Sixty something year old female with moderate to severe atypical melanocytic lesion of the left cheek s/p excision with residual atypical melanocytes at the margins. Review of her pathology revealed the lesion to be a melanoma in-situ. Option of additional excision with or without Mohs guidance was discussed. Alternatively, Aldara applied over 2-3 months can be an excellent alternative.
Longest follow-up of Aldara in a study has been a medium of 3 years. Clinical clearance was achieved in 90%. However, histologic recurrence occurred in 50% of patients 1-2 years later. Follow-up biopsies are critical in these patients after the treatment course.
References on Long-Term Follow-Up: Lentigo Maligna Dx and Treatment – McKenna, Dermatologic Surgery 2006.pdf