Superficial Basal Cell Carcinoma Research Articles

Jet-injection assisted photodynamic therapy for superficial and nodular basal cell carcinoma: A pilot study.

Photodynamic therapy (PDT) with topical δ-Aminolevulinic acid (ALA) has efficacy in treating basal cell carcinoma (BCC) but is limited by incomplete penetration of ALA into the deeper dermis. This prospective open-label pilot trial investigated the safety and efficacy of photosensitizer jet injection for PDT (JI-PDT) for BCC treatment. It was performed with 15 patients (n = 15) with histologically confirmed, untreated, low-risk nodular BCCs at a single institution. For the intervention, JI-PDT patients (n = 11) received two sessions of jet-injected ALA with PDT separated by four to 6 weeks. To further understand treatment technique, another group of patients (n = 4) received jet-injected ALA followed by tumor excision and fluorescence microscopy (JI-E). Treatment tolerability was assessed by local skin responses (LSR) score at five distinct time intervals. Fluorescence microscopy assessed protoporphyrin IX penetration depth and biodistribution within the tumor. At the primary endpoint, tumor clearance was evaluated via visual inspection, dermoscopy and reflectance confocal microscopy. Postinjection and postillumination pain levels, and patient satisfaction, were scored on a 0-10 scale. Fifteen participants with mean age of 58.3, who were 15/15 White, non-Hispanic enrolled. The median composite LSR score immediately after JI-PDT was 5(interquartile range [IQR] = 3) which decreased to 0.5 (IQR = 1) at primary endpoint (p < 0.01). Immunofluorescence of excised BCC tumors with jet-injected ALA showed photosensitizer penetration into papillary and reticular dermis. Of the 13 JI-PDT tumors, 11 had tumor clearance confirmed, 1 recurred, and 1 was lost to follow-up. 1/11 patients experienced a serious adverse event of cellulitis. 70% of patients had local scarring at 3 months. Patients reported an average pain level of 5.6 (standard deviation [SD] = 2.3) during jet injection and 3.7 (SD = 1.8) during light illumination. Jet injection of ALA for PDT treatment of nodular low-risk BCC is tolerable and feasible and may represent a novel modality to improve PDT.

Clinical versus Histological Assessment of Basal Cell Carcinoma Subtype and Thickness of Tumours Selected for Photodynamic Therapy.

Photodynamic therapy is an approved treatment for primary, superficial, and small nodular basal cell carcinomas with a thickness of < 2 mm located on low-risk sites. Histologically verified basal cell carcinomas clinically assessed as suited for photodynamic therapy were included. The study aimed to investigate the agreement between clinical and histological assessments of basal cell carcinoma subtypes and thickness of tumours selected for photodynamic therapy with histopathological evaluation as a reference. A total of 343 tumours were included. The agreement between clinical and histological diagnosis of basal cell carcinoma subtype was 72% (p < 0.001). Clinical assessment of subtype had a sensitivity of 93% and specificity of 55% for superficial tumours and a sensitivity of 55% and specificity of 85% for nodular tumours. The mean ± SD thickness values by clinical and histological assessments were 0.95 ± 0.53 and 0.86 ± 0.75. The difference of 0.09 mm was statistically significant (p = 0.017), but not considered to be clinically relevant, although the differences between specific subgroups could be relevant. Among basal cell carcinomas clinically diagnosed as superficial, 91% were histologically consistent with the current photodynamic therapy criteria. The main results suggest that histopathological evaluation should precede photodynamic therapy to ensure selection of suitable basal cell carcinomas. In selected cases, the clinical diagnosis alone may be adequate before proceeding with photodynamic therapy.

Cutaneous Superficial Basal Cell Carcinomais a Basal Cell Carcinoma In Situ: Electron Microscopy of a Case Series of Basal Cell Carcinomas.

