In relation to Bowen’s disease of skin:
Can be treated successfully with photodynamic therapy. Photodynamic therapy consists of treatment with a photosensitizer such as 5- aminolevulinic acid, and the application of narrow wavelength light or a laser for activation and cellular destruction. It can be painful during photoactivation. It can be used on a range of malignant and premalignant skin conditions, especially actinic keratosis, Bowen’s disease (squamous carcinoma in situ) and BCC. The modality does not provide histopathological confirmation of clearance, but can yield cure rates in superficial lesions approaching those of surgical excision with excellent cosmesis. The commonest complication is hypopigmentation.
In relation to basal cell carcinoma:
A 4mm margin on the face gives a cure rate of greater than 90%. Metastasis is extremely rare, but reported. The commonest lower lip tumour is squamous carcinoma. Pigmented BCCs are a well-recognised subtype. BCCs are familial in Gorlin’s syndrome as an autosomal dominant trait, although up to a third are de novo mutations.
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