Kryochirurgie in der Dermatologie

Abstract

This article provides information on the clinical development of skin reactions after cryosurgery/cryotherapy and the indications, complications and contraindications of skin cryosurgery. Successful skin cryosurgery requires rapid freezing and slow thawing, minimum tissue temperature of -25 to -60℃ and, in malignant lesions, repetition of the freeze-thaw cycle. Frozen tissue reacts with peripheral erythema immediately after thawing, followed by edema, bulla formation, exudation and mumification. Lesions usually heal with a fine atrophic scar after approximately 4 weeks. Nowadays, cryosurgery is considered the treatment of choice in hypertrophic scars and keloids, granuloma annulare, small capillary infantile hemangioma and isolated actinic keratoses. It is also a valuable alternative therapy for various other skin diseases, including common warts, solar lentigo, superficial basal cell carcinoma and Kaposi's sarcoma. Cryosurgery is a safe regimen with relatively few adverse effects and contraindications. Pain during and/or shortly after treatment, bulla formation and local edema are the major temporary adverse effects; lesional hypopigmentation and/or peripheral hyperpigmentation is the most common long-term complication.

Modern applications of cryosurgery in oncology

“…It shows a very good esthetic and the fi rst choice or an alternative option to conventional surgery [35]. Cryoenergy is an excellent energy source to combine with a single-shot device, resulting in an excellent safety profi le and good clinical results [36][37][38][39][40][41][42].…”

Management of keratinocyte carcinoma - Special considerations in the elderly

“…Scarring from cryotherapy may be more pronounced compared with topical chemotherapeutic regimens; if aggressively performed, cosmesis can be inferior to other treatment options (Bichakjian et al., 2017a). Cryotherapy can also lead to local cicatrizing alopecia when used on hair-bearing sites (Zouboulis, 2015).

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Keloidbehandlung mit intraläsionaler Kryochirurgie

“…In dieser Übersicht wurden die Möglichkeiten und auch die Grenzen dieser neuen Methode vorgestellt. Obwohl bereits eine gute Studienlage existiert [3], [4], [6], [7], [8], [9], [10], [12], [14], [15], [16], [17], [18], [19], [23], [24], [25], [26], [27], [28], [29], [30], ist die IC noch nicht in die Leistungen der gesetzlichen Versicherung aufgenommen.…”