Cryosurgery in dermatology

The aim of this article is to provide current information on the clinical development of cutaneous cryoreaction and the indications, complications and contraindications of cutaneous cryosurgery. Successful cutaneous cryosurgery requires rapid freezing and slow thawing, minimum tissue temperatures of -25 degrees C to -60 degrees C and, in malignant lesions, repeated freeze-thaw cycles. Frozen tissue reacts with peripheral erythema immediately following thawing, and consequently with oedema, bulla formation, exudation, mummification, and usually heals with a fine atrophic scar within a 4-week period. Cryosurgery is now considered the treatment of choice in hypertrophic scars and keloids, granuloma annulare and capillary haemangioma of the newborn. It also represents a valuable alternative therapy for various skin diseases, including common warts, solar lentigo, actinic keratoses, superficial basal cell carcinoma and Kaposi's sarcoma. Cryosurgery is a safe regimen with only a few adverse effects and contraindications. Pain during and/or shortly after treatment, bulla formation and local oedema are the major, temporary adverse effects; lesional hypopigmentation and/or peripheral hyperpigmentation is the most common by occurring long-term complication.