Basal cell carcinoma (BCC) is the most common skin cancer. Skin cancers may present either as a non-invasive tumor or an invasive malignancy. The terminology of carcinoma in situ is used when the tumor is either just limited to epidermis or not present as single cells or nests in the dermis. However, currently the terminology superficial BCC is inappropriately used instead of BCC in situ when the skin cancer is limited to epidermis. In this study we compare the pathologic changes of superficial, nodular, and infiltrative BCCs using electron microscopy to identify the ultrastructural characteristics and validate the previously proposed terminology. Three cases of BCC (superficial BCC, nodular BCC, and infiltrative BCC) diagnosed by dermatopathologists at our institute were selected for review. Paraffin block tissues from these cases were sent for electron microscopy studies which demonstrated disruption of basal lamina in both nodular and infiltrative type of BCC, while it remains intact in BCC superficial type after extensive examination. Therefore, similar to other in situ skin cancers, there is no invasion of the neoplasm in superficial BCC into the dermis. Hence, the older term superficial BCC should be appropriately replaced with the newer terminology BCC in situ.

Treatment and follow-up of melanoma in situ in a geriatric patient that is a nonsurgical candidate

Background: The standard of care for melanoma in situ is a wide excision with at least 0.5 cm margins. These melanomas can be large in size, and some elderly patients are not good surgical candidates so alternative treatment options have been explored. Topical imiquimod is currently approved by the Federal Drug Administration for the treatment of actinic keratosis, external anogenital warts, and superficial basal cell carcinoma. In some patients, treatment with topical imiquimod for malignant melanoma in situ has been shown to be successful. Case report: A 97-year-old male patient presented to a dermatology office with a 4.5×4.0 cm malignant melanoma in situ. The patient was given treatment options of excision and radiation therapy but refused due to his advanced age and desire to avoid extensive surgery. The patient agreed to topical treatment with imiquimod cream 5 times weekly for 5 months. A post-treatment repeat biopsy showed no evidence of residual malignant melanoma in situ. Continued post-treatment follow-up at 3-month internals with pigmented lesion assay(s) and repeat biopsies showed no evidence of recurrence at 1 year. Conclusions: In geriatric patients with a large-sized melanoma in situ that are not good surgical candidates, treatment with topical imiquimod should be considered. Long-term follow-up with pigmented lesion assay(s) should be considered in these patients to help avoid biopsy fatigue, wound management, and complications from comorbidities.

Diagnostic Value of Dermoscopic Structures in Predicting Superficial Basal Cell Carcinoma in the Skin of Color.

Basal cell carcinoma (BCC) manifests different dermoscopic patterns in individuals with dark skin complexion compared to those with fair skin types. This study aimed to investigate the diagnostic utility of dermoscopy in discerning superficial BCC from other types of BCC, specifically in patients with dark skin complexion. This cross-sectional study focuses on patients diagnosed with BCC who were referred for skin biopsy between July 2020 and September 2022. Initially, the demographic characteristics of patients, clinical attributes of lesions, and pathological sub-types of BCC were documented. Subsequently, videodermoscopy was employed to capture comprehensive views and dermoscopic images of the lesions. Univariate logistic regression analysis was then utilized to assess the reliability of dermoscopic structures in distinguishing superficial BCC from other BCC types. Last, the study evaluated the sensitivity, specificity, positive predictive value, and negative predictive value of dermoscopy in the differentiation of superficial BCC from other BCC sub-types. The study enrolled 49 patients diagnosed with BCC, with a mean age of 66.22 ± 10.41 years. The most prevalent pathological sub-type observed was nodular (53.1%). Dermoscopy exhibited a higher specificity compared to the naked eye in the differentiation of superficial BCC from other types (55% vs. 35%, respectively). Univariate analysis revealed a significant association between spoke-wheel structures and superficial BCC (P = 0.02, odds ratio = 7.2, 95% confidence interval = 1.35-38.32). Dermoscopy exhibited superior specificity compared to the naked eye in differentiating superficial BCC from other BCC types. Notably, the spoke-wheel structure demonstrated the most robust correlation with superficial BCC.

