title: Recurrent in situ melanoma successfully treated with ingenol mebutate.
abstract: BACKGROUND
  Treatment options for melanoma in situ (MIS) include imiquimod, radiation therapy, cryotherapy, excisional and Mohs surgery. Ingenol mebutate is a new topical treatment option recognized for actinic keratosis. Although in vitro effectiveness has been demonstrated on melanoma cell lines, its therapeutic potential for in vivo melanomas is unknown.
  
  
  METHODS
  In 2011, a 91-year-old woman presented a thick melanoma of her cheek. The lateral sections revealed persisting in situ melanoma, which were again excised. She presented for follow-up and a recurrent MIS was evidenced centered on the previous scar. She refused further surgery and ingenol mebutate (0.015% gel) was administered on three consecutive days. One month later, a complete clinical resolution was observed. Histology and immunohistology revealed no residual MIS.
  
  
  CONCLUSIONS
  In this patient, ingenol mebutate was successful and well-tolerated as a topical, alternative therapy for MIS after failure of other treatment options.
authors.affiliation: Department of Dermatology, Skin Cancer Centre, CHU du Sart Tilman, University de Liège, 4000, Liège, Belgium.
authors.forename: Marion
authors.initials: M
authors.lastname: Mansuy
authors.forename: Nazli
authors.initials: N
authors.lastname: Nikkels-Tassoudji
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Arrese
authors.forename: Andree
authors.initials: A
authors.lastname: Rorive
authors.forename: Arjen F
authors.initials: AF
authors.lastname: Nikkels