Investigation on Basal Cell Carcinoma that Recurred after Laser Ablation

Lee, Jin Sub; Jang, Yong Hyun; Lee, Seok Jong; Kim, Do Won; Lee, Weon Ju

Abstract

BACKGROUND
In our outpatient clinic, we sometimes encounter basal cell carcinoma (BCC) patients that have a history of laser treatment without skin biopsy at private clinics.
OBJECTIVE
To investigate BCC that recurred after laser ablation.
METHODS
We performed a retrospective analysis of clinical reports of 635 BCC patients biopsy-proven from January 1997 to December 2012. Histopathological examination for BCC that recurred after laser ablation was done.
RESULTS
Out of 635, 85 had a history of one or more laser treatments for BCC before visiting our hospital. The mean age of patients was 66.3 years, and the ratio of male to female was 1 : 1.24. The most common site was the face (91.1%). Out of 85, 19 were treated by dermatologists and 8 by non-dermatologists. Out of 85, 58 did not remember the doctor's specialty. Histopathological examination for BCC showed basaloid tumor cell nests and peripheral palisading in all patients and pigment deposits in over two third of the patients. One patient had accompanying intradermal nevocytic nests without transformation of nevus cell to basal cell carcinoma.
CONCLUSION
BCC can be misdiagnosed as pigmented nevus and subsequently mistreated with laser ablation. Skin biopsy or dermoscopy should be considered to make a correct diagnosis when an ambiguous pigmented lesion is detected in a patient.