Toggle Main Menu Toggle Search

Open Access padlockePrints

Long-term outcomes of imiquimod-treated lentigo maligna

Lookup NU author(s): Dr Cliff Lawrence


Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


© 2019 British Association of Dermatologists Background: Lentigo maligna (LM) may be disfiguring and can progress to LM melanoma. Surgical excision remains the mainstay of treatment, but may result in disfigurement when used for large facial lesions. Topical imiquimod is a nonsurgical alternative although data on its long-term efficacy remain limited. Aim: To assess long-term outcomes of LM treated with imiquimod cream. Methods: We collected data retrospectively for 33 patients treated with imiquimod cream for biopsy-proven LM from 2001 to 2016. Patients initially applied imiquimod once daily, 5 days/week for 6 weeks, aiming to produce a brisk local inflammatory response. If there was no response, the dose was increased to twice daily 7 days/week for 6 weeks and if again there was no response, to twice daily for 10 weeks. Results: An inflammatory response developed in 29 (88%) of the 33 patients, and of these, 4 patients stopped treatment earlier than planned because they could not tolerate the inflammatory reaction, while 3 patients reported systemic side effects. There was lesion clearance in 21 (72%) of the 29 patients, and they remained clear after a mean follow-up of 4.1 years. Eight failed to clear; in five the lesion was excised, while the remaining three were managed expectantly. Conclusions: Our results support the use of imiquimod as an alternative to surgery for the treatment of LM in selected cases. With adequate patient preparation, imiquimod is generally tolerated and can achieve excellent cosmetic results. A clinical response is more likely if there is a brisk inflammatory response, and LM will not resolve if there is no inflammatory response.

Publication metadata

Author(s): Papanikolaou M, Lawrence CM

Publication type: Article

Publication status: Published

Journal: Clinical and Experimental Dermatology

Year: 2019

Volume: 44

Issue: 6

Pages: 631-636

Print publication date: 01/08/2019

Online publication date: 20/01/2019

Acceptance date: 20/09/2018

ISSN (print): 0307-6938

ISSN (electronic): 1365-2230

Publisher: Wiley-Blackwell


DOI: 10.1111/ced.13896


Altmetrics provided by Altmetric