Cargando…

Lentigo Maligna on a Difficult Location of the Face Treated with 5% Imiquimod: A Case Report of 2-Year Follow-Up

Topical imiquimod is an off-label alternative treatment for lentigo maligna used when surgery cannot be performed. Severe inflammatory response induced by this drug may generate many complaints and force patients to discontinue use. We present a case in which interval treatment with 5% topical imiqu...

Descripción completa

Detalles Bibliográficos
Autores principales: Misiak-Galazka, Magdalena, Czuwara, Joanna, Galazka, Adam, Czaplicka, Anna, Rudnicka, Lidia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8850510/
https://www.ncbi.nlm.nih.gov/pubmed/35083713
http://dx.doi.org/10.1007/s13555-021-00667-w
_version_ 1784652614488555520
author Misiak-Galazka, Magdalena
Czuwara, Joanna
Galazka, Adam
Czaplicka, Anna
Rudnicka, Lidia
author_facet Misiak-Galazka, Magdalena
Czuwara, Joanna
Galazka, Adam
Czaplicka, Anna
Rudnicka, Lidia
author_sort Misiak-Galazka, Magdalena
collection PubMed
description Topical imiquimod is an off-label alternative treatment for lentigo maligna used when surgery cannot be performed. Severe inflammatory response induced by this drug may generate many complaints and force patients to discontinue use. We present a case in which interval treatment with 5% topical imiquimod was implemented for severe inflammatory response. An 82-year-old Caucasian woman presented with a large, irregularly pigmented lesion on her left cheek within the scar of a previously excised melanocytic lesion diagnosed as junctional nevus. Based on dermatoscopical examination confirmed by histopathological description, lentigo maligna was diagnosed. Since the lesion was large and covered the lower left eyelid and due to the risk of disfigurement, the patient refused surgical excision. Therefore, treatment with imiquimod 5% once daily, five times per week, was offered. After 5 weeks, the treatment was stopped because of intense inflammatory reaction and ulceration. On the follow-up visit after 3 months, videodermatoscopical examination revealed changes in the pigmentation of the lentigo maligna including the presence of residual gray dots and fading of the previous dark brown and black colors. The inflammatory response had almost resolved. The second course of treatment with imiquimod five times a week was implemented again for 5 weeks, and after a 2-month interval the third course with the same regimen was started. Total clearance of the lesion was achieved, which was confirmed by videodermatoscopical examination. During the 2-year follow-up, no relapse was observed based on dermatoscopical examination. We propose interval treatment with topical imiquimod 5% lentigo maligna for severe inflammatory reactions in patients with contraindications to surgery. This could help patients overcome this typical response effect and decrease their cessation of treatment.
format Online
Article
Text
id pubmed-8850510
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Springer Healthcare
record_format MEDLINE/PubMed
spelling pubmed-88505102022-02-23 Lentigo Maligna on a Difficult Location of the Face Treated with 5% Imiquimod: A Case Report of 2-Year Follow-Up Misiak-Galazka, Magdalena Czuwara, Joanna Galazka, Adam Czaplicka, Anna Rudnicka, Lidia Dermatol Ther (Heidelb) Case Report Topical imiquimod is an off-label alternative treatment for lentigo maligna used when surgery cannot be performed. Severe inflammatory response induced by this drug may generate many complaints and force patients to discontinue use. We present a case in which interval treatment with 5% topical imiquimod was implemented for severe inflammatory response. An 82-year-old Caucasian woman presented with a large, irregularly pigmented lesion on her left cheek within the scar of a previously excised melanocytic lesion diagnosed as junctional nevus. Based on dermatoscopical examination confirmed by histopathological description, lentigo maligna was diagnosed. Since the lesion was large and covered the lower left eyelid and due to the risk of disfigurement, the patient refused surgical excision. Therefore, treatment with imiquimod 5% once daily, five times per week, was offered. After 5 weeks, the treatment was stopped because of intense inflammatory reaction and ulceration. On the follow-up visit after 3 months, videodermatoscopical examination revealed changes in the pigmentation of the lentigo maligna including the presence of residual gray dots and fading of the previous dark brown and black colors. The inflammatory response had almost resolved. The second course of treatment with imiquimod five times a week was implemented again for 5 weeks, and after a 2-month interval the third course with the same regimen was started. Total clearance of the lesion was achieved, which was confirmed by videodermatoscopical examination. During the 2-year follow-up, no relapse was observed based on dermatoscopical examination. We propose interval treatment with topical imiquimod 5% lentigo maligna for severe inflammatory reactions in patients with contraindications to surgery. This could help patients overcome this typical response effect and decrease their cessation of treatment. Springer Healthcare 2022-01-26 /pmc/articles/PMC8850510/ /pubmed/35083713 http://dx.doi.org/10.1007/s13555-021-00667-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Case Report
Misiak-Galazka, Magdalena
Czuwara, Joanna
Galazka, Adam
Czaplicka, Anna
Rudnicka, Lidia
Lentigo Maligna on a Difficult Location of the Face Treated with 5% Imiquimod: A Case Report of 2-Year Follow-Up
title Lentigo Maligna on a Difficult Location of the Face Treated with 5% Imiquimod: A Case Report of 2-Year Follow-Up
title_full Lentigo Maligna on a Difficult Location of the Face Treated with 5% Imiquimod: A Case Report of 2-Year Follow-Up
title_fullStr Lentigo Maligna on a Difficult Location of the Face Treated with 5% Imiquimod: A Case Report of 2-Year Follow-Up
title_full_unstemmed Lentigo Maligna on a Difficult Location of the Face Treated with 5% Imiquimod: A Case Report of 2-Year Follow-Up
title_short Lentigo Maligna on a Difficult Location of the Face Treated with 5% Imiquimod: A Case Report of 2-Year Follow-Up
title_sort lentigo maligna on a difficult location of the face treated with 5% imiquimod: a case report of 2-year follow-up
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8850510/
https://www.ncbi.nlm.nih.gov/pubmed/35083713
http://dx.doi.org/10.1007/s13555-021-00667-w
work_keys_str_mv AT misiakgalazkamagdalena lentigomalignaonadifficultlocationofthefacetreatedwith5imiquimodacasereportof2yearfollowup
AT czuwarajoanna lentigomalignaonadifficultlocationofthefacetreatedwith5imiquimodacasereportof2yearfollowup
AT galazkaadam lentigomalignaonadifficultlocationofthefacetreatedwith5imiquimodacasereportof2yearfollowup
AT czaplickaanna lentigomalignaonadifficultlocationofthefacetreatedwith5imiquimodacasereportof2yearfollowup
AT rudnickalidia lentigomalignaonadifficultlocationofthefacetreatedwith5imiquimodacasereportof2yearfollowup