Rajpar S F, Marsden J R
Skin Oncology Service, University Hospital Birmingham NHS Trust, Birmingham B29 6JD, UK.
Br J Dermatol. 2006 Oct;155(4):653-6. doi: 10.1111/j.1365-2133.2006.07476.x.
Lentigo maligna (LM) is treated to prevent progression to lentigo maligna melanoma (LMM). Surgery remains the treatment of choice, although topical immunotherapy with imiquimod has recently become a popular alternative.
In this review, we have analysed the published literature relating to the use of imiquimod for LM, in order to understand better the utility of this treatment.
All English language studies relating to the use of imiquimod for LM were analysed up to January 2006.
Eleven case reports and four open-label studies were identified, comprising a total of 67 patients who completed treatment with imiquimod for LM. There was significant variability in treatment schedules and regimens. Eight patients failed to respond, with LMM developing in two of these. In certain cases there were discrepancies between clinical and histological response with some patients clearing clinically but not histologically, and vice versa. Follow-up periods were short, exceeding 12 months in only five cases.
Although imiquimod clearly has an effect on LM, this analysis of available studies has helped to identify concerns about its use. Without controlled evidence and prolonged follow up, the use of imiquimod for LM must still be considered experimental.
恶性雀斑样痣（LM）需接受治疗以防止进展为恶性雀斑样痣黑色素瘤（LMM）。手术仍是首选治疗方法，尽管咪喹莫特局部免疫疗法最近已成为一种流行的替代方法。
在本综述中，我们分析了已发表的有关咪喹莫特用于治疗LM的文献，以便更好地了解这种治疗方法的效用。
分析了截至2006年1月所有有关咪喹莫特用于治疗LM的英文研究。
确定了11例病例报告和4项开放标签研究，共有67例患者完成了咪喹莫特治疗LM的疗程。治疗方案和疗程存在显著差异。8例患者无反应，其中2例发展为LMM。在某些情况下，临床反应与组织学反应存在差异，一些患者临床清除但组织学未清除，反之亦然。随访期较短，只有5例超过12个月。
尽管咪喹莫特对LM显然有作用，但对现有研究的分析有助于确定对其使用的担忧。在没有对照证据和长期随访的情况下，咪喹莫特用于治疗LM仍必须被视为实验性的。
