Nodular basal cell carcinoma: when in doubt, cut it out

Area of Science:

• Dermatology
• Oncology

Background:

• Superficial basal cell carcinomas (BCCs) can be treated with photodynamic therapy (PDT) or topical imiquimod, especially when excisional surgery is not feasible.
• These alternative treatments have been investigated for nodular BCCs, with recent studies providing more data on their effectiveness.

Discussion:

• While PDT and topical imiquimod show promise, treatment failure rates can be as high as 25%, indicating they are not as consistently effective as surgical excision for BCC.
• Despite higher failure rates, these non-surgical options appear to offer superior cosmetic outcomes compared to traditional surgical approaches.

Key Insights:

• Photodynamic therapy and topical imiquimod are viable alternatives for specific basal cell carcinoma cases.
• Efficacy of non-surgical BCC treatments is lower than surgery, with significant failure rates.
• Cosmetic results favor non-surgical treatments over excisional surgery for BCC.

Outlook:

• Further research may refine PDT and topical imiquimod protocols to improve efficacy for basal cell carcinoma.
• The balance between treatment efficacy and cosmetic outcome will guide clinical decisions for BCC management.
• Investigating combination therapies could enhance outcomes for nodular and superficial BCCs.