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Immunocryosurgery - an effective combinational modality for Bowen's disease.

Georgios Gaitanis¹, Ioannis D Bassukas²

¹Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.

Dermatologic Therapy

|June 9, 2016

Summary

This study shows immunocryosurgery, combining topical imiquimod and cryosurgery, is a highly effective treatment for Bowen's disease (BD). This minimally invasive approach achieved a 91.7% remission rate in patients with various lesion sizes.

Keywords:

Bowen's disease cryosurgery imiquimod immunocryosurgery

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Area of Science:

Dermatology
Surgical Oncology
Cutaneous Oncology

Background:

Bowen's disease (BD) is a common intraepidermal squamous cell carcinoma.
Standard treatments include topical imiquimod and cryosurgery, but novel approaches are explored for efficacy and patient outcomes.

Purpose of the Study:

To evaluate the efficacy and outcomes of a standardized immunocryosurgery protocol for treating Bowen's disease.
To assess the feasibility and cosmetic results of this combined therapeutic approach.

Main Methods:

A retrospective single-center study involving 21 patients with 24 Bowen's disease lesions treated between 2009 and 2014.
Treatment involved daily topical imiquimod 5% cream application with a 5 mm rim for 5-week cycles.
Cryosurgery (liquid nitrogen, open spray, 2 cycles of 15 seconds each) was administered bi-weekly within each cycle.

Main Results:

Complete clearance was achieved in 100% of lesions after one or two cycles of immunocryosurgery.
Lesions <80 mm diameter cleared after one cycle; larger lesions (100-200 mm) required two cycles.
Sustained complete remission was observed in 91.7% (22/24 lesions) after a median follow-up of 24 months.

Conclusions:

Standardized immunocryosurgery is a feasible, highly efficacious, and minimally invasive treatment option for Bowen's disease.
The treatment demonstrates excellent long-term remission rates and satisfactory cosmetic outcomes, even for extensive lesions.