Office-based treatment of basal cell carcinoma with immunocryosurgery: feasibility and efficacy.

INTRODUCTION: Minimally invasive, non-surgical, office-based modalities are a welcome alternative to surgery for basal cell carcinoma(BCC). This study evaluates the treatment of BCC with immunocryosurgery (cryosurgery during topical imiquimod) in a dermatology office setting.

METHODS: Response of BCC to immunocryosurgery (daily imiquimod for 5 weeks and a liquid N2 cryosurgery session at the end of the 2nd week) was evaluated according to treatment feasibility, tumor clearance, and relapse.

RESULTS: Twenty-four patients with a total of 36 BCC (four relapses after cryosurgery or surgery) were recruited and all finished treatment (follow-up: 2-24 months). One month after the end of treatment, 30/36 sites were clinically cured. In five cases, a repeat cryosurgery at this time led to clinical cure (one patient refused cryosurgery; overall cure rate: 97.2%). Two relapses occurred after 12 and 14 months follow-up, which were successfully treated with immunosurgery and cryosurgery, respectively. Adverse effects included hypopigmentation, redness persisting for up to 3 months after treatment, superficial scarring that improved with time, and worry during treatment because of skin irritation (resolved with a phone discussion in all cases).

CONCLUSION: Immunocryosurgery is a feasible and efficacious procedure that can be performed at a dermatology office for the treatment of primary and relapsed BCC.