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Correspondence |

Failed Treatment of Amelanotic Lentigo Maligna With Imiquimod Followed by Pigment Production

Kathryn J. Martires, BA; Laura Capaldi, MD; Sean F. Pattee, MD; Mary E. Maloney, MD; Jeremy S. Bordeaux, MD, MPH
Arch Dermatol. 2010;146(9):1047-1048. doi:10.1001/archdermatol.2010.237.
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A melanotic lentigo maligna (ALM) represents a small subset of lentigo maligna (LM) that lacks pigment. At least 2 cases of ALM responsive to imiquimod therapy with short-term follow-up have been reported.1 We report herein a case of ALM that failed to respond to imiquimod treatment. Furthermore, after therapy was initiated, the ALM began to produce pigment and transformed to LM.

Powell  AMRussell-Jones  R Amelanotic lentigo maligna managed with topical imiquimod as immunotherapy. J Am Acad Dermatol 2004;50 (5) 792- 796
PubMed Link to Article[[XSLOpenURL/10.1016/j.jaad.2003.11.057]]
Johnson  TMHeadington  JTBaker  SRLowe  L Usefulness of the staged excision for lentigo maligna and lentigo maligna melanoma: the “square” procedure. J Am Acad Dermatol 1997;37 (5, pt 1) 758- 764
PubMed Link to Article[[XSLOpenURL/10.1016/S0190-9622(97)70114-2]]
Rajpar  SFMarsden  JR Imiquimod in the treatment of lentigo maligna. Br J Dermatol 2006;155 (4) 653- 656
PubMed Link to Article[[XSLOpenURL/10.1111/bjd.2006.155.issue-4]]
McGovern  VJShaw  HMMilton  GWFarago  GA Cell type and pigment content as prognostic indicators in cutaneous malignant melanoma. Ackermann  ABedPathology of Malignant Melanoma. New York, NY Masson1981;327- 331
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PubMed Link to Article[[XSLOpenURL/10.1001/archderm.142.12.1551]]
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Figure.

Lesion before (A) and after (B) imiquimod treatment. A, Clinical image of amelanotic lentigo maligna on the medial and lateral nasal sidewall (subsequently confirmed by biopsy). B, Lentigo maligna with pigment production after treatment with imiquimod.

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