TERAPIJA VEĆE LEZIJE LENTIGO MALIGNA I LENTIGO MALIGNI MELANOM U OKVIRU LEZIJE INCIZIONOM BIOPSIJOM I 5% IMIKVIMODOM
Sažetak
Lentigo maligni melanom (LMM) je invazivni melanom koji se najčešće javlja na glavi i vratu, čija se klinička dijagnoza, potpomognuta specifičnim dermoskopskim karakteristikama, potvrđuje biopsijom. Lečenje LMM podrazumeva eksciziju lezije, dok za njegovu prekursorsku leziju lentigo maligna (LM, poznata i kao Hačinsonova melanocitna pega) – melanoma in situ – postoje alternativni terapijski modaliteti, kao što je lokalna primena 5% imikvimod kreme. Naša bolesnica imala je leziju veličine 7 cm x 4 cm sa dermoskopskim karakteristikama LM i LMM. Bolesnica je odbila hirurško lečenje, zbog potencijalne deformacije estetski osetljive regije. Dijagnoza je postavljena patohistološkim pregledom materijala incizone biopsije. Lečena je 5% imikvimod kremom. Dermoskopija je pomogla u postavljanju kliničke dijagnoze, omogućila neinvazivno praćenje i prilagođavanje treapije radi postizanja zadovoljavajućeg rezultata – nestanak dermoskopskih karakteristika, koje sugerišu na LM i LMM i estetski zadovoljavajući rezultat.
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Bichakjian CK, Halpern AC, Johnson TM, Foote Hood A, Grichnik JM, Swetter SM, et al. American Academy of Dermatology. Guidelines of care for the mana-gement of primary cutaneous melanoma. American Academy of Dermatology. J Am Acad Dermatol. 2011;65(5):1032-47. [CrossRef] [PubMed]
Connolly KL, Nehal KS, Busam KJ. Lentigo maligna and lentigo maligna melanoma: contemporary issues in diagnosis and management. Melanoma Manag. 2015;2(2):171-8. [CrossRef] [PubMed]
Hamilko de Barros M, Conforti C, Giuffrida R, Seabra Resende FS, Di Meo N, Zalaudek I. Clinical usefulness of dermoscopy in the management of lentigo maligna melanoma treated with topical imiquimod: A case report. Dermatol Ther. 2019;32(5):e13048. [CrossRef] [PubMed]
Hemminki K, Zhang H, Czene K. Incidence trends and familial risks in invasive and in situ cutaneous mela-noma by sun-exposed body sites. Int J Cancer. 2003;104(6):764-71. [CrossRef] [PubMed]
Pralong P, Bathelier E, Dalle S, Poulalhon N, Debarbieux S, Thomas L. Dermoscopy of lentigo ma-ligna melanoma: report of 125 cases. Br J Dermatol. 2012;167(2):280-7. [CrossRef] [PubMed]
Read T, Noonan C, David M, Wagels M, Foote M, Schaider H, Soyer HP, Smithers BM. A systematic review of non-surgical treatments for lentigo maligna. J Eur Acad Dermatol Venereol. 2016 May;30(5):748-53. [CrossRef] [PubMed]
Tio D, van der Woude J, Prinsen CAC, Jansma EP, Hoekzema R, van Montfrans C. A systematic review on the role of imiquimod in lentigo maligna and lentigo maligna melanoma: need for standardization of treat-ment schedule and outcome measures. J Eur Acad Dermatol Venereol. 2017;31(4):616-24. [CrossRef] [PubMed]
Tiodorovic-Zivkovic D, Argenziano G, Lallas A, Thomas L, Ignjatovic A, Rabinovitz H, et al. Age, gender, and topography influence the clinical and dermoscopic appearance of lentigo maligna. J Am Acad Dermatol. 2015;72(5):801-8. [CrossRef] [PubMed]
Tiodorovic-Zivkovic D, Zalaudek I, Lallas A, Stratigos AJ, Piana S, Argenziano G. The importance of gray color as a dermoscopic clue in facial pigmented lesion evaluation: a case report. Dermatol Pract Concept. 2013;3(4):37-9. [CrossRef] [PubMed]
Tsay C, Kim S, Norwich-Cavanaugh A, Hsia HC, Narayan D. An Algorithm for the Management of Resi-dual Head and Neck Melanoma In Situ Using Topical Imiquimod: A Pilot Study. Ann Plast Surg. 2019;82(4S Suppl 3):S199-S201. [CrossRef] [PubMed]
Weinstock MA, Sober AJ. The risk of progression of lentigo maligna to lentigo maligna melanoma. Br J Dermatol. 1987;116(3):303-10. [CrossRef] [PubMed]