The pulsed dye laser for the treatment of basal cell carcinoma

• Published in: Lasers in medical science 2011-09, Vol.26 (5), p.641-644
• Main Authors: Ballard, Christopher J., Rivas, Maria P., McLeod, Michael Patrick, Choudhary, Sonal, Elgart, George W., Nouri, Keyvan
• Format: Article
• Language: English
• Subjects: Adult; Aged; Carcinoma, Basal Cell - blood supply; Carcinoma, Basal Cell - surgery; Dentistry; Female; Humans; Lasers; Lasers, Dye - adverse effects; Lasers, Dye - therapeutic use; Male; Medical treatment; Medicine; Medicine & Public Health; Middle Aged; Optical Devices; Optics; Original Article; Photonics; Quantum Optics; Skin cancer; Skin Neoplasms - blood supply; Skin Neoplasms - surgery; Treatment Failure; Treatment Outcome
• ISSN: 0268-8921; 1435-604X
• DOI: 10.1007/s10103-011-0952-8

Basal cell carcinomas (BCC) have a specialized microvasculature system that can be targeted by the 585-nm pulsed dye laser (PDL) utilizing the theory of selective photothermolysis. Seven volunteers with nine well-defined, biopsy-proven BCCs, were treated with the PDL (585-nm wavelength, a single 450-μs pulse, 7-mm spot size, and 9.0 J/cm 2 energy). The lesions, along with a 4-mm border of normal skin were treated. Pain assessment was carried out immediately after the laser treatment. A deep shave biopsy with histological examination occurred 4 weeks after the laser treatment. Pain was assessed on a scale of 0 (no pain) to 10 (worst pain possible). The average patient score was 2.1 (range 1–4). On histology, 5/9 (55.6%) sites demonstrated no evidence of BCC; however, 4/9 (44.4%) sites showed residual BCC. Although the PDL was able to clear over half of the BCCs in this study, there was an unacceptably high persistence rate of 44.4%. The PDL did not achieve the clearance rate that can be attained with current standard BCC treatment modalities. At this time, we do not recommend that a single treatment with the 585-nm PDL can be used as a primary therapy for BCC.