P052 Treatment of nodular basal cell carcinomas on the tip of the nose, with a diameter < 1 cm, on an Aegean Sea island with a combination of immunocryosurgery and laser CO2: 5-year follow-up

Abstract

We report the 5-year follow-up results of CO2 laser and immuno­cryosurgery for the treatment of nodular basal cell carcinomas (BCC) on the tip of the nose, with a diameter < 1 cm, on an Aegean Sea island. We present 15 patients (11 men, 4 women; age range 42–87 years), with nodular BCC of diameter < 1 cm on the tip of the nose. The treatment protocol was as follows. Firstly, CO2 laser was used to flatten the tumour. Secondly, immunocryosurgery was commenced with imiquimod 5% given daily, followed by cryosurgery on day 14 in two cycles of 10 s (less than the usual time, due to the risk of cartilage necrosis), with a thaw cycle. The limit of cryosurgery was 3 mm. Imiquimod was applied for another 2 weeks after the cryosurgery, for 8 h during the night. Five years after the initial treatment all 15 patients were clinically tumour free. The only side effect was slight hypopigmentation (n = 7) and/or a small scar (n = 3). In three patients we had to repeat the immuno­cryosurgery 1.5 years after the initial treatment, but after 5 years they are tumour free. The combination of CO2 laser and immunocryosurgery is an effective, minimally invasive, office-based, alternative treatment, especially in islands with limited surgical amenities (such as Mohs or plastic surgery), for BCCs of the tip of the nose, with a diameter < 1 cm.