Nodular basal cell carcinoma: when in doubt, cut it out.

Treating superficial basal cell carcinomas (BCCs) with photodynamic therapy or topical imiquimod can provide effective results in situations where an excisional approach is contraindicated or undesirable. Numerous studies have sought to test these treatments for nodular BCCs. Recent larger studies better define the efficacy of these alternative modalities. With treatment failures expected in at least 25% of patients, these approaches are not comparable to surgery. At the same time, it appears that cosmetic outcomes are superior to excisional approaches.