Local cryosurgery and imiquimod: A successful combination for the treatment of locoregional cutaneous metastasis of melanoma: A case series

Abstract

Locoregional cutaneous metastases of melanoma (LCMM) represent a therapeutic challenge. Many treatment options are available with varying results. The combination of cryotherapy and imiquimod, two treatments with a possible synergistic effect, has not yet been described for treating this disease. In this paper, we aimed to show the response of LCMM to cryotherapy combined with topical imiquimod 5%. A retrospective review of 20 patients diagnosed with LCMM and treated with cryotherapy combined with topical imiquimod 5% between November 2000 and May 2014 at three institutions was performed. The locoregional cutaneous response was evaluated. After a mean of five sessions, 13 patients (65%) responded to treatment, eight (40%) of these completely and five (25%) partially. Systemic disease progressed in 16 (80%) patients. Cryotherapy followed by topical imiquimod 5% is simple to apply, has minimal adverse effects and provides response rates similar to other, more complex treatment options.

Immunocryosurgery as monotherapy for lentigo maligna or combined with surgical excision for lentigo maligna melanoma

“…Recent experimental studies, in vitro and in vivo , have supported the potential benefits of imiquimod for melanoma, combined or not with cryosurgery . By the other hand, we have recently reported the use of immunocryosurgery in palliative management of melanoma skin metastases …”

“…9,[24][25][26][27] By the other hand, we have recently reported the use of immunocryosurgery in palliative management of melanoma skin metastases. 8 To our knowledge, only three reports have been published about the treatment of LM/LMM with immunocryosurgery ( Table 1). The first one is a case report of LM, published by Bassukas et al, where cryotherapy was preceded and followed by topical imiquimod, as already mentioned and described in Methods.…”

“…Based on our previous experience on immunocryosurgery (cryotherapy plus imiquimod) as treatment of locoregional skin metastasis of melanoma and other bibliographic references, we decided to try this therapy modality as an off‐label single treatment for LM or combined with surgery for LMM patients not amenable to large surgeries.…”

“…Thus, less invasive treatment modalities such as radiotherapy, topical imiquimod and laser therapies, alone or combined with surgical excision, are under evaluation. [5][6][7] Based on our previous experience on immunocryosurgery (cryotherapy plus imiquimod) as treatment of locoregional skin metastasis of melanoma 8 and other bibliographic references, 9,10 we decided to try this therapy modality as an offlabel single treatment for LM or combined with surgery for LMM patients not amenable to large surgeries.…”

Cryosurgery in a dermatology setup: a hospital based study

“…In a multricentric intralesional randomized trial cryotherapy was found to have higher efficacy than topical methyl aminolaevulinate-photodynamic therapy by Kaufmann et al [17]. A case series of loco-regional cutaneous metastasis of melanoma combination therapy of cryosurgery and imiquimod was found to be successful [18]. Cryotherapy as a useful procedure used for other dermatological indications in case series and case reports mentioned in the literature are Xanthelasma palpebrarum, dermatofibrosarcoma protuberans, Refractory cutaneous Rosa Dorfman disease, cutaneous sporotrichosis, and also in oral lesions in children [19][20].…”