Treatment of lentigo maligna with imiquimod 5% cream.

Lentigo maligna (LM) is an in situ melanoma that occurs in sun-damaged skin on the head and neck of elderly patients. Surgical excision is the treatment of choice for LM. However, surgical options may be limited by the location of LM in cosmetically sensitive areas. We present a woman with a history of skin cancer with a large, asymmetrically pigmented lesion on her right superior cheek below her eyelid. The lesion had been present for approximately 15 years. Histologic analysis confirmed that the lesion was an LM. Imiquimod 5% cream was applied topically once daily. Approximately 5 months later, the previous LM had healed well and no new lesions were observed. Histologic clearance of the lentigo maligna was evident in skin biopsies. Imiquimod 5% cream appears effective in the treatment of lentigo maligna. We describe the treatment of a patient with facial LM with imiquimod 5% cream.

Photodynamic therapy for perioral dermatitis.

BACKGROUND: Treatment of perioral dermatitis (POD) consists of topical steroids, oral antibiotics, and topical antibiotics. OBJECTIVE: To evaluate the safety and efficacy of photodynamic therapy (PDT) with topical 5-aminolevulinic acid (ALA) in the treatment of POD. METHODS: A split-face 21-patient study was conducted in which one side of the face was treated 4 times weekly with ALA PDT (30-minute ALA incubation) with blue light activation and the other side with topical clindamycin. Lesions were counted and photographs were taken before and after the final treatment. Patient satisfaction was also evaluated. RESULTS: Fourteen patients (66.7%) completed the study. Facial sides treated with ALA PDT achieved a mean clearance of 92.1% compared to 80.9% for the clindamycin-treated sides. The difference was significant (P=0.0227). The mean patient satisfaction level for the ALA PDT-treated side was 4.4 (1-5 scale). CONCLUSION: ALA PDT may be a promising alternative to antibiotics for the treatment of POD.