Abstract
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.
摘要
雀斑样痣为原位黑色素瘤的良性亚型, 可进展为具有侵袭性的雀斑样恶性黑色素瘤。完全手术切除是治疗雀斑样痣的金标准, 但手术需要较大的切缘。如果累及眼周区域, 手术切除会导致眼表保护屏障的广泛缺损, 复杂重建和功能损坏。本文我们回顾分析了与5%咪喹莫特外用乳膏治疗睑缘雀斑样痣的治疗效果、副作用和耐受性相关的已发表文献。此外, 我们报道了咪喹莫特治疗非雀斑样痣的副作用, 以便更好地辅助临床决策。咪喹莫特治疗眼周雀斑样痣后, 有56–86%的病人表现出完全缓解, 90%的病人表现为耐受。然而, 研究报道的治疗方案多种多样, 且组织病理学证实仅有56%的雀斑样痣被彻底清除。为了使清除率最大化, 研究者需要进一步探索来确定最佳治疗方案。总之, 咪喹莫特在眼周区域耐受良好。
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IN: Conceived and designed the analysis, Collected the data, Contributed data or analysis tools, Performed the analysis, Wrote the paper, Other contribution; HT: Conceived and designed the analysis, Collected the data, Contributed data or analysis tools, Performed the analysis, Wrote the paper, Other contribution; RP: Conceived and designed the analysis, Collected the data, Contributed data or analysis tools, Performed the analysis, Wrote the paper, Other contribution; MK: Conceived and designed the analysis, Collected the data, Contributed data or analysis tools, Performed the analysis, Wrote the paper, Other contribution; CD: Conceived and designed the analysis, Collected the data, Contributed data or analysis tools, Performed the analysis, Wrote the paper, Other contribution.
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Neumann, I., Patalay, R., Kaushik, M. et al. Treatment of periocular lentigo maligna with topical 5% Imiquimod: a review. Eye 37, 408–414 (2023). https://doi.org/10.1038/s41433-022-02165-5
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DOI: https://doi.org/10.1038/s41433-022-02165-5
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