In vivo reflectance confocal microscopy to monitor the response of lentigo maligna to imiquimod.
J Am Acad Dermatol
; 71(1): 49-55, 2014 Jul.
Article
in En
| MEDLINE
| ID: mdl-24725478
ABSTRACT
BACKGROUND:
Imiquimod has been used for treating lentigo maligna (LM) in selected cases when surgery is not an appropriate option because of functional or aesthetic impairment. Reflectance confocal microscopy (RCM) is a noninvasive method that has not been validated for monitoring the treatment of LM with imiquimod.OBJECTIVE:
We sought to evaluate the use of in vivo RCM to accurately monitor the response of LM to nonsurgical treatment with topical imiquimod.METHODS:
Twenty patients with confirmed facial LM, not amenable to surgical treatment or radiation therapy, were included prospectively. Clinical evaluation was performed by dermoscopy, RCM, and histopathology. Patients applied imiquimod 5% for 8 weeks. The affected area was assessed using the previously described LM score on RCM, and target sample biopsies were performed to confirm or discard RCM findings.RESULTS:
Fifteen of the 20 patients (75%) presented histologic tumor clearance. Confocal microscopy identified 70% of these responders with no false-negative results, and when compared with histopathology, there was no significant difference in evaluating the response to imiquimod.LIMITATIONS:
The impossibility of examining the entire lesion by means of histopathology is a limitation.CONCLUSION:
In vivo RCM evaluation was useful in accurately monitoring the response of LM to nonsurgical treatment with topical imiquimod in patients when surgery is contraindicated.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Skin Neoplasms
/
Facial Neoplasms
/
Adjuvants, Immunologic
/
Hutchinson's Melanotic Freckle
/
Microscopy, Confocal
/
Aminoquinolines
Type of study:
Observational_studies
/
Prognostic_studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Am Acad Dermatol
Year:
2014
Document type:
Article
Affiliation country:
Spain