Medicamentous Therapy of Malignant Eyelid Tumors

Although surgical therapy is often the first-line treatment for malignant eyelid tumors, pharmacological treatment approaches can also be included and pursued in the treatment plan. Narrative review with a selective literature search on PubMed and Google Scholar. Various pharmacological therapeutic principles are currently available. One option is the local application of agents within the tumor area. This can be achieved through cytostatically active drugs such as 5-fluorouracil for superficial basal cell carcinomas and precursors of squamous cell carcinomas, or through mitomycin C in specific cases of sebaceous gland carcinoma. Another form of pharmacological local therapy is local immunomodulation using Imiquimod for superficial basal cell carcinomas, actinic keratosis, and Bowen's disease. Furthermore, there are systemic pharmacological therapies like chemotherapies, for example in sebaceous cell carcinoma, or systemic immunomodulation using checkpoint inhibitors for example in basal cell carcinoma, squamous cell carcinoma, Merkel cell carcinoma, and melanoma. Additionally, targeted therapies offer yet another treatment modality that exploits the molecular biological characteristics of various tumor entities. Examples of this include Hedgehog inhibitors for basal cell carcinomas, EGFR inhibitors for squamous cell carcinomas, or BRAF inhibitors for melanomas. This review addresses these treatment options for malignant tumors of the eyelid and systematically organizes them for the reader. Even though the data on these eye tumors is still limited, the reported case studies using systemic therapies for malignant eyelid tumors demonstrate the potential of this treatment modality. However, the need for further research is high especially concerning the combination of different therapy principles for increasing the effectiveness of eyelid tumor therapy.

Imiquimod: Newer Perspectives to an Old Drug

Imiquimod is a topical age-old drug belonging to the imidazoquinolones class which acts by modulating the immune system. It has been approved by the US Food and Drug Administration for treating external genital and perianal warts, actinic keratoses and superficial basal cell carcinoma. Along with these, there have been a large number of diseases for which the drug has played a beneficial role with a good safety profile.

Efficacy of photodynamic therapy using ALAHCl in gel with a lipid nanoemulsion and MALHCl in cream in superficial basal cell carcinoma.

Photodynamic therapy (PDT) is a therapeutic option for low-risk basal cell carcinoma (BCC). The aim of the study was to assess the efficacy of topical PDT in the treatment of superficial BCC (sBCC) using two different photosensitizers: aminolevulinic acid hydrochloride (ALA-HCl) in a gel formulation with a lipid nanoemulsion (ALA-HCl in gel) and ALA methyl ester hydrochloride (MAL-HCl) in a cream formulation (MAL-HCl in cream). 21 patients were treated twice with a one week interval between treatments. The formulations were applied onto lesions: 10 patients were treated with MAL-HCl in cream, and 11 with ALA-HCl in gel. After three hours of incubation and removing the preparations, fluorescence was assessed. The skin areas were then irradiated with red light 630 ± 5 nm. At the follow-up visit 12 weeks after the second treatment, complete clinical remission was found in 82% after ALA-HCl in gel and in 80% after MAL-HCl in cream. An excellent cosmetic result was found in 96% of patients after MALHCl in cream and in 100% after ALA-HCl in gel. Faster skin healing and less post-inflammatory hyperpigmentation during follow-up visits was observed after treatment with ALA-HCl in gel. Both formulations - ALA-HCl in gel and MAL-HCl in cream - were highly effective photosensitisers for PDT. The advantage of ALA-HCl in a gel formulation with a lipid nanoemulsion was faster skin healing, resulting in better cosmetic results.

