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Recurrent basal cell carcinoma following ablative laser procedures
Do-Sang Jung1, Hyun-Ho Cho, Hyun-Chang Ko
1Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.
Journal of the American Academy of Dermatology
|March 19, 2011
Summary
Basal cell carcinoma (BCC) developing after laser ablation of undiagnosed lesions showed a longer diagnosis interval and more aggressive features. These post-laser BCCs required more complex surgical excisions compared to primary BCCs.
Area of Science:
- Dermatology
- Oncology
- Surgical Pathology
Background:
- Basal cell carcinoma (BCC) is frequently diagnosed in Korean patients with prior laser ablations of undiagnosed skin lesions.
- Laser treatments for undiagnosed lesions may precede the development of BCC.
Purpose of the Study:
- To compare the clinical, pathological, and surgical characteristics of BCC that develops after laser ablation (post-laser BCC) with primary BCC.
- To evaluate the implications of prior laser treatment on BCC development and management.
Main Methods:
- A retrospective study of 359 patients with 373 BCC lesions treated with Mohs micrographic surgery (MMS) between 1998 and 2008.
- BCC lesions were categorized into post-laser BCC and primary BCC based on treatment history.
- Data analyzed included clinical photographs, pathology slides, and MMS records.
Main Results:
- 15.5% (58/373) of BCCs were classified as post-laser BCC.
- Post-laser BCC patients were younger and had a significantly longer disease interval to diagnosis (7.18 vs. 3.33 years).
- Post-laser BCC exhibited a higher frequency of the micronodular pattern and required more MMS stages for complete excision.
Conclusions:
- BCC developing after laser ablation presents with a longer diagnostic delay and more aggressive histological features.
- Post-laser BCC necessitates more extensive surgical intervention during Mohs micrographic surgery.
- The carbon dioxide laser is suspected as the likely modality used in most post-laser BCC cases, though not definitively identified.
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