Nonsurgical Options for the Treatment of Basal Cell Carcinoma

Abstract

Objectives: The aim of this review article is to summarize the effectiveness, potential adverse events, and indications of the main nonsurgical treatment alternatives for basal cell carcinoma.
 Methods: An extensive literature review was carried out. The most relevant articles were discussed and selected by the authors in order to provide a brief but evidence-based overview of the most common nonsurgical methods used for treating basal cell carcinoma.
 Results: Although surgery and Mohs micrographic surgery are often considered the optimal treatment options for basal cell carcinoma, these tumors can also be treated successfully with destructive techniques (eg, curettage alone, cryosurgery, or electrodesiccation), photodynamic therapy, topical drugs (eg, 5-fluorouracil, imiquimod, or ingenol mebutate), radiotherapy, or hedgehog pathway inhibitors. When choosing between these alternatives, physicians must take into consideration the tumor’s size, location, and histopathological subtype. Special care should be taken when treating recurrent tumors. Furthermore, physician experience is of great importance when using destructive techniques. Finally, patient preference, potential adverse events, and cosmetic outcome should also be considered.
 Conclusions: Dermatologists and physicians treating basal cell carcinoma should have knowledge of and experience with the large arsenal of therapeutic alternatives available for the successful, safe, and individualized management of patients with basal cell carcinoma.

What We Need to Learn When Exploring the Mixed Basal Cell Carcinoma of Head and Neck

“…There are various methods of treating BCCs, ranging from minimally invasive methods to surgical therapy, in which the histopathological findings of the tumour is one of the most determining factors in choosing an appropriate treatment method (Drucker et al, 2018). The specialists involved in the diagnostics and treatment of BCC should be aware of the successful and safe management of patients due to frequent recurrence, even in the case of a complete primary surgical removal of the tumour (Paoli et al, 2019).…”

Prospective Clinical Trial Comparing Curettage and Cryosurgery to Curettage and Electrodesiccation in the Management of Minimally Invasive Basal and Squamous Cell Carcinomas

“…This cure rate for the curettage and cryosurgery procedure is consistent with the results of 3 prospective studies with a similar protocol reporting clearance rates of more than 98% for basal cell carcinomas with this technique. 12 Another study has also established a 99% 5-year recurrence-free endpoint with C&C for minimally invasive carcinomas, including the squamous cell type. 10 The only recurrence in the C&C group of our study occurred in a 98-year-old woman who had a histopathological diagnosis of nodular and infiltrative basal cell carcinoma on the temple.…”

Imiquimod does not elicit inflammatory responses in the skin of the naked mole rat (Heterocephalus glaber)

“…Imiquimod (IMQ) is a toll-like receptor (TLR) 7 and 8 agonist used topically to treat external genital and perianal warts caused by human papilloma virus, actinic keratosis and superficial basal cell carcinomas and potential to treat many other skin disorders [18][19][20][21][22][23][24][25][26]. Through activation of its receptors, IMQ application, even on a short-term basis, triggers inflammatory skin reactions that closely resemble those seen in psoriasis [27][28][29][30].…”