Initial clinical manifestations and early diagnosis of basal cell skin carcinoma

Background/Aim: Basal cell carcinoma (BCC) is the most common cancer of the skin. It is believed that increased UV radiation from the sun accounts for almost 90 % of the risk of BCC. There is a growing trend in the incidence of BCC in a younger population. The aim of study was to analyse the initial clinical symptoms of BCC that may be important for the early detection of this skin tumour. Method: The study was a prospective, multicentre study performed in the period from March 2017 to February 2022. A total of 69 respondents with BCC were analysed. Respondents applied for a targeted examination to examine a suspicious skin lesion (due to certain symptoms) or were diagnosed with BCC by accident, when examining other skin changes. Respondents were divided into 2 groups. The first, Group I (35 respondents), consisted of respondents with nodular BCC. The second, Group II (34 respondents), consisted of respondents with superficial spreading BCC. Initially, a careful history and data on the characteristics, shape and character of the tumour were taken from all respondents. Data on all (even the smallest) initial symptoms and relevant signs of evolution, as well as subjective problems related to the tumour were noted. All respondents underwent dermoscopy of suspected skin changes. Results: A significant difference was found between the examined groups in the characteristics of bleeding, crust formation and tendency to injury in lesions, where they occur more often in patients with nodular BCC. Symptoms such as burning and flaking occurred significantly more often in patients with superficial spreading BCC (p &lt; 0.01), as well as the diameter of lesions over 5 mm (p &lt; 0.05). Conclusion: Early clinical diagnosis of BCC is possible with a tumour diameter of only a few mm. The predominant initial (highly susceptible) symptoms of nodular BCC were initial bleeding and / or scab formation on the lesions, as well as propensity to injury. The superficial spreading form of BCC was often larger than 5 mm in diameter, with more frequent scaling of the lesion, as well as burning and stinging sensations in the tumour area. Itching was observed to be a very common previous occurrence in the BCC initial focus zone in subjects of both study groups. Dermsocopy is a highly reliable diagnostic method for early detection of BCC.

Superficial Basal Cell Carcinoma of the Nipple Masquerading as Paget&amp;rsquo;s Disease of the Breast

Superficial Basal Cell Carcinoma of the Nipple Masquerading as Paget&amp;rsquo;s Disease of the Breast

Incidence of malignant eyelid tumors: A 6-year period review (2015–2021)

Abstract Background: Basal cell carcinoma (BCC), the most common malignant tumor, accounts for 85%–95% of cases of eyelid malignant tumors. Demographic factors such as age, gender, tumor location, and subtype play a crucial role in epidemiological knowledge. We investigated eyelid BCC diagnosis and treatment at the Department of Ophthalmology in Centro Hospitalar de Setúbal (CHS). Methods: A retrospective study was conducted on patient cases with suspected eyelid epithelial tumors who underwent excisional biopsy surgery. The study included data from the CHS database between 2015 and 2021. Data collection and subsequent analysis were based on histopathological results. Results: In our study, were analyzed a total of 47 tumor cases, with 68.1% located on the lower eyelids and 31.9% on the upper eyelids. Among these cases, 25 (53.2%) were classified as benign, while 22 (46.8%) were identified as malignant eyelid tumors. BCCs accounted for 90.9% of all malignant cases, with an average age of 71.7 ± 16.6 years. The nodular subtype was the most prevalent, followed by infiltrative and superficial subtypes. Superficial BCC patients were older than infiltrative BCC patients (median age = 69.5 years vs. 61.5 years). BCC primarily affected the lower eyelids compared to the upper eyelid, and there was a slight female predominance (n = 11). All diagnosed BCCs correlated with sun-exposed regions. Conclusions: Timely intervention is crucial for reducing morbidity. These findings emphasize the need for improved registration and notification systems to enhance the prevention and treatment of eyelid BCCs. Furthermore, despite advancements in ultraviolet-blocking technologies, further development of sunscreen specifically formulated for ocular use remains necessary to reduce the incidence of eyelid tumors.

