Role of non-surgical therapies in the management of periocular basal cell carcinoma and squamous intra-epidermal carcinoma: a case series and review of the literature.

摘要

Basal cell carcinoma (BCC) and squamous intra-epidermal carcinoma (IEC) are the most common periocular tumours and can be associated with significant morbidity. Five percent of imiquimod cream and photodynamic therapy (PDT) are popular non-surgical treatment options but are currently not licensed for periocular use.To review our experience with these treatments and summarize published literature (PubMed: up to September 2011).We conducted a review of case notes for all patients with periocular BCC and IEC treated with either PDT or imiquimod, within National Health Service (NHS) Tayside, Scotland, from 1996 to 2009.Six of 13 and five of 12 lesions treated with imiquimod (median duration of clearance=35 months; range=24-55 months) and PDT (median duration of clearance=66 months; range=4-80 months), respectively, achieved clinical clearance. The majority of patients in our series did manage to tolerate and continue both treatments, with no significant longer-term adverse effects.Our limited experience along with published reports suggests that both imiquimod and PDT are effective in the treatment of periocular non-melanoma skin cancers in selected patients. However, surgical excision with margin control remains the gold standard for the treatment of periocular tumours.