Ultrapulse CO2 Used for the Successful Treatment of Basal Cell Carcinomas Found in Patients with Basal Cell Nevus Syndrome

Abstract

background. Basal cell nevus syndrome (BCNS) is an inherited condition marked by multiple basal cell carcinomas (BCCs) associated with several other abnormalities. Various treatment modalities have been used to eradicate these tumors. However, recurrences and scarring limit their use. objective. To evaluate the treatment of multiple BCCs associated with BCNS. methods. We describe three cases of BCNS in which multiple BCCs were effectively treated with ultrapulse CO 2 laser. Post-operative Mohs micrographic surgical sections (thin sections looking for residual tumor) verified complete histologic clearance of the tumors. results. All three patients were effectively treated with ultrapulse CO 2 laser. Minimal scarring was noted at follow-up. conclusion. Ultrapulse CO 2 laser can be used to effectively treat small BCCs in low-risk areas associated with BCNS with minimal posttreatment scarring.

Update of the European guidelines for basal cell carcinoma management

“…Therefore, it may be considered when a bleeding diathesis is present, as bleed-ing is unusual when this laser is used. However, the main disadvantage of this technique is the great variability in reported recurrence rates [100].…”

Guidelines for the management of basal cell carcinoma

“…When combined with curettage, CO 2 laser surgery may be useful in the treatment of large or multiple low‐risk sBCCs. In one small series, the Ultrapulse CO 2 laser appeared effective in treating small BCCs in low‐risk areas with minimal post‐treatment scarring in three patients with BCNS 127 …”

Basal Cell Carcinoma. Treatment with Carbon Dioxide Laser Vaporization

“…In With ablative lasers as carbon dioxide laser (Adams and Price 1979, Wheeland et al 1987, Fairhurst et al 1992, Grobbelaar et al 1997, Krunic et al 1998, Humpreys et al 1998, Horlock et al 2000, Nouri et al 2002, Campolmi et al 2002, Robinson et al 2003 and erbium:YAG laser (Smuckler et al 2008), the angiogenic component being a guide to the surgeon that indicates the elimination of the tumour, the lesion can be vaporized as deep as possible with the increase of the passes number. The ability to vaporize of carbon dioxide laser is higher than erbium:YAG laser and the majority of studies concerning the treatment of BCC with ablative lasers was performed with CO2 laser.…”

“…Several treatment options for basal cell carcinoma have been described including surgical excision (Walker et al 2006), curettage (Barlow et al 2006) and cautery (Spiller et al 1984), cryotherapy (Mallon et al 1996, Kokoszka 2003, radiotherapy (AlOthman 2001), photodynamic therapy (Star et al 2006, Chapas et al 2006, Brathen et al 2007, micrographic surgery (Bieley et al 1992, Rowe et al 1989), ablative laser (Goldman and Wilson 1964, MacGuff 1966, Goldman et al 1968, Adams and Price 1979, Wheeland et al 1987, Fairhurst et al 1992, Grobbelaar et al 1997, Krunic et al 1998, Humpreys et al 1998, Horlock et al 2000, Nouri et al 2002, Campolmi et al 2002, Robinson et al 2003, and Smuckler et al 2008, other laser systems (El-Tonsy et al 2004, Moskalik et al 2009, Allison et al 2003, Campolmi et al 2008, Shah et al 2009, Konnikov et al 2011, Ibrahimi et al 2011, topical treatment with 5-fluorouracil and immunomodulators, such as imiquimod (Kagy andAmonette 2000, Schulze et al 2005) and intralesional agents as interferon (Greenway et al 1986).…”