 2-mm margins, were then performed. The rate of recurrence of LM after long-term follow-up. Patients included 235 men (70%) and 99 women (30%) with a mea...Continue Reading

References

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Citations

Jul 22, 2019·Journal of the European Academy of Dermatology and Venereology : JEADV·C Navarrete-DechentK S Nehal
Jul 12, 2020·International Journal of Dermatology·Emilio Lopez-TrujilloSonia Segura Tigell
May 10, 2020·Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete·L FalkW Stolz
Jul 28, 2020·International Journal of Dermatology·Valeria CocoKetty Peris
Oct 4, 2019·The Journal of Investigative Dermatology·Heloise HalseVictoria J Mar
Nov 24, 2020·Clinical, Cosmetic and Investigational Dermatology·Helena IznardoOriol Yélamos
May 11, 2020·Journal of the American Academy of Dermatology·Timothy S WangElise M Roman

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