title: [In-transit metastasis in melanoma: Efficacy of topical imiquimod combined with carbon dioxide laser or with electrocautery].
abstract: BACKGROUND
  In-transit metastases in cutaneous melanoma are common and difficult to manage. Therapy is mainly palliative. Use of topical imiquimod has been assessed for surface metastases.
  
  
  METHODS
  We report on four patients with cutaneous melanoma metastases treated with topical imiquimod associated with carbon dioxide laser in the first two patients and with electrocoagulation in the two others. For two patients, we noted complete regression of the lesions after 15 and 18 months. For the two others, treatment was stopped after 9 to 10 months because of progression of subcutaneous metastasis and distant metastasis.
  
  
  CONCLUSIONS
  Topical imiquimod is an alternative treatment used in superficial in-transit metastasis of melanoma. Its use as a monotherapy is sometimes ineffective. We elected to use combined pre-treatment with carbon dioxide laser or electrocoagulation in order to potentiate the action of imiquimod. This simple and inexpensive therapeutic strategy constitutes a palliative treatment that can allow prolonged local control of cutaneous metastasis.
authors: Service de dermatologie générale et oncologique, hôpital Ambroise-Paré, faculté de médecine Paris-Ile de France Ouest, université de Versailles-SQY, 9, avenue Charles-De-Gaulle, 92104 Boulogne cedex, France. Electronic address: fatiza59@hotmail.fr.
authors: F-Z
authors: FZ
authors: Elfatoiki
authors: Service de dermatologie générale et oncologique, hôpital Ambroise-Paré, faculté de médecine Paris-Ile de France Ouest, université de Versailles-SQY, 9, avenue Charles-De-Gaulle, 92104 Boulogne cedex, France.
authors: C
authors: C
authors: Longvert
authors: Service d'anatomie pathologique, hôpital Ambroise-Paré, faculté de médecine Paris-Ile de France Ouest, université de Versailles-SQY, 9, avenue Charles-De-Gaulle, 92104 Boulogne cedex, France.
authors: T
authors: T
authors: Clerici
authors: Service de dermatologie générale et oncologique, hôpital Ambroise-Paré, faculté de médecine Paris-Ile de France Ouest, université de Versailles-SQY, 9, avenue Charles-De-Gaulle, 92104 Boulogne cedex, France.
authors: I
authors: I
authors: Bourgault-Villada
authors: Service de dermatologie générale et oncologique, hôpital Ambroise-Paré, faculté de médecine Paris-Ile de France Ouest, université de Versailles-SQY, 9, avenue Charles-De-Gaulle, 92104 Boulogne cedex, France.
authors: C
authors: C
authors: Roudier-Pujol
authors: Service de dermatologie générale et oncologique, hôpital Ambroise-Paré, faculté de médecine Paris-Ile de France Ouest, université de Versailles-SQY, 9, avenue Charles-De-Gaulle, 92104 Boulogne cedex, France.
authors: E
authors: E
authors: Vasseur
authors: Service de dermatologie générale et oncologique, hôpital Ambroise-Paré, faculté de médecine Paris-Ile de France Ouest, université de Versailles-SQY, 9, avenue Charles-De-Gaulle, 92104 Boulogne cedex, France.
authors: P
authors: P
authors: Saiag
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000634:Aminoquinolines / Q000008:administration & dosage / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018450:Disease Progression; D004564:Electrocoagulation; D005153:Facial Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D017809:Fatal Outcome; D006801:Humans; D000077271:Imiquimod; D016898:Interferon-alpha / Q000627:therapeutic use; D053685:Laser Therapy; D054020:Lasers, Gas; D007866:Leg; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D010166:Palliative Care; D012074:Remission Induction; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery
chemical_list: D000634:Aminoquinolines; D000970:Antineoplastic Agents; D016898:Interferon-alpha; D000077271:Imiquimod
keywords: Carbon dioxide laser; Electrocoagulation; Imiquimod topique; In-transit metastases in cutaneous melanoma; Laser CO(2); Melanoma; Mélanome; Métastases cutanées en transit; Topical imiquimod; Électrocoagulation