{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T22:50:33Z","timestamp":1773960633182,"version":"3.50.1"},"reference-count":10,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,7,25]],"date-time":"2020-07-25T00:00:00Z","timestamp":1595635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In recent years, there has been an ongoing interest in topical treatment for lentigo maligna (LM) as imiquimod 5% cream owing to the localization of this tumor and the advanced age of patients; however, the efficacy of imiquimod 5% cream is controversial, and the rate of local relapses is about 25\u201353%. Reflectance confocal microscopy (RCM) is a noninvasive diagnostic tool useful not only for diagnostic purpose but also for monitoring the response to the local treatment of LM. Our aim was to demonstrate the role of RCM in the follow\u2010up of a topical treatment with imiquimod 5% cream in clinical practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We report three patients with histopathologically confirmed LM who were not candidates for surgery and were successfully treated with imiquimod 5% cream. In such patients, dermatoscopic images and reflectance confocal microscopy were useful to evaluate treatment response and to verify long\u2010term clinical benefits during the follow\u2010up visits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No relapses were observed in our patients 18 months after the end of treatment; although, continuous follow\u2010up visits are needed in these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In the case series presented herein, we highlight the importance of RCM as a noninvasive tool to monitor the efficacy of imiquimod to treat LM during and after treatment. Detailed confocal images of two of our patients allowed us to establish the persistence of atypical cells and to continue treatment, although clinical and dermatoscopic examinations showed \u201capparent complete remission\u201d after the first cycle of therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijd.15070","type":"journal-article","created":{"date-parts":[[2020,7,25]],"date-time":"2020-07-25T11:11:43Z","timestamp":1595675503000},"page":"196-200","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Reflectance confocal microscopy and its role in the follow\u2010up of a topical treatment for lentigo maligna"],"prefix":"10.1111","volume":"60","author":[{"given":"Valeria","family":"Coco","sequence":"first","affiliation":[{"name":"Institute of Dermatology Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"},{"name":"Fondazione Policlinico Universitario A. Gemelli \u2010 IRCCS Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Perino","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario A. Gemelli \u2010 IRCCS Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Di Stefani","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario A. Gemelli \u2010 IRCCS Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Cappilli","sequence":"additional","affiliation":[{"name":"Institute of Dermatology Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ketty","family":"Peris","sequence":"additional","affiliation":[{"name":"Institute of Dermatology Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"},{"name":"Fondazione Policlinico Universitario A. Gemelli \u2010 IRCCS Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,7,25]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.5826\/dpc.0904a08"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2011.02042.x"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14085"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2015.02.008"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/hupa.2000.7640"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1054\/bjps.2002.3967"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2018.0531"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2018.0530"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2007.34031.x"},{"key":"e_1_2_5_11_1","first-page":"e12757","article-title":"Imiquimod 5% cream in occlusion, for the treatment of lentigo maligna: a new scheme of short cycles and the need for clinical trials","author":"Astorino S","year":"2018","journal-title":"Dermatol Ther"}],"container-title":["International Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.15070","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ijd.15070","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.15070","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T19:10:10Z","timestamp":1693422610000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijd.15070"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,25]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1111\/ijd.15070"],"URL":"https:\/\/doi.org\/10.1111\/ijd.15070","archive":["Portico"],"relation":{},"ISSN":["0011-9059","1365-4632"],"issn-type":[{"value":"0011-9059","type":"print"},{"value":"1365-4632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,25]]},"assertion":[{"value":"2020-04-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}