Clinical case of basal cell carcinoma therapy using 5 % imiquimod cream
DOI:
https://doi.org/10.14739/2310-1237.2020.2.212814Keywords:
basal cell carcinoma, skin neoplasms, topical therapyAbstract
Aim. To describe clinical case of the basal cell carcinoma treatment, determine personalized diagnostic algorithm of the patient management with further selection of the therapy method regarding visual, dermatoscopic and pathomorphological picture of disease.
Materials and methods. The own observation of clinical case of local treatment of the patient with basal cell carcinoma by means of 5% imiquimod cream was described.
Results. Based on comprehensive examination of the patient with determination of features of visual, dermatoscopic and pathohistological picture the diagnosis “Basal cell carcinoma, nodular variant” was determined. Taking into account considerable traumatization and possibility of functional motor impairment after surgery it was determined to replace the treatment approach with the local use of 5 % imiquimod cream according to the standardized scheme. Step-by-step application of topical agent on the upper part of BCC affected area had also influence on the non-treated zone which began to regress by itself starting from the 9th week. Spontaneous regress of BCC stipulates rare and unusual course of disease. Control clinical and pathomorphological examination did not reveal any neoplastic processes in skin after 12 weeks course of treatment with 5 % imiquimod cream and within 1 year of further observation. In case of BCC the possibility of using topical agents increases therapeutic potential and compliance between doctor and patient.
Conclusions. Annual increase of quantity of new cases of non-melanoma skin tumours and variability of clinical implications enable the rise of oncological suspicion level among practicing physicians. Creation of personalized algorithm of diagnostics ensures making the diagnosis timely and selection of differential treatment approach. Neglecting the neoplasm with significant affected area size the topical use of 5 % imiquimod is the effective alternative to invasive intervention for treatment of patients with the basal cell carcinoma.
References
Peris, K., Fargnoli, M. C., Garbe, C., Kaufmann, R., Bastholt, L., Seguin, N. B., Bataille, V., Marmol, V. D., Dummer, R., Harwood, C. A., Hauschild, A., Höller, C., Haedersdal, M., Malvehy, J., Middleton, M. R., Morton, C. A., Nagore, E., Stratigos, A. J., Szeimies, R. M., Tagliaferri, L., … European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organization for Research and Treatment of Cancer (EORTC) (2019). Diagnosis and treatment of basal cell carcinoma: European consensus-based interdisciplinary guidelines. European journal of cancer (Oxford, England : 1990), 118, 10-34. https://doi.org/10.1016/j.ejca.2019.06.003
Muzic, J. G., Schmitt, A. R., Wright, A. C., Alniemi, D. T., Zubair, A. S., Olazagasti Lourido, J. M., Sosa Seda, I. M., Weaver, A. L., & Baum, C. L. (2017). Incidence and Trends of Basal Cell Carcinoma and Cutaneous Squamous Cell Carcinoma: A Population-Based Study in Olmsted County, Minnesota, 2000 to 2010. Mayo Clinic proceedings, 92(6), 890-898. https://doi.org/10.1016/j.mayocp.2017.02.015
Ukrainian cancer registry statistics. (2020). Rak v Ukraini, 2017-2018. Zakhvoriuvanist, smertnist, pokaznyky diialnosti onkolohichnoi sluzhby [Cancer in Ukraine, 2017-2018. Occupation, death, demonstration of oncological service]. Bulletin of National Cancer Registry of Ukraine, 20. [in Ukrainian]. http://ncru.inf.ua/publications/BULL_20/index.htm
Asgari, M. M., Moffet, H. H., Ray, G. T., & Quesenberry, C. P. (2015). Trends in Basal Cell Carcinoma Incidence and Identification of High-Risk Subgroups, 1998-2012. JAMA dermatology, 151(9), 976-981. https://doi.org/10.1001/jamadermatol.2015.1188
Tang, S., Thompson, S., & Smee, R. (2017). Metastatic basal cell carcinoma: case series and review of the literature. The Australasian journal of dermatology, 58(2), e400e43. https://doi.org/10.1111/ajd.12459
Elder, D. E., Massi, D., Scolyer, R. A., & Willemze, R. (2018). Who classification of skin tumours. Lyon: International Agency for Research on Cancer.
