Managing lentigo maligna with imiquimod

In cases of lentigo maligna where surgery is not possible or declined by the patient, is imiquimod a viable treatment alternative?

Need to know:

  • The risk of untreated lentigo maligna progressing to invasive disease is uncertain but low.
  • Imiquimod therapy for lentigo maligna appears to be an attractive non-invasive treatment option, but there is a lack of evidence of long-term efficacy and mortality benefit.
  • As lentigo maligna may harbour occult invasive disease, complete excision remains the treatment of choice.
  • The decision to use non-surgical options in the management of lentigo maligna ideally should be made by a multidisciplinary team of expert clinicians.

The terms shark and melanoma both conjure fear in our hearts. Despite this fear, most sharks are harmless. The same is true of many melanomas.