An Unusual Case of Mixed Superficial and Adenoid Basal Cell Carcinoma in a 57-year-old Filipino Female

Introduction: Basal cell carcinoma (BCC) is the most common cutaneous malignancy worldwide often occurring in sun-exposed areas. While the nodular variant accounts for the majority of cases, the adenoid type is extremely rare, comprising about 1.3% of all BCCs. Contrary to the typical presentation of BCC, adenoid BCC features a large sized lesion and a tendency to involve non-sun exposed areas such as the trunk. This case study presents a unique form of mixed superficial and adenoid BCC in a 57-year-old Filipino female. Case Report: A 57-year-old female presented with a 2-year history of a slowly enlarging bluish-black plaque with rolled borders on the left flank with noted bleeding, pain, and pruritus. Dermoscopy revealed arborizing vessels, leaf-like structures, blue gray globules, and white streaks, consistent with BCC. Histopathology showed a diagnosis of a superficial and adenoid type of BCC. Conclusion: Encounters with unusual forms of cutaneous carcinoma may arise in dermatologic practice. Dermoscopy serves as a powerful tool in identifying suspicious lesions and a pre-operative biopsy is done to correlate with the clinical diagnosis. Hence, the dermatologist will be able to decide the appropriate treatment option based on the clinical presentation and histopathologic type.

The effectiveness of using a combination of laser radiation with wavelengths of 585 nm and 1064 nm in the treatment of patients with basal cell skin cancer.

Background: Basal cell skin cancer is the most common skin malignancy, and its incidence has been rapidly increasing throughout the world in recent decades.&#x0D; Aims: To study the effectiveness of using laser radiation with a wavelength of 585 nm and 1064 nm in a sequential (sequential) combined mode for the treatment of patients with superficial and nodular forms of basal cell skin cancer using dermoscopic and confocal microscopic in vivo examination.&#x0D; Materials and methods: The study included 30 patients with histologically confirmed basal cell skin cancer, who received treatment in the conditions of the Consultative and Diagnostic Center of the State Research Center of Dermatovenereology and Cosmetology of Russian Ministry of Health in the period from 2020 to 2021, using a pulsed dye laser (wavelength 585 nm) and long-pulse neodymium laser (wavelength 1064 nm).&#x0D; Results: In the subgroup of patients with the nodular form of basal cell carcinoma (n=15): in 11 patients the duration of treatment was 1 procedure, in 3 patients 2 procedures, in 1 patient 3 procedures. In the subgroup of patients with superficial basal cell carcinoma (n=15 ): in 2 patients the course of treatment was 2 procedures, in 13 patients 1 procedure. Patients have now completed treatment and are being followed up with visits every 6 months for 3 years. According to dermoscopic and confocal microscopic studies, there is no evidence of continued growth and relapse in all patients. No side effects or adverse events were recorded.&#x0D; Conclusions: The combined sequential use of 585 nm and 1064 nm laser radiation may be an effective treatment for patients with low-risk basal cell skin cancer of recurrence. The results of our study indicate that clinical tumor removal without scarring can be achieved and may be an alternative treatment option for those who do not wish to use traditional surgical approaches.

Exploring multisite heterogeneity of human basal cell carcinoma proteome and transcriptome.

Basal cell carcinoma (BCC) is the most common type of skin cancer. Due to multiple, potential underlying molecular tumor aberrations, clinical treatment protocols are not well-defined. This study presents multisite molecular heterogeneity profiles of human BCC based on RNA and proteome profiling. Three areas from lesions excised from 9 patients were analyzed. The focus was gene expression profiles based on proteome and RNA measurements of intra-tumor heterogeneity from the same patient and inter-tumor heterogeneity in nodular, infiltrative, and superficial BCC tumor subtypes from different patients. We observed significant overlap in intra- and inter-tumor variability of proteome and RNA expression profiles, showing significant multisite heterogeneity of protein expression in the BCC tumors. Inter-subtype analysis has also identified unique proteins for each BCC subtype. This profiling leads to a deeper understanding of BCC molecular heterogeneity and potentially contributes to developing new sampling tools for personalized diagnostics therapeutic approaches to BCC.

