Second-intention Healing Combined with ALA-PDT in the Treatment of Periocular Basal Cell Carcinoma.

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

Objectives: This research aimed to evaluate the efficacy and safety of second-intention healing after tumor excision with ALA-PDT in periocular BCC.

Methods: A total of 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 (3-6 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) that consists of the overall satisfaction with medical experience (0-10 scores) and cosmetic outcome (0-10 scores) were recorded.

Results: 10 women and 6 men aged between 33 to 84 years old periocular BCC (8/16 were nodular type, 2/16 were infiltrative type, 2/16 were nodular cystic type, 1/16 were ulcerative type and 3/16 were unknown type) completed the treatment with good overall satisfaction with medical experience (mean score: 9.5) and cosmetic outcome (mean score: 8.625). No serious complications and scar formation were reported in all the patients. No recurrence of tumor 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 rate, offers an alternative and aesthetic treatment for localized periocular BCC.