BCC Laser Treatment
Basal – cell carcinoma (BCC) is the most common skin cancer affecting mainly the skin of the face. Treatment involves large number of specialists, dermatologists, pathologists, surgeons, oncologists and radiologists. Effective treatment of this epithelial dermatosis stands as a particular problem for the modern medical science related to the high incidence of this type of skin cancer on the one side, and the need of a cosmetically acceptable result for the patient without compromising on the therapeutic efficiency. This is especially important when lesions facial localization. Layered laser ablation with a CO2 laser is extremely effective in the BCC removal; also when the lesions are in their early stages final aesthetic result varies from very good to excellent. The depth of ablation destruction could easily be controlled visually in a relatively bloodless conditions where the surrounding tissue as well as the in depth healthy tissue structures are being preserved. This manipulation can be performed in an outpatient setting and takes several minutes under local anesthesia, and in most cases of treating smaller lesions requires no anesthesia at all. Last but not least, cosmetic results vary from very good to excellent. Laser ablation is especially suitable for small and medium-sized (up to 20 mm) lesions yet, larger formations can be treated in few stages. My own experience of more than twenty five years in clinical application of lasers in treatment of basal-cell carcinoma proves that this methodology should find wider application as a therapeutic approach, especially when it pertains to facial localization. My long-standing clinical practice in laser treatment of basal-cell carcinoma signifies that the observed recurrences are rare and when occurred are easily eliminated with a subsequent ablation in an outpatient setting within the mandatory follow- ups. Comparing to traditional surgery techniques where the wounded surface is stitched and the procedure risks burying the eventual tumor cell underneath, in my method of skin cancer treatment in conditions of open wound epithelialization recurrent lesions are visible, small, clustered, and easily removable during the follow- ups. Laser ablation allows for aesthetic correction of post-therapeutic scars. During the control check-ups all solar induced, senile, and precancerous lesions that these patients usually abound can be removed. А course of treatment with topical 5 fluorouracil is also suitable. A complete facial resurfacing may be offered, achieving thus a long lasting facial rejuvenation to improve significantly the quality of patient’s life. Below are present results of CO2 laser treatment of basal-cell Carcinoma (SJC, as well as some other forms of cancer of highly dedifferentiated flat - cell carcinomas.
Before and After
Pyogenic granuloma
Pyogenic granuloma is a benign vascular tumor, although its name Granuloma pyogenicum is inaccurate and wrong, it became a clinical diagnosis. More precisely this disease can be described as eruptive acquired hemangioma. Usually it's appearance is associated with physical trauma or hormonal imbalances. Often it occurs during pregnancy and mainly located in the oral mucosa, head and limbs. More often people with light skin suffer from this disease. Pyogenic granuloma's dimensions can vary from a few millimeters to several centimeters in diameter. If it is located on places where there is mechanical irritation it is usually painful. Pyogenic granuloma bleed profusely when there is a little minimal mechanical irritation or even spontaneously. In differential diagnostic terms it should always be considered as amelanotic melanoma, even if this statement is hardly to be proven by dermoskop analysis. Right before the procedure must be excised biopsies for histological examination and if there is cellular atopy therapeutic plan extends to the treatment of malignant neoplasm. In my clinical practice I manage to develop and improve two laser methods for effective treatment of this tumor: - The first method is performed with a copper bromide laser (511,578nm) and is essentially a selective thermocoagulation. The manipulation is performed after a glass is pressed to the lesion (vitriopresiya). Under these conditions, the laser light passes through the glass and can reach a greater depth achieved by vitriopresion. This approach obliterans reliable large vassals in the center of the lesion and creates bloodless working environment without separation of smoke particles. The same technique can be performed with dalgopulsov YAG: Nd laser, which has more larger penetration, but the impact is generally less selective. - Second technique is performed with CO2 laser and represents ablation till the healthy tissues combined with widely focus thermocoagulation. Homeostasis in this technique is performed with a tourniquet, when the lesion is located on the fingers or through a hole of the clamp metal spatula, when the lesion is located on other parts of the body. Both techniques are therapeutic Resultant and relapses have been observed very rarely. The cosmetic results after laser treatment methods are better than surgery and avoids any nasty scarring .
