Successful Surgery of Multiple Recurrent Basal Cell Carcinomas Guided by Photodynamic Diagnosis

Abstract

We describe a 56-year-old Caucasian man with history of multiple regressed basal cell carcinomas. During the last 20 years approximately 200 histologically proven basal cell carcinomas preferentially localized on the face were surgically treated. Several large skin grafts were necessary to cover the extensive tissue defects on the face and scalp. Although all excised tissues were histologically proven to be basal cell carcinomas with tumor-free margins, new tumors developed in proximity to the skin graft margins. The dissemination of the new tumors made it difficult to perform additional invasive operation procedures without influencing the cosmetic result. Thus, we used photodynamic diagnosis to improve detection and demarcation of the neoplastic tissues. This procedure facilitated surgical planning and enabled primary in toto excisions. Surgical trauma and a number of interventions were thus minimized with the consequence of improved cosmetic and functional results.

Photodynamic Therapy for Acne Vulgaris With Topical 5-Aminolevulinic Acid

“…6 Therefore, PDT coupled with ALA is used not only for treatment but also for diagnosis. 6,8 This treatment is also effective for benign cutaneous disorders. 4,6,9 Concerning the influence of ALA-PDT on sebaceous glands and hair follicles, Divaris et al 3 reported an in vivo study in albino mice.…”

New developments in fluorescence diagnostics

“…While the emission spectrum of autofluorescence is in the green spectrum, the emission spectrum of ALA/MAL is in the red range. The advantage of the use of autofluorescence in cancer demarcation is that there is no need to apply exogenous substances, which may be time-consuming and potentially harmful [15,16,17,18].…”

Fluorescence guided PDT for optimization of the outcome of skin cancer treatment

“…This type of clinical application has been widely reported in literature [8][9][10]. This is possible because the photosensitizer molecules have higher affinity to cancer cells compared to normal cells.…”