Periocular lentigo maligna successfully treated with immunocryosurgery

Oro‐Ayude, Marcos; González‐Sixto, B.; Faraldo‐Lorenzo, Jose Manuel; Feal, Carlos; Flórez, Ángeles

doi:10.1111/dth.14561

Cited by 6 publications

(6 citation statements)

References 8 publications

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“…This combination increases the inflammatory response and thus the likelihood of a complete response [ 94 ]. Different case reports and case series showed good clearance rates and functional/cosmetic results [ 24 , 43 , 48 , 95 , 96 , 97 , 98 ].…”

Section: Immunotherapy In Melanoma In Situmentioning

confidence: 99%

Section: Immunotherapy In Melanoma In Situmentioning

confidence: 99%

“…Liquid nitrogen reaches very low temperatures of up to −196 °C, which can cause significant local adverse effects [ 95 ]. In order to reduce local reactions in sensitive areas, Oro-Ayude et al described a different technique to treat two periocular LM using an ophthalmic cryosurgery system [ 95 ]. This system uses nitrous oxide, which has a freezing temperature of −89 °C, not as intense as that of liquid nitrogen, resulting in lower patient morbidity [ 95 ].…”

Section: Immunotherapy In Melanoma In Situmentioning

confidence: 99%

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Topical and Intralesional Immunotherapy for Melanoma In Situ: A Review

Martínez-Fernández,

González-Sixto,

Espasandín-Arias

et al. 2023

Cancers

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The incidence of in situ melanoma (MIS) has increased over the last decades. The mainstay of treatment for MIS, including lentigo maligna (LM), is complete surgical excision with clear margins (0.5 to 1.0 cm). Nevertheless, MIS lesions often affect elderly patients with comorbidities and involve large lesions in cosmetically sensitive areas, which means surgery is not always appropriate. Non-surgical treatments have a role in these cases, and include radiotherapy, cryosurgery, immunotherapy, laser therapy, and other topical medications. This study aims to review the applications of immunotherapy in MIS, either in monotherapy or in combination with other therapeutic alternatives. The main forms of immunotherapy used are imiquimod and, to a lesser extent, intralesional interferon-α (IL-INF-α) and ingenol mebutate (IM). IL-INF-α and IM have not been studied as extensively as imiquimod, whose results in real-life practice are encouraging. The clearance and recurrence rates reported in MIS treated with imiquimod as monotherapy, or as an adjuvant after surgery with affected or narrow margins, make imiquimod a reliable therapeutic alternative in selected cases. Also, its use as a neoadjuvant therapy before surgery was shown to reduce the final surgical defect size required to confirm negative histologic margins. In conclusion, local immunotherapy is frequently used in clinical practice and experience confirms it to be an excellent option for certain patients.

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Section: Immunotherapy In Melanoma In Situmentioning

confidence: 99%

Section: Immunotherapy In Melanoma In Situmentioning

confidence: 99%

Section: Immunotherapy In Melanoma In Situmentioning

confidence: 99%

See 1 more Smart Citation

Topical and Intralesional Immunotherapy for Melanoma In Situ: A Review

Martínez-Fernández,

González-Sixto,

Espasandín-Arias

et al. 2023

Cancers

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“…Notably, the first case report of the clinical use of immunocryosurgery was a case of lentigo maligna [1]. Additional cases with successful eradication of this in situ melanoma have followed [9], including a case of periocular lentigo maligna [40]. As with immunocryosurgery, for keratinocytic skin cancers, an adequate amount of inflammatory response is typical for the successful eradication of lentigo maligna; this can be achieved with repeated cryosurgery sessions during continuing imiquimod application, as required [41].…”

