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Research Letter
July 21, 2008

Imiquimod Treatment of Lentigo Maligna: An Open-Label Study of 34 Primary Lesions in 32 Patients

Arch Dermatol. 2008;144(7):943-945. doi:10.1001/archderm.144.7.943

Lentigo maligna (LM) is an in situ lesion with a 2% to 50% risk of progression to LM melanoma.1 Currently, surgery or radiotherapy is usually recommended as the primary treatment for LM. In the literature, the recurrence rates reported for radiotherapy range from 0% to 19%, with a mean recurrence rate of approximately 7%; in addition, radiotherapy carries the risk of causing chronic radiodermatitis or radiation-induced malignant neoplasm.2 A margin-controlled excision using “slow Mohs” (rush permanent sections) and Mohs micrographic surgery has the lowest recurrence rate, perhaps as low as 3%.3

Thirty-two patients with 34 histologically confirmed facial LM lesions were enrolled in an open-label trial of imiquimod, 5%, cream (Aldara; 3M Pharma, Rueschlikon, Switzerland). No patient had been treated by other methods previously. The diagnosis was based on clinical examination including dermoscopy and histologic evaluation of a 3-mm punch biopsy specimen. Informed consent was obtained from all patients.