Clinical Observation Of Electrocauterization Combined With ALA-PDT For The Treatment Of NMSC And Precancerous Lesions In Craniofacial Skin

Objective To investigate the efficacy,comfort level and adverse events of electrocauterization combined with ALA-PDT for the treatment of NMSC and precancerous lesions in craniofacial skin.The recurrence rate was also observed within 1-6 months after treatment.Methods 27 patients,including 12 male and 15 female,participated in the study.All the skin lesions locate in the head and skin.Among them,8 patients have multiple lesions,11 patients' lesions locate in special place(lip,nose,periorbital skin and ear),4 patients had large skin lesions(diameter?3cm),4 patients are unable to tolerate surgery due to visceral disease.Before the first photodynamic therapy,the skin lesion was electrocauterized to reduce the tumor thickness.Immediately after the electrocauterization therapy,the first photodynamic therapy started.The number of photodynamic therapy was selected according to the nature of skin lesions and the depth in pathology.Four weeks after completion of treatment course,the efficacy was evaluated.During the treatment,adverse events were reviewed by 2 board certified dermatologists and intraoperative comfort were self-evaluated by the subjects based on the level of pain.The recurrence rate was observed at month 3 and 6.Results 1.Clinical efficacy: in total 37 lesions,10(27.03%)of the lesions were completely clear,23(62.16%)of the lesions had good response,and only 4(10.81%)of the lesions had mild response or no change.The total effective rate was 89.19%..2.Intraoperative comfort: in all the 27 patients,intraoperative comfort was 3.46±1.31 on basis of the pain.19 patients(70.4%)experienced slight pain,8 patients(29.6%)experienced medium discomfort.3.Adverse events: 16 patients experienced mild erythema which resolved in less than 24 hours,3 patients lasted 72 hours and 6 patients lasted 3 months.14 patients had mild swelling in less than 24 hours,3 patients lasted 72 hours.Two patients showed mild itching within 24 hours and eventually disappeared.All patients felt skin searing but disappeared after 10 to 12 hours;The 22 patients had a small number of scabs,and the 5 patients had a moderate number of scabs,but all the scabs disappeared within 4 weeks after the end of the treatment.4?Of the 33 lesions that have been treated effectively,2 lesions recur.The recurrence rate was 6.06%.Conclusion Electrocauterization combined with ALA-PDT provides a satisfying method for the treatment of NMSC and precancerous lesions in craniofacial skin,which features great efficacy and low recurrence rate.In the course of treatment,the patient has a high degree of comfort and less adverse events.