Second-intention healing combined with aminolaevulinic acid photodynamic therapy in the treatment of periocular basal cell carcinoma.

Abstract

Background: Basal cell carcinoma (BCC) is the most common skin cancer. Recently, aminolaevulinic acid photodynamic therapy (ALA-PDT) has emerged as a noninvasive treatment for facial lesions.

Objectives: To evaluate the efficacy and safety of second-intention healing after tumour excision with ALA-PDT in periocular BCC.

Methods: In total, 16 patients with periocular BCC from an academic, large, metropolitan-based hospital were included in this study. All the patients received marginal resection combined with topical ALA-PDT. No suture was performed, and ALA-PDT treatments (three to six times) were applied to each patient with 633-nm red light directly after surgical resection. Patient demographics, images, medication and prognosis were evaluated and recorded. Patient Satisfaction Questionnaire (PSQ) scores were recorded, consisting of overall satisfaction with the medical experience (scored 0-10) and cosmetic outcome (scored 0-10).

Results: Ten women and six men aged 33-84 years with periocular BCC were included. Subtypes of periocular BCC were nodular (8 of 16), infiltrative (2 of 16), nodular cystic (2 of 16), ulcerative (1 of 16) and unknown (3 of 16). All patients completed the treatment and had good overall satisfaction with the medical experience (mean score 9.5) and good cosmetic outcome (mean score 8.6). No serious complications or scar formation were reported in any patient. No recurrence of tumour was observed in the long-term follow-up of 1-3.5 years.

Conclusions: Our results indicate that second-intention healing after marginal resection combined with ALA-PDT can reduce the tissue defect and maintain excellent cure rates. This method offers an alternative and aesthetic treatment for localized periocular BCC.