Evidence map›Paper›PMID 41004090›Full record

ReviewDermatology and therapy2025

Long-Term Outcomes of Topical 5% Imiquimod Treatment for Lentigo Maligna: A Systematic Review.

Pablo Balado-Simó, Marc Hernández-Santacana, Daniel Morgado-Carrasco

Abstract readReview
In one paragraph

Review in Dermatology and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Pablo Balado-SimóDermatology Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Villarroel 170, 0836, Barcelona, Spain.
Marc Hernández-SantacanaDermatology Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Villarroel 170, 0836, Barcelona, Spain.
Daniel Morgado-CarrascoDermatology Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Villarroel 170, 0836, Barcelona, Spain. morgadodaniel8@gmail.com.ORCID http://orcid.org/0000-0002-4704-6132

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionLentigo maligna (LM) is a melanoma in situ frequently located on sun-exposed areas. While surgery is the standard of care, topical 5% imiquimod has emerged as a non-invasive alternative for patients unsuitable for surgery. However, existing literature often lacks long-term follow-up. This systematic review aims to assess the long-term effectiveness and safety of imiquimod in LM, focusing on studies with ≥ 48 months of follow-up.

methodsA comprehensive search was conducted in MEDLINE (PubMed) and the Cochrane Library up to July 2025. Inclusion criteria comprised original studies reporting on LM treated with 5% imiquimod with ≥ 48 months of follow-up.

resultsSix studies (422 patients) met the inclusion criteria: one prospective and five retrospective studies. Median follow-up ranged from 49 to 205 months. Clinical clearance rates varied between 63.6% and 97.1%, with recurrence rates ranging from 0% to 20.7%. Histological clearance was inconsistently confirmed. Progression to lentigo maligna melanoma (LMM) was infrequent (9/422). One retrospective study (n = 111) reported melanoma-specific survival at 10 years as 100% (95% CI 90.5-100%). The presence of a robust local inflammatory response was consistently associated with improved outcomes. Adverse effects were mostly mild and self-limiting. Overall evidence certainty was moderate to low. DISCUSSION: This review provides evidence that 5% imiquimod may offer durable responses for LM, particularly in patients who develop a marked inflammatory reaction. Nevertheless, recurrence and occasional progression to LMM underscore the need for long-term monitoring, ideally combining clinical, dermoscopic and histological assessment. Lack of standardized treatment protocols and heterogeneous definitions of response limit comparability between studies.

conclusionTopical 5% imiquimod may be a viable long-term treatment option for selected patients with LM, although the evidence is scarce and mostly of low quality. A strong local inflammatory response appears predictive of clinical success. Given the potential for late recurrence and risk of progression to LMM, long-term structured follow-up is essential. Future prospective studies with uniform protocols are warranted.

Indexed as

ImiquimodLentigo malignaMortalityRecurrenceSurvival

Identifiers

PMID41004090
PMCPMC12619878

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.