Immunocryosurgery as monotherapy for lentigo maligna or combined with surgical excision for lentigo maligna melanoma

J Dermatol. 2018 May;45(5):564-570. doi: 10.1111/1346-8138.14248. Epub 2018 Feb 11.

Abstract

The incidence of lentigo maligna (LM), in situ (LM) or invasive (lentigo maligna melanoma, LMM), has increased during the last decades. Due to functional or cosmetic outcomes, optimal treatment with surgical excision may not be appropriate in some cases. We tried less invasive therapy, immunocryosurgery, as a single treatment for LM or combined with surgery for LMM, with better aesthetic results. Three patients with LM or LMM not amenable to complete surgical excision were selected. LMM patients underwent limited surgical resection of the invasive area. Subsequently, a combined treatment with topical imiquimod and cryosurgery was performed. The LM patient received immunocryosurgery directly. All of them were free of local and systemic disease at 48, 42 and 41 months after discontinuation of therapy. We consider that immunocryosurgery is an alternative option for LM or even for LMM (after removal of the invasive tissue with narrow margins) in poor surgical candidates, with good therapeutic, functional and cosmetic results.

Keywords: cryosurgery; imiquimod; immunocryosurgery; lentigo maligna; lentigo maligna melanoma.

Publication types

  • Case Reports

MeSH terms

  • Adjuvants, Immunologic / therapeutic use
  • Administration, Cutaneous
  • Aged
  • Aged, 80 and over
  • Aminoquinolines / therapeutic use
  • Biopsy
  • Combined Modality Therapy / adverse effects
  • Combined Modality Therapy / methods
  • Cryosurgery / adverse effects
  • Cryosurgery / methods*
  • Dermatologic Surgical Procedures / adverse effects
  • Dermatologic Surgical Procedures / methods
  • Female
  • Humans
  • Hutchinson's Melanotic Freckle / pathology
  • Hutchinson's Melanotic Freckle / therapy*
  • Imiquimod
  • Immunotherapy / adverse effects
  • Immunotherapy / methods*
  • Melanoma / pathology
  • Melanoma / therapy*
  • Skin / pathology
  • Skin Cream / therapeutic use
  • Skin Neoplasms / pathology
  • Skin Neoplasms / therapy*

Substances

  • Adjuvants, Immunologic
  • Aminoquinolines
  • Imiquimod