ABSTRACT
BACKGROUND: More data are needed to define factors that predict long-term success after imiquimod therapy for lentigo maligna (LM). OBJECTIVE: We sought to determine the demographic, clinical, and histologic prognostic markers of relapse-free survival in patients with LM who were treated with imiquimod. METHODS: This was a single-arm, open-label, nonrandomized, prospective study. RESULTS: Eighty-nine patients with histologically confirmed LM and a median follow-up time of 4.8 years after imiquimod treatment were included in our study. Sixteen patients (18%) relapsed. Statistically significant indicators of an increased risk of local recurrence included: the total number of melanocytes, the number of basal and suprabasal melanocytes and the number of pagetoid spreading melanocytes. LIMITATIONS: Our study was a single-center, nonrandomized study. CONCLUSION: An assessment of different melanocyte fractions in the diagnostic baseline biopsy specimen may help to predict the response of LM to imiquimod therapy.
Subject(s)
Aminoquinolines/administration & dosage , Hutchinson's Melanotic Freckle/drug therapy , Hutchinson's Melanotic Freckle/pathology , Neoplasm Recurrence, Local/pathology , Skin Neoplasms/drug therapy , Skin Neoplasms/pathology , Administration, Cutaneous , Adult , Aged , Aged, 80 and over , Antineoplastic Agents/administration & dosage , Biomarkers, Tumor/analysis , Biopsy, Needle , Disease-Free Survival , Female , Follow-Up Studies , Humans , Hutchinson's Melanotic Freckle/mortality , Imiquimod , Immunohistochemistry , Male , Melanocytes/pathology , Middle Aged , Neoplasm Recurrence, Local/epidemiology , Neoplasm Staging , Prospective Studies , Risk Assessment , Skin Cream/administration & dosage , Skin Neoplasms/mortality , Switzerland , Time Factors , Treatment OutcomeABSTRACT
A 34 year-old man from Eritrea presented with gradual onset bilateral loin and leg pain. Clinical examination revealed lower abdominal tenderness, ataxia and a tendency to fall backwards. The imaging and lumbar puncture provided new information. Our differential diagnosis included tuberculosis, lymphoma or other granulomatous illness. He was admitted and started on IV methylprednisolone with subsequent resolution of symptoms. Serum ELISA yielded a diagnosis of Schistosomiasis. Consequently treatment with Praziquantel was initiated and steroid therapy continued.
