Department of Internal Medicine and Dermatology, University of Manitoba, Winnipeg, MB.
J Cutan Med Surg. 2012 Jul-Aug;16(4):245-9. doi: 10.1177/120347541201600405.
Standard treatment for lentigo maligna (LM) is surgical excision with 5 to 10 mm margins. This can be cosmetically disfiguring. Imiquimod locally induces Toll-like receptors to release cytokines that destroy neoplastic melanocytes.
The off-label use of topical 5% imiquimod cream may provide an alternative to surgery. This study reviews the use of imiquimod to treat LM.
A 5-year retrospective and prospective chart analysis was conducted. Pretreatment biopsies confirmed the diagnosis. Treatment was individualized for each patient. Posttreatment biopsies and dermoscopy determined clearance of LM.
Twenty-seven patients were reviewed. There were 20 responders (74.1%) and 7 failures. The mean tumor size (area of an ellipse) was 6.69 cm2, and the mean treatment duration was 17.68 weeks. Neither the size of the tumor (p = .86) nor treatment duration (p = .18) was related to resolution of the lesion.
Imiquimod is an effective treatment for LM that provides patients with a cosmetically favorable outcome when standard surgery is not an option.
基底细胞癌的标准治疗方法是手术切除，切除边缘为 5 至 10 毫米。但这种方法可能会影响外观。咪喹莫特局部诱导 Toll 样受体释放细胞因子，从而破坏肿瘤性黑素细胞。
局部使用 5%咪喹莫特乳膏的非适应证治疗可能是手术的替代方法。本研究回顾了咪喹莫特治疗基底细胞癌的应用。
对 27 例患者进行了为期 5 年的回顾性和前瞻性图表分析。治疗前活检证实了诊断。为每位患者制定个体化治疗方案。治疗后活检和皮肤镜检查确定基底细胞癌是否清除。
共 27 例患者接受了治疗，其中 20 例（74.1%）为有效，7 例（25.9%）为无效。肿瘤平均大小（椭圆面积）为 6.69cm2，平均治疗持续时间为 17.68 周。肿瘤大小（p=0.86）和治疗持续时间（p=0.18）均与病变的缓解无关。
咪喹莫特是一种有效的基底细胞癌治疗方法，为不能接受标准手术的患者提供了美容效果良好的选择。
