title: Using topical imiquimod for the management of positive in situ margins after melanoma resection.
abstract: The treatment of melanoma in situ (MIS) is controversial with current standard of care being surgical excision with clear margins. Alternative topical therapy with imiquimod has been proposed in recent studies as a possible treatment for MIS. This study aimed to evaluate the use of topical 5% imiquimod as an alternative approach for the treatment of residual melanoma in situ after surgical resection of the primary lesion. A retrospective chart review of all patients treated with topical 5% imiquimod for residual MIS following standard resection with 5-10 mm margins at Yale-New Haven Hospital from 2008 through 2013 was performed. The pre- and posttreatment results were confirmed by diagnostic tissue biopsy. Twenty-two patients were included in the study. One of these 22 patients was lost to follow up. Twenty patients (95%) had complete resolution of their residual MIS and 1 patient did not respond to imiquimod (5%). No reports of recurrences were noted at the treatment sites. For patients with residual melanoma in situ after the initial excision, topical 5% imiquimod appears to be a reasonable alternative treatment with good clinical and histopathologic success rates.
authors.affiliation: Department of General Surgery, Western Connecticut Health Network, Danbury, Connecticut, 06810.
authors.forename: Amrita S
authors.initials: AS
authors.lastname: Pandit
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Geiger
authors.forename: Stephan
authors.initials: S
authors.lastname: Ariyan
authors.forename: Deepak
authors.initials: D
authors.lastname: Narayan
authors.forename: Jennifer Nam
authors.initials: JN
authors.lastname: Choi
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D000369:Aged, 80 and over; D000634:Aminoquinolines / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D000077271:Imiquimod; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000601:surgery; D008875:Middle Aged; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D000634:Aminoquinolines; D000970:Antineoplastic Agents; D000077271:Imiquimod
keywords: Cutaneous; imiquimod; immunomodulator; melanoma; melanoma in situ