Cryosurgery and 5-Fluorouracil Combination Therapy for Treatment of Bowen's Disease and Superficial Basal Cell Carcinoma.

Non-melanoma skin cancer (NMSC), which includes both Bowen's disease (BD) and superficial basal cell carcinoma (sBCC), is the most commonly diagnosed cancer in Canada. BD and sBCC are amenable to minimally invasive treatments however, large-scale studies assessing long-term outcomes are lacking, particularly regarding the timing and duration of non-invasive combination treatments. Examine the clinical cure rate of BD and sBCC using a combination treatment consisting of a single cycle of cryotherapy followed by a three to four-week course of topical 5-fluorouracil (5-FU). Retrospective chart review at a single center. Inclusion criteria included histology-proven sBCC or BD treated with either a combination protocol, cryosurgery, or 5-FU alone. 310 biopsy-confirmed cases of BD and 176 biopsy-confirmed cases of sBCC were analyzed. Of these, 229 cases of BD and 61 cases of sBCC were treated with cryosurgery and immediate 5-FU application, yielding a clearance rate of 90% and 86.9% at 6 months from initial treatment. Cryosurgery followed by immediate 5-FU use may be an effective mode of treatment for BD and sBCC, negating the need for invasive procedures and allowing for increased accessibility. Further studies with longer follow-up intervals, comparisons with other non-invasive treatments, and evidence of histologic cure are required. J Drugs Dermatol. 2023;22(12):1166-1171. doi:10.36849/JDD.7378.

Multiple aggregated yellow-white globules are a major dermoscopic sign of basal cell carcinoma regardless of their histological subtype.

Multiple aggregated yellow-white globules (MAY globules) have been recently described as dermoscopic structures of high specificity associated with high-risk non-pigmented basal cell carcinoma (BCC). To evaluate the diagnostic accuracy of MAY globules in a cohort of pigmented and non-pigmented BCC of all histological types. This was a retrospective case-control study. Dermoscopic and clinical images were all histopathologically confirmed as BCCs of patients seen consecutively at dermatology consultation. Control cases were benign or malignant tumours randomly selected from the database of 8,250 patients. A total of 389 BCCs were included. MAY globules were present in 192 (49%) cases in the BCC group and in only 25 cases in the control group (6,4%). The odds ratio for the diagnosis of BCC was 14.2 (95%CI: 9.62-20.95]). The presence of MAY globules was significant in three histological subtypes, including superficial BCCs. This study shows that MAY globules are a major dermoscopic sign for the diagnosis of BCC, regardless of their histological subtype and their pigmentation.

Superficial basal cell carcinoma treated with curettage followed by topical imiquimod cream: A retrospective study

Superficial basal cell carcinoma treated with curettage followed by topical imiquimod cream: A retrospective study

Recommendations for Cost-Conscious Treatment of Basal Cell Carcinoma.

