Videodermatoscopy of Lentigo MalignaTreated With Imiquimod

Lentigo maligna (LM) is an in situ variant of cutaneous melanoma, which usually occurs in sun-damaged skin. Surgical treatment of LM is often difficult and not well accepted by patients, as lesions are usually quite large and located on the face. Imiquimod 5% cream is a local immune response modifier that has been used off-label to treat LM. The authors report of 2 female patients with LM on the nose (aged 39 and 48 years) treated with imiquimod 5% cream applied 5 times a week for a total duration of 4 months. Videodermatoscopy, a noninvasive diagnostic technique, was used to address the diagnosis and to monitor treatment response with imiquimod therapy and during follow-up. At the end of the treatment period, the lesions had cleared in both patients, with no evident remnants confirmed by videodermatoscopy. The patients refused to undergo a control biopsy, but complied for a 30-month followed-up period which revealed no evident changes. The authors' experience, in agreement with other clinical reports and open trials, suggests that topical imiquimod is a valuable treatment option capable of leading LM to clinical clearance.