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- W2000559124 abstract "<h3>Objective</h3>To determine if the complete response rates of lentigo maligna (LM) to imiquimod, 5%, cream can be improved by the addition of a topical retinoid.<h3>Design</h3>Prospective randomized study of patients treated with imiquimod alone vs imiquimod plus a topical retinoid, followed by conservative staged excisions.<h3>Setting</h3>Mohs surgical clinic in an academic institution.<h3>Patients</h3>Ninety patients with biopsy-confirmed LM.<h3>Interventions</h3>Ninety patients with 91 LMs were randomized into 2 groups. One group received imiquimod, 5%, cream 5 d/wk for 3 months, while the other group also received tazarotene, 0.1%, gel 2 d/wk for 3 months. Following topical therapy, all patients underwent staged excisions and frozen section analysis with Melan-A immunostaining to confirm negative margins.<h3>Main Outcome Measure</h3>The presence or absence of residual LM at the time of staged excision.<h3>Results</h3>Forty-six patients with 47 LMs were randomized to receive monotherapy: 42 of 47 LMs reached the intended treatment duration, with 27 complete responses (64%). Forty-four patients with 44 LMs were randomized to receive combined therapy: 37 of 44 LMs reached the intended treatment duration, with 29 complete responses (78%). This difference did not reach statistical significance (P = .17). There have been no recurrences to date, with a mean follow-up period of 42 months.<h3>Conclusions</h3>Among patients who received topical imiquimod with vs without tazarotene, 22% (8 of 37) of lesions vs 36% (15 of 42) of lesions showed residual LM on staged excisions. Pretreating LM with imiquimod, 5%, cream may decrease surgical defect sizes; however, total reliance on topical imiquimod as an alternative to surgery may put the patient at increased risk of a local recurrence.<h3>Trial Registration</h3>clinicaltrials.gov Identifier: NCT00707174" @default.
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- W2000559124 date "2012-05-01" @default.
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- W2000559124 title "A Randomized Trial of the Off-label Use of Imiquimod, 5%, Cream With vs Without Tazarotene, 0.1%, Gel for the Treatment of Lentigo Maligna, Followed by Conservative Staged Excisions" @default.
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- W2000559124 doi "https://doi.org/10.1001/archdermatol.2012.270" @default.
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