Pulsed Dye Laser as a Novel Non-Surgical Treatment for Basal Cell Carcinomas: Response and Follow Up 12-21 Months After Treatment

Background and Objective: We showed previously that pulsed dye laser (PDL) is a potentially effective therapy for BCCs < 15 mm on trunk and extremities. To follow-up, we conducted a study based on optimized parameters and expanded the duration of the study to at least 1 year after treatment. Materials and Methods: Fourteen patients with 20 biopsy-proven BCCs on trunk and extremities, 8-35 mm in diameter, were treated. Each BCC received four consecutive PDL treatments at 3-4 week intervals. A 4 mm margin of clinically normal skin was also treated. Standardized photography was performed prior to each treatment and follow up visit. Patients were asked to consent for standard excision or at least scouting biopsies after treatment completion. Results: Complete clinical response was seen with 19 of 20 treated BCCs, regardless of size and histologic subtype. One did not respond completely to therapy. All remaining 19 BCCs were followed between 12 and 21 months (median = 18 months) after the last PDL treatment. Of these 19 BCCs, only one recurred at 17 months follow up. The remaining 18 BCCs did not show any clinical signs of residual or recurrent tumor at 12-21 months follow-up. Overall, 90% (18/20 tumors) of treated BCCs in this study showed no clinical or histologic evidence of BCC more than 12 months after PDL treatment. Additionally, 18/19 (95%) BCCs less than or equal to 17 mm showed no evidence of residual or recurrent tumor clinically or on histology 12-21 months post-laser treatment. Conclusions: PDL treatment of BCC represents a novel, quick, and relatively non-painful treatment that does not usually produce scar and may represent an alternative treatment for certain types of BCC in the appropriate clinical setting. This study confirms prior findings regarding the efficacy of PDL in the treatment of BCC, with longer follow-up period. Lasers Surg. Med. 43:72-78, 2011. (C) 2011 Wiley-Liss, Inc.