title: Topical imiquimod for periocular lentigo maligna.
abstract: OBJECTIVE
  To evaluate the efficacy of topical imiquimod 5%, a local immune response modifier, in the treatment of periocular lentigo maligna.
  
  
  METHODS
  Retrospective, interventional case series.
  
  
  METHODS
  Five consecutive patients with biopsy-proven periocular lentigo maligna.
  
  
  METHODS
  Periocular lentigo maligna was treated with topical imiquimod 5%. The clinical features, treatment schedule, response to treatment, and complications were analyzed retrospectively.
  
  
  METHODS
  Response to treatment and complications.
  
  
  RESULTS
  The mean patient age was 73 years. The anatomic location of lentigo maligna was the medial canthal area in 2 patients, the lateral canthal area in 1 patient, and the lower eyelid in 2 patients. Topical imiquimod 5% was used for 5 days per week in 3 patients and for 7 days per week in 2 patients. The medication was placed only on the skin and not the globe. The mean duration of treatment was 9 months (range, 1-14 months). Lentigo maligna partially resolved in 3 patients and completely resolved in 2 patients. The most common side effects included localized erythema and discomfort (n = 4), swelling (n = 3), and cutaneous excoriation (n = 2). There were no patients with toxicity to the conjunctiva, cornea, or globe. Treatment was discontinued in 2 patients (one temporarily and the other permanently) because of intolerable local side effects of discomfort, redness, swelling, and cutaneous excoriation. There was no recurrence of lentigo maligna in those with complete or partial response (mean follow-up, 20 months).
  
  
  CONCLUSIONS
  Periocular lentigo maligna seems to respond to topical imiquimod 5% treatment. Topical imiquimod 5% treatment for periocular lentigo melanoma deserves further study.
  
  
  BACKGROUND
  The author(s) have no proprietary or commercial interest in any materials discussed in this article.
authors.affiliation: Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: Hakan
authors.initials: H
authors.lastname: Demirci
authors.forename: Carol L
authors.initials: CL
authors.lastname: Shields
authors.forename: Carlos G
authors.initials: CG
authors.lastname: Bianciotto
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Shields
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage* / Q000009:adverse effects; D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000634:Aminoquinolines / Q000008:administration & dosage* / Q000009:adverse effects; D005142:Eyelid Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D018327:Hutchinson's Melanotic Freckle / Q000188:drug therapy* / Q000473:pathology; D000077271:Imiquimod; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D000077271:Imiquimod