Lang, B. M., Balermpas, P., Bauer, A., Blum, A., Brölsch, G. F., Dirschka, T., Follmann, M., Frank, J., Frerich, B., Fritz, K., Hauschild, A., Heindl, L. M., Howaldt, H. P., Ihrler, S., Kakkassery, V., Klumpp, B., Krause-Bergmann, A., Löser, C., Meissner, M., Sachse, M. M., … Grabbe, S. (2019). S2k Guidelines for Cutaneous Basal Cell Carcinoma - Part 1: Epidemiology, Genetics and Diagnosis. Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, 17(1), 94-103. https://doi.org/10.1111/ddg.13733
Stanoszek, L. M., Wang, G. Y., & Harms, P. W. (2017). Histologic Mimics of Basal Cell Carcinoma. Archives of Pathology & Laboratory Medicine, 141(11), 1490-1502. https://doi.org/10.5858/arpa.2017-0222-ra
Kunz, M., Kerl, K., & Braun, R. P. (2018). Basal Cell Carcinoma Mimicking Desmoplastic Trichoepithelioma: A Case with Correlation of Dermoscopy and Histology. Case reports in dermatology, 10(2), 133-137. https://doi.org/10.1159/000489164
Reiter, O., Mimouni, I., Gdalevich, M., Marghoob, A. A., Levi, A., Hodak, E., & Leshem, Y. A. (2019). The diagnostic accuracy of dermoscopy for basal cell carcinoma: A systematic review and meta-analysis. Journal of the American Academy of Dermatology, 80(5), 1380-1388. https://doi.org/10.1016/j.jaad.2018.12.026
Aguilar, J. A., Garces, M. H., Bayona, J. I. Y., Rodriguez, M. A., Ezquerro, I. M. D., & Aldecoa-Otalora, J. S. (2019). Dermoscopic signs as predictors of non-response to imiquimod treatment in superficial basal cell carcinoma. Anales Del Sistema Sanitario De Navarra, 42(3), 303-307. https://doi.org/10.23938/assn.0722
Godoy, C., Neta, A., Leão, S., Dantas, R. L., Carvalho, V., & Silva, S. (2017). Evaluation of surgical margins according to the histological type of basal cell carcinoma. Anais brasileiros de dermatologia, 92(2), 226-230. https://doi.org/10.1590/abd1806-4841.20175076
Cameron, M. C., Lee, E., Hibler, B. P., Barker, C. A., Mori, S., Cordova, M., Nehal, K. S., & Rossi, A. M. (2019). Basal cell carcinoma: Epidemiology; pathophysiology; clinical and histological subtypes; and disease associations. Journal of the American Academy of Dermatology, 80(2), 303-317. https://doi.org/10.1016/j.jaad.2018.03.060
Williams, H. C., Bath-Hextall, F., Ozolins, M., Armstrong, S. J., Colver, G. B., Perkins, W., Miller, P., & Surgery Versus Imiquimod for Nodular and Superficial Basal Cell Carcinoma (SINS) Study Group (2017). Surgery Versus 5% Imiquimod for Nodular and Superficial Basal Cell Carcinoma: 5-Year Results of the SINS Randomized Controlled Trial. The Journal of investigative dermatology, 137(3), 614-619. https://doi.org/10.1016/j.jid.2016.10.019
Work Group, Invited Reviewers, Kim, J., Kozlow, J. H., Mittal, B., Moyer, J., Olencki, T., & Rodgers, P. (2018). Guidelines of care for the management of basal cell carcinoma. Journal of the American Academy of Dermatology, 78(3), 540-559. https://doi.org/10.1016/j.jaad.2017.10.006
Kebalo, D. I., Yermolova, V. I., Miroshnykova, N. P., Pashchenko, S. M., Zvantseva, O. D., Voloshyna, N. N., & Lashtabega, D. Y. (2016). Efektyvnist zastosuvannia fotodynamichnoi terapii z fotosensybilizatorom pry zakhvoriuvanni na bazalno-klitynnyi rak shkiry holovy [Effectiveness of the photodynamic therapy with photosensitizer for treatment of basal cell skin cancer located on the head]. Zaporozhye Medical Journal, (5), 84-88. [in Ukrainian]. https://doi.org/10.14739/2310-1210.2016.5.82692
Jansen, M., Mosterd, K., Arits, A., Roozeboom, M. H., Sommer, A., Essers, B., van Pelt, H., Quaedvlieg, P., Steijlen, P. M., Nelemans, P. J., & Kelleners-Smeets, N. (2018). Five-Year Results of a Randomized Controlled Trial Comparing Effectiveness of Photodynamic Therapy, Topical Imiquimod, and Topical 5-Fluorouracil in Patients with Superficial Basal Cell Carcinoma. The Journal of investigative dermatology, 138(3), 527-533. https://doi.org/10.1016/j.jid.2017.09.033
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeThe Effect of Open Access).
