Department of Dermatology, Amsterdam University Medical Centers, Location Vrije Universiteit Medical Center, 1081HV Amsterdam, The Netherlands.
Acta Derm Venereol. 2019 Sep 1;99(10):884-888. doi: 10.2340/00015555-3241.
Lentigo maligna (LM) is treated to prevent progression to lentigo maligna melanoma (LMM). Surgery is the gold standard but an alternative treatment is off-label topical imiquimod. The aim of this study was to evaluate the effectiveness of 5% topical imiquimod treatment for lentigo maligna. In the period 2007-2017 57 patients with lentigo maligna were treated with off-label topical imiquimod once daily for 12 weeks. Complete clinical clearance was observed in 48 patients (84.2%) and partial clearance in 3 patients (5.3%). Three patients (5.3%) showed no response and another 3 patients (5.3%) stopped treatment due to side-effects. After 4.5 years during follow-up one patient developed a lentigo maligna melanoma which was subsequently excised. Treatment with topical imiquimod resulted in complete clearance of lentigo maligna in 48 out of 57 patients (84.2%). Topical imiquimod is an acceptable treatment option for patients with lentigo maligna who prefer topical treatment to surgery or radiotherapy.
恶性雀斑样痣(LM)的治疗目的是预防其进展为恶性雀斑样黑素瘤(LMM)。手术是金标准,但替代治疗方法是外用咪喹莫特。本研究旨在评估外用 5%咪喹莫特治疗恶性雀斑样痣的有效性。在 2007 年至 2017 年期间,57 例恶性雀斑样痣患者接受了为期 12 周、每日一次的外用咪喹莫特治疗。48 例患者(84.2%)获得完全临床缓解,3 例患者(5.3%)部分缓解。3 例患者(5.3%)无反应,另有 3 例患者(5.3%)因副作用停止治疗。在随访的 4.5 年期间,1 例患者发生了恶性雀斑样黑素瘤,随后进行了切除。外用咪喹莫特治疗使 57 例患者中的 48 例(84.2%)完全清除了恶性雀斑样痣。对于偏爱外用治疗而非手术或放疗的恶性雀斑样痣患者,外用咪喹莫特是一种可接受的治疗选择。