Management of vulval melanoma in situ with imiquimod

Abstract

A 75 year old lady presented to her local hospital with vulval pigmentation that she noticed six months previously. She was generally in good health with a past medical history of hypertension, migraine and hypercholesterolemia treated with Indapamide, Simvastatin, Aspirin and Amitryptyline. On examination, there was an extensive area of pigmentation affecting both labia minora and the right labium majus. The pigmentation did not extend into the vagina or the urethral orifice. A punch biopsy from the left labium minus confirmed melanoma in situ, and wide local excision was recommended. Therefore, both labia minora were excised and histology showed melanoma in situ extending to the peripheral margins.

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