Basal Cell Carcinoma. Treatment with Carbon Dioxide Laser Vaporization

Jesús Del Pozo,Laura Rosende

doi:10.5171/2013.442049

Abstract

Background: Basal cell carcinoma (BCC) is the most common malignant epidermal tumor of the skin. Several treatment options for BCC have been described including ablative and other laser systems. Objectives : To evaluate the efficacy of carbon dioxide (CO2) laser vaporization in the treatment of superficial and nodular BCC. Method of treatment : All treatments were performed with local anaesthesia. In the first pass, superpulsed and focused mode, with a power density of 5 to 10 W/cm2, to eliminate the superficial layer was used. When the necrotic debris was eliminated a flaming red surface appeared with central bleeding surrounded by a pink peripheral area that corresponds to unaffected skin. In the next passes, this area must disappear. Results: In all patients BCCs are adequately removed after treatment. After a year of follow-up no recurrences were observed. Our patients presented three secondary effects: persistent and transitory erythema, hypopigmented areas and textural alterations. Discussion: CO2 vaporization shows some advantages in the treatment of BCC, in patients with numerous and large lesions, it had a highly precise and confined tissue damage. The treatment offers a virtually bloodless intraoperative field, the postoperative evolution by a minimal postoperative pain and it is easy to repeat the treatment if necessary. Conclusion: “97% long-term cure rate in patients with BCC treated with the CO2 laser can be achieved.” Although surgical excision remains the treatment of choice for basal cell carcinoma, CO2 laser ablation offers many advantages in specific situations.”

Highlights

Basal cell carcinoma (BCC) is the most common malignant epidermal tumour of the skin that’s derived from the basal layer of the epidermis
This paper presents some cases of BCC treated with CO2 laser vaporization in order to illustrate this treatment modality
With non-ablative lasers as pulsed dye laser (Allison et al 2003, Campolmi et al 2008, Shah et al 2009, Konnikov et al 2011), Nd:YAG laser (El-Tonsy et al 2004, Moskalik et al 2009) and alexandrite laser (Ibrahimi et al 2011), the treatment of BCC is based on the angiogenic component presented in this tumour

Summary

Introduction

Basal cell carcinoma (BCC) is the most common malignant epidermal tumour of the skin that’s derived from the basal layer of the epidermis. The tumour infiltrates tissues in a three-dimensional fashion (Braun et al 2005) usually with a slow growing, and metastases are extremely rare (Lo et al 1991). BCCs vary greatly in appearance and several clinical types had been described including nodular, cystic, superficial, sclerosing, keratotic, and pigmented. Dermatologists usually perform clinical diagnosis of BCC. Biopsy is indicated when clinical doubt exists or when the histological subtype of BCC may influence treatment selection and prognosis (Telfer et al 2008). Basal cell carcinoma (BCC) is the most common malignant epidermal tumor of the skin. Several treatment options for BCC have been described including ablative and other laser systems

Objectives

Methods

Results

Conclusion