The role of the 595‐nm pulsed dye laser in treating superficial basal cell carcinoma: outcome of a double‐blind randomized placebo‐controlled trial. (19th January 2015)

• Record Type: Journal Article
• Authors: Karsai, S.; Friedl, H.; Buhck, H.; Jünger, M.; Podda, M.
• Is Part Of: British journal of dermatology. Volume 172:Number 3(2015:Mar.)
• Page Start: 677
• Page End: 683
• Publication Date: 2015-01-19
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.13266
• Languages: English
• ISSNs: 0007-0963

Abstract

Summary: Background: Pulsed dye laser (PDL) treatments have been suggested to be a safe and effective therapeutic approach for treating basal cell carcinomas (BCCs). However, robust supporting evidence is lacking due to inconsistent design of available studies. Objectives: To evaluate PDL efficacy and safety in treating superficial BCC (sBCC) at low‐risk anatomical sites in an evidence‐based study setting. Materials and methods: Thirty‐nine patients (27 men and 12 women, 75·9 ± 10 years) with a total of 100 sBCCs were randomized to receive PDL treatment (wavelength 595 nm; fluence 8 J cm −2 ; pulse duration 0·5 ms; spot size 10 mm) or sham treatment. The primary endpoint was complete clinical and histological remission of the tumour at 6‐month follow‐up; the secondary endpoints were the evaluation of side‐effects and pain as well as patient satisfaction. Results: The primary endpoint showed significant superiority of the laser group to the sham group ( P < 0·0001). Complete remission was achieved in 44 of 56 cases (78·6%) in the laser and in two of 44 cases (4·5%) in the sham treatment arm. The main adverse events in the laser group were crusts, hyper‐ and hypopigmentation. An average of 72% of patients stated at the individual sessions that they were 'satisfied' with the laser treatment, whereas 25% were 'very satisfied'. Conclusions: PDL is an effective and safe method for treating sBCC. However, the occurrence of persistent dyspigmentation still limits the potential for excellent cosmetic outcomes. Abstract : What's already known about this topic? Pulsed dye lasers (PDLs) are increasingly used for treating basal cell carcinomas (BCCs). However, so far there have been no sufficiently powered randomized controlled trials (RCTs) in the literature analysing the efficacy and safety of these devices. What does this study add? To the best of our knowledge, this is the first RCT that analyses the 595‐nm PDL in the treatment of superficial BCC at uncritical anatomical sites (trunk and extremities) with a follow‐up of 6 months.