Basal cell carcinoma (BCC) affects 3.3 million Americans annually. Treatment modalities for BCC include many surgical and nonsurgical options. The cost of BCC treatment can pose a substantial burden to patients and the healthcare system. Cost can be an important consideration in BCC treatment planning. We present an approach to the management of BCC when cost reduction is a priority. A PubMed literature search identified studies on effectiveness of current BCC therapies. Treatment prices were obtained from the Medicare National Fee Schedule, GoodRx, and pharmaceutical companies. The American Academy of Dermatology's (AAD) guidelines for treating BCC were used to develop recommendations for cost-reductive treatment. The cost of treating a primary superficial BCC < 0.5cm arising on Area M (cheeks, forehead, scalp, neck, jawline, pretibial surface) was $143 with curettage and electrodesiccation (C&E), $143 with cryosurgery, $210 with standard excision and simple reconstruction (SE), $1221 with Mohs Micrographic Surgery (MMS) and simple reconstruction, $472 with imiquimod, $186 with 5-fluorouracil (5-FU), and $354-$371 for photodynamic therapy (PDT). The cost of treating a primary nodular BCC 1.1-2cm arising on Area L (trunk and extremities, excluding pretibial surface, hands, feet, nail units and ankles) was $183 with C&E, $183 with cryosurgery, $251 with SE and simple reconstruction, $1163-1351 with MMS and simple reconstruction, $472 with imiquimod, $186 with 5-FU, and $354-$371 for photodynamic therapy (PDT). The cost of treating a giant BCC (BCC > 10cm with aggressive behavior) was $465-3311 with radiation, $139,560 with vismodegib, $144,452 with sonidegib, ~ $44.5 with cisplatin (medication cost only), and at least $184,836 with cemiplimab-rwlc. For a primary superficial BCC < 0.5cm arising on Area M, the cost-conscious algorithm prioritizes C&E or cryosurgery. For a primary nodular BCC 1.1-2cm arising on Area L, the cost-conscious algorithm prioritizes C&E, cryosurgery, or 5-FU. For a giant BCC, the cost-conscious algorithm identifies superficial radiation therapy as first line.

Rare Cutaneous Side Effects of Imiquimod: A Review on Its Mechanisms, Diagnosis, and Management.

As an immune-response modifier, imiquimod can bind to Toll-like receptors on immune cells and enhance innate and adaptive immune responses, exerting potential antitumor and antiviral effects, which led to its approval by the US Food and Drug Administration for the treatment of actinic keratosis, superficial basal cell carcinomas, and anogenital warts, and to its off-label use in treating many other benign and malignant dermatoses. Although topical administration of imiquimod has been considered well tolerated, an increasing number of cutaneous and noncutaneous side effects are being reported as its clinical applications expand. This review primarily focuses on rare cutaneous side effects. To the best of our knowledge, this is the first article to summarize the mechanism, diagnosis, and management of rare cutaneous side effects of imiquimod, which may help to heighten awareness among physicians, especially dermatologists, about potential imiquimod-induced cutaneous side effects.

D‐OCT‐assisted and histology‐controlled evaluation of 1064 nm Nd:YAG laser therapy of basal cell carcinomas

AbstractBackgroundBasal cell carcinomas (BCC) have classically been surgically removed. Alternative treatments for superficial BCC include local immunotherapy, topical chemotherapy and photodynamic therapy. Recent data suggest 1064 nm Nd:YAG laser as a new treatment for those lesions.Dynamic optical coherence tomography (D‐OCT) is an established imaging procedure analysing BCC margins and its vascular plexus.ObjectivesOur goal is to further evaluate 1064 nm Nd:YAG laser therapy of BCC as a potential alternative treatment, employing D‐OCT and histopathology to standardise effective treatment protocols.MethodsIn this retrospective cohort study, 50 histologically confirmed superficial and nodular BCC with tumour thickness ≤1 mm were treated with 1064 nm Nd:YAG laser. Initial D‐OCT scans were performed and repeated for 3 months posttreatment. Tumoral clearance was histologically confirmed and local adverse effects, patient tolerability and satisfaction were recorded. Clinical remission was evaluated after 1 year.ResultsComplete clearance was achieved in 78% of BCC (39/50) at a 3‐month follow‐up. Treatment failures were slightly more likely to correspond to superficial BCC (91%, 10/11) of thickness ≤0.5 mm (73%, 8/11), located on the trunk (64%, 7/11). No treated lesions presented scarring. Patient satisfaction and tolerability displayed excellent results. Remission at 1 year occurred in 100% of initially cleared BCC (35/35, four patients were lost to follow‐up due to nonmedical reasons).ConclusionsOCT‐assisted 1064 nm Nd:YAG laser treatment of superficial BCC is a safe and effective method with excellent patient satisfaction, tolerability, practicability and cosmetic end result.