Supplementary Material for: Non-Surgical Treatment of Lentigo Maligna with Imiquimod and Cryotherapy: A Case Report

Lentigo maligna (LM) is a melanoma in situ caused by prolonged UV radiation exposure, typically affecting
the head and neck. It has a potential progression to invasive lentigo maligna melanoma in approximately
5% of cases. We report the case of a 92-year-old female with a history of non-melanoma skin cancer who
presented with an atypical pigmented lesion on her left zygomatic area. The lesion measured 7.0 x 7.0 cm
and exhibited distinct dermoscopic features. The lesion was diagnosed as early-evolving LM through a skin
biopsy. Given the patient’s age and preference to avoid surgery, imiquimod 5% cream was applied topically
for 16 weeks, leading to a significant reduction in lesion size. Subsequent cryotherapy was performed,
further reducing the lesion. At the 6-month follow-up, the lesion had resolved completely both clinically
and histopathologically. This case demonstrates the efficacy of imiquimod combined with cryotherapy as
a non-surgical treatment option for LM, particularly for patients who are poor surgical candidates. This
approach offers a viable alternative to surgery with minimal side effects and highlights the necessity of
vigilant monitoring for recurrence.