Cryosurgery during topical imiquimod: a successful combination modality for lentigo maligna.
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| Abstract | BACKGROUND: Either cryosurgery or topical imiquimod have been used to treat patients with lentigo maligna in cases where surgery is not feasible. METHODS: We report a patient with lentigo maligna, who was treated with the combination of topical imiquimod and cryosurgery, and review the rationale, which led us to design the present combined cryo-immunological treatment modality. RESULTS: Sustained clearance of lentigo maligna to date (26 months after treatment). The successful treatment of this patient was based on the following rationale: A cryosurgery session during continuing imiquimod application may: (i) reinforce apoptosis of tumor cells; (ii) strengthen antiangiogenesis in the treated tumor; and (iii) build-up a potent tumor-destructive immune response by a cascade of events starting with imiquimod-promoted attraction of immature dendritic antigen-presenting cells (DCs) into the tumor. DCs further mature within the tumor-antigen-rich environment of subsequently cryo-destructed tumor and upon imiquimod-driven migration into the peripheral lymph nodes can stimulate a specific antineoplastic cell-mediated immunity. Finally, continuing imiquimod application after cryosurgery may increase recruitment of activated effector cells into the tumor tissue leading to its destruction. CONCLUSION:
Cryosurgery during continued topical imiquimod seems to be a promising treatment for lentigo maligna.
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| Authors | I D Bassukas, C Gamvroulia, A Zioga, K Nomikos, C Fotika |
| Journal | International journal of dermatology (Int J Dermatol) Vol. 47 Issue 5 Pg. 519-21 (May 2008) ISSN: 1365-4632 [Electronic] England |
| PMID | 18412875 (Publication Type: Case Reports, Journal Article) |
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