Successful treatment of in‐transit melanoma metastases using topical 2‐4 dinitrochlorobenzene

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Abstract
A 78‐year‐old woman presented with multiple histologically proven in‐transit melanoma metastases involving the lower half of the left leg. Initial therapy with liquid nitrogen cryotherapy had some short‐lived success but was not tolerated by the patient. As further lesions began to develop, daily topical application of 2% 2‐4 dinitrochlorobenzene to the lesions was commenced. During the first 2 years of therapy a partial response was achieved, with treated lesions regressing while new lesions developed. Eventually a long‐term remission of almost 2 years with no clinical evidence of cutaneous melanoma deposits was achieved. This treatment did not prevent metastatic lymph node and ultimately fatal liver involvement. Topical immunotherapy can be a useful adjunct in the treatment of cutaneous melanoma metastases, particularly in those patients who are unable to tolerate other destructive modalities of therapy.