In what clinical scenarios do you consider pre- or post-treatment with Imiquimod for cutaneous melanoma?  

In short, never. I can think of hypothetical situations but in reality I've never done it. I do Mohs for melanoma on the head and neck so no need for adjuvant imiquimod ("out is out"). For melanomas of trunk or extremities, I use WLE. In the rare case of positive margins after excision, I would then...