Successful treatment of malignant melanoma in situ with topical 5% imiquimod cream

Background Current treatment recommendations for malignant melanoma in situ include surgical excision with at least 0.5 cm margins. On the head or neck, obtaining adequate surgical margins for melanoma can be challenging and often disfiguring. In addition, some elderly patients may not be good surgical candidates and may request less aggressive interventions. Methods We report herein three cases of malignant melanoma in situ on the face treated with topical imiquimod cream. Results Complete regression of malignant melanoma in situ was observed on treatment with 5% topical imiquimod cream. The varied treatment regimens, rationale for using imiquimod rather than performing surgery, and the possible mechanisms of action are discussed. Conclusions Topical imiquimod can be used successfully for the treatment of malignant melanoma in situ on the face.