Section: Non Keratinocytic Skin Cancers 421 Lentigo Maligna and Malignant Melanomamentioning

confidence: 99%

A Review of Immunocryosurgery and a Practical Guide to Its Applications

Gaitanis

Bassukas

2021

Diseases

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Immunocryosurgery is a minimally invasive combinational therapeutic procedure that has been designed, developed, and evaluated in the Dermatology Department of the University of Ioannina from 2004. In a fixed time protocol, this approach combines immune stimulatory therapy with imiquimod and cryosurgery, i.e., cryosurgery is applied during continuous imiquimod treatment. Laboratory findings in tissue and blood level credit the efficacy to the synergy of imiquimod and cryosurgery. The synergy has been established through clinical trials and the excellent feasibility and efficacy demonstrated in clinical practice. Immunocryosurgery has extensive proof of excellent efficacy, comparable to surgery, in the treatment of basal cell carcinoma. It has also been evaluated in cases of Bowen’s disease, keratoacanthoma, Merkel cell carcinoma, lentigo maligna, and cutaneous squamous cell carcinoma with or without the addition of adjuvants. The aims of this review are to detail the immunocryosurgery protocol with the addition of daily practice clinical tips, compile data on the mechanism of action of immunocryosurgery, and delineate indications and possible future applications. Most of the available data originate from the treatment of BCC, of all histological types and localizations, and the principles reported mainly reflect on evidence related to the treatment of this common skin cancer.

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“…Corresponding alterations in the profile of cytokines and immune cells in the blood reflect this induction of immunoenhancing effects during the local treatment of BCC [ 8 ]. Due to its satisfactory feasibility including the treatment of older and frail patients and the excellent safety profile, immunocryosurgery is gaining recognition and is used in the outpatient setting in addition to the treatment of BCC and Bowen’s disease in immunocompetent and immunocompromised patients [ 9 , 10 , 11 ] as well as in the therapy of selected cases of lentigo maligna [ 12 , 13 ], Merkel cell carcinoma [ 14 ], and squamous cell carcinoma [ 15 ]. Of note, immunocryosurgery is a tissue sparing modality whose efficacy is not really limited by the tumors’ localization, tumor histology, or patients’ overall health condition [ 1 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

The Feasibility of Immunocryosurgery in the Treatment of Non-Superficial, Facial Basal Cell Carcinoma That Relapsed after Standard Surgical Excision: An Experience Report from Two Centers

et al. 2022

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In this retrospective, chart review study, we evaluated the feasibility of immunocryosurgery in facial, non-superficial basal cell carcinomas (BCC) that had relapsed after standard surgery. Inclusion criteria were (a) ‘biopsy confirmed relapse of facial BCC’, (b) known ‘calendar year of surgical excision(s)’, and (c) ‘relapse within 10 years after the last surgical excision’. Tumors treated from 1 January 2011 to 31 December 2020 with a standard 5-week immunocryosurgery cycle (daily imiquimod application for 5 weeks and a cryosurgery session at day 14) were included. Descriptive statistics, Kaplan–Meier method, and Cox proportional hazards model were calculated with significance at p < 0.05. From the n = 27 BCC evaluated, n = 20 (74.1 ± 8.4%) cleared after one immunocryosurgery cycle. Two of the remaining cases cleared completely after a repeat cycle, one patient favored surgery, and four BCC did not clear despite additional immunocryosurgery cycles (feasibility 81.5 ± 7.5%). Of the 22 tumors with clinical outcome ‘complete clearance with immunocryosurgery’, three BCC relapsed at 9, 28, and 50 months. Overall, the 5–year treatment efficacy rate was 60.2 ± 13.4% (mean follow-up 94.6 ± 15.1 months). In total, 20/27 BCC relapses after surgery (74.1%) were tumor-free at the end of personalized follow-up times (66.7 ± 12.4% tumor free patients at 5-year follow-up). Number of tumor relapses before immunocryosurgery was the single predictor of tumor progression after immunocryosurgery (p = 0.012). Conclusively, immunocryosurgery could be further evaluated as an alternative, definitive treatment of selected facial BCC relapsing after surgery.

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Periocular lentigo maligna successfully treated with immunocryosurgery

Cited by 6 publications

References 8 publications

Topical and Intralesional Immunotherapy for Melanoma In Situ: A Review

Topical and Intralesional Immunotherapy for Melanoma In Situ: A Review

A Review of Immunocryosurgery and a Practical Guide to Its Applications

The Feasibility of Immunocryosurgery in the Treatment of Non-Superficial, Facial Basal Cell Carcinoma That Relapsed after Standard Surgical Excision: An Experience Report from Two Centers

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