Adnexal Department, Moorfields Eye Hospital, London, UK.
Dermatology Department, Guys and St. Thomas Hospital, London, UK.
Eye (Lond). 2023 Feb;37(3):408-414. doi: 10.1038/s41433-022-02165-5. Epub 2022 Jul 14.
Lentigo Maligna is a benign subtype of melanoma in situ and can progress to lentigo maligna melanoma, which is invasive. Complete surgical excision is the gold standard of treatment but requires large margins. If affecting the peri-ocular region, surgical excision leads to extensive defects, complex reconstructions, and functional impairment of the protection of the ocular surface. Here we review the reported literature about the use of Imiquimod 5% topical cream for lentigo maligna of the eyelid, the treatment outcomes, side effects and tolerance. In addition, the side effects of imiquimod treatment of non-LM lesions are described to help better inform the decision-making process. Treatment for peri-ocular Lentigo maligna showed a 56-86% complete treatment response and a 90% tolerability rate. However, reported treatment protocols vary and histopathological confirmation of clearance was only obtained in 56%. Further studies are required to determine the optimal treatment protocol to maximise clearance rates. Overall, Imiquimod was well tolerated in the peri-ocular area.
恶性雀斑样痣是一种良性原位黑素瘤亚型，可进展为侵袭性恶性雀斑样黑素瘤。完全手术切除是治疗的金标准，但需要大的切缘。如果累及眶周区域，手术切除会导致广泛的缺损、复杂的重建和眼表面保护的功能损害。本文回顾了有关 5%咪喹莫特乳膏治疗眼睑恶性雀斑样痣的文献报道，包括治疗结果、副作用和耐受性。此外，还描述了咪喹莫特治疗非 LM 病变的副作用，以帮助更好地为决策过程提供信息。眼周恶性雀斑样痣的治疗显示完全治疗反应率为 56-86%，耐受性率为 90%。然而，报告的治疗方案存在差异，仅 56%获得了组织病理学清除的确认。需要进一步的研究来确定最佳的治疗方案，以最大限度地提高清除率。总体而言，咪喹莫特在眶周区域具有良好的耐受性。
