Park Andrew J, Paul Joan, Chapman M Shane, Samie Faramarz H
*Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; †Section of Dermatology, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; ‡Department of Dermatology, Columbia University Medical Center, New York, New York.
Dermatol Surg. 2017 Aug;43(8):1017-1022. doi: 10.1097/DSS.0000000000001115.
Melanoma in situ (MIS) is a noninvasive form of melanoma for which nonsurgical therapeutic options continue to be explored. The off-label use of topical 5% imiquimod cream in the management of MIS has shown potential but reported recurrence rates vary considerably between 0% and 40%. Furthermore, the long-term efficacy of imiquimod is not well established.
To determine the recurrence rate of MIS among patients treated with topical 5% imiquimod cream at Dartmouth-Hitchcock Medical Center with at least 1 year of follow-up.
A retrospective chart review identified 12 patients with MIS who have been treated with topical 5% imiquimod cream for 6 to 12 weeks. Patients who underwent surgical treatment for MIS were excluded from analysis.
Of 12 patients with histologically confirmed MIS treated with topical 5% imiquimod cream, there were 2 recurrences (17%) during a median follow-up time of 5.5 years.
Although surgery is still considered the gold standard for the treatment of MIS, imiquimod may represent a potentially effective noninvasive treatment option for patient who are not surgical candidates.
原位黑色素瘤（MIS）是黑色素瘤的一种非侵袭性形式，目前仍在探索其非手术治疗方案。外用5%咪喹莫特乳膏在MIS治疗中的非适应证使用已显示出一定潜力，但报道的复发率在0%至40%之间差异很大。此外，咪喹莫特的长期疗效尚未明确。
确定在达特茅斯-希区柯克医疗中心接受外用5%咪喹莫特乳膏治疗且随访至少1年的MIS患者的复发率。
一项回顾性病历审查确定了12例接受外用5%咪喹莫特乳膏治疗6至12周的MIS患者。接受MIS手术治疗的患者被排除在分析之外。
在12例经组织学证实接受外用5%咪喹莫特乳膏治疗的MIS患者中，中位随访时间为5.5年，有2例复发（17%）。
尽管手术仍被认为是MIS治疗的金标准，但对于不适合手术的患者，咪喹莫特可能是一种潜在有效的非侵入性治疗选择。
