Change in lentigo maligna score assessed by in vivo reflectance confocal microscopy after 1 month of imiquimod treatment for lentigo maligna management

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

卷:86

Article

Soenen, Anouk¹  Vourc'h, Morgane¹  Khammari, Amir¹  Nguyen, Jean-Michel²  Bossard, Celine³  Musquer, Marie Denis³  Vergier, Beatrice⁴  Dreno, Brigitte¹ 

[1] Nantes Univ, Dept Dermatol, Nantes, France

[2] Nantes Univ, Dept Epidemiol & Biostat, Nantes, France

[3] Nantes Univ, Dept Pathol, Nantes, France

[4] Bordeaux Univ, Dept Pathol, Bordeaux, France

关键词: histology;    imiquimod;    lentigo maligna;    lentigo maligna score;    margin control;    melanoma in;    situ;    reflectance confocal microscopy;    surgery;   

DOI  :  10.1016/j.jaad.2021.03.077

来源: Elsevier

【 摘 要 】

Background: Treatment of lentigo maligna (LM) is challenging because of the potential functional and esthetic surgical sequelae. Imiquimod has been proposed as a treatment for LM. Reflectance confocal microscopy (RCM) is a noninvasive method for the diagnosis of LM and margin assessment. Objectives: To compare the overall LM score (LMS) assessed by RCM before and 1 month after the start of imiquimod treatment compared to placebo and to define the immunohistochemical (IHC) profile of responders to imiquimod. Methods: A controlled randomized study was conducted. Forty patients underwent RCM examination with calculation of the LMS at baseline and after 1 month of treatment. An IHC analysis of excised tissues was performed. Results: The 1-month LMS was significantly lower in patients treated with imiquimod compared to those treated with placebo (P < .001). The criteria in the imiquimod-treated patients that demonstrated significant decrease were nonedged papillae; large, round pagetoid cells; atypical cells at the dermoepidermal junction; and follicular location of atypical cells. IHC analysis showed a higher level of interferon gamma in the resected specimens of patients responding to imiquimod (P = .04). Limitations: Sample size was small. Conclusion: Assessing the LMS by RCM was useful to monitor LM response to imiquimod accurately. ( J Am Acad Dermatol 2022;86:1042-8.)

【 授权许可】

Free