SIGNIFICANCE Lentigo maligna is treated to prevent progression to lentigo maligna melanoma. The current treatment of choice for lentigo maligna is surgical excision. Topical imiquimod is an alternative option. In this study, topical imiquimod treatment was successful in 84.2% of patients with lentigo maligna. Lentigo maligna (LM) is treated to prevent progression to lentigo maligna melanoma (LMM). Surgery is the gold standard, but an alternative treatment is offlabel topical imiquimod. The aim of this study was to evaluate the effectiveness of 5% topical imiquimod treat ment for lentigo maligna. In the period 2007-2017 57 patients with lentigo maligna were treated with off-label topical imiquimod once daily for 12 weeks. Complete clinical clearance was observed in 48 patients (84.2%) and partial clearance in 3 patients (5.3%). Three patients (5.3%) showed no response and another 3 patients (5.3%) stopped treatment due to side-effects. After 4.5 years, during follow-up, one patient developed a lentigo maligna melanoma, which was subsequently excised. Treatment with topical imiquimod resulted in complete clearance of lentigo maligna in 48 out of 57 patients (84.2%). Topical imiquimod is an acceptable treatment option for patients with lentigo maligna who prefer topical treatment to surgery or radiotherapy.

2 Li W, Han J, Choi HK et al. Smoking and risk of incident psoriasis among women and men in the United States: a combined analysis.