Using topical imiquimod for the management of positive in situ margins after melanoma resection.
Bottom Line: The pre- and posttreatment results were confirmed by diagnostic tissue biopsy.Twenty patients (95%) had complete resolution of their residual MIS and 1 patient did not respond to imiquimod (5%).No reports of recurrences were noted at the treatment sites.
Affiliation: Department of General Surgery, Western Connecticut Health Network, Danbury, Connecticut, 06810.Show MeSH
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Mentions: A total of 22 patients having residual MIS at surgical margins after excision procedures for primary melanoma or MIS were treated with topical 5% imiquimod cream. Patient demographics and details of the primary lesions are provided in Table1. Twenty patients (95%) had an excellent response with complete resolution of their residual MIS at a mean follow-up period of 24 months. This was confirmed by a minimum of two 4-mm punch biopsies of the affected margins following the treatment. Table2 indicates the frequency and duration of topical imiquimod treatment, as well as the cutaneous inflammatory response of each patient during treatment and their associated clinical outcome. One patient (5%) was lost to follow-up. Another patient (5%) had persistent MIS after treatment with imiquimod. She was subsequently treated by reresection but was again found to have residual MIS at the margins. She is currently being monitored clinically with no evidence of repigmentation of the affected area. Figure2A–C shows representative photos of reactive inflammation during the course of imiquimod treatment for patient 3.
Affiliation: Department of General Surgery, Western Connecticut Health Network, Danbury, Connecticut, 06810.