Basal cell on nose
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These studies suggest that basal cell carcinoma on the nose can be effectively treated with various methods including composite-skin grafting, CO2 and dye laser techniques, Mohs surgery, wide local excision with chemoradiotherapy, cryosurgery, chemosurgical removal, and radiant surgical excision with reconstructive rhinoplasty.
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Basal Cell Carcinoma on the Nose: Treatment and Reconstruction
Introduction to Basal Cell Carcinoma on the Nose
Basal cell carcinoma (BCC) is the most common type of skin cancer, frequently occurring on the nose due to its high exposure to ultraviolet (UV) radiation. BCC is characterized by local spreading and a very low tendency to metastasize . The nose, being a prominent facial feature, often requires careful consideration for both effective treatment and aesthetic reconstruction.
Surgical Excision and Reconstruction Techniques
Composite Skin Grafts
Surgical excision is the preferred treatment for BCC on the nose, ensuring the highest chance of cure. Post-excision, defects can be covered using various techniques. Composite skin grafting, which involves harvesting a graft that includes the epidermis, dermis, and superficial layers of subcutaneous tissue, has shown favorable results. This method provides the necessary thickness and texture to match the nasal skin, leading to satisfactory clinical and aesthetic outcomes.
Local Flaps and Grafts
Local flaps and full-thickness skin grafts are also commonly used for nasal reconstruction post-BCC excision. These methods are chosen based on the defect's size and location. For instance, nasolabial flaps are often used for defects on the ala of the nose, providing good cosmetic results . Additionally, septal and auricular cartilage grafts can be employed to support the nasal structure and improve the aesthetic outcome.
Laser Treatment for Post-Surgical Complications
Post-surgical complications, such as flap necrosis, can lead to scarring and unsatisfactory aesthetic results. Combined CO2 and dye laser techniques have been proposed to improve the appearance of scars resulting from surgical failures and flap necrosis. These laser treatments can significantly enhance the cosmetic outcomes for patients who have undergone surgery for BCC on the nose.
Cryosurgery and Chemosurgery
Cryosurgery is another treatment option for BCC on the nose, particularly for patients who may not be suitable candidates for traditional surgery. This method involves freezing the cancer cells, leading to their destruction. While cryosurgery has shown excellent cosmetic results on the eyelids, its predictability on the nose is less certain. Chemosurgery, which involves the application of chemical agents to remove cancerous tissue, is also used, especially for lesions with deep and lateral extensions.
Uncommon Presentations and Risk Factors
While UV radiation is the primary risk factor for BCC, it can also arise in sun-protected areas due to other factors. For example, BCC has been reported at the site of nasal piercings, suggesting that trauma or chronic irritation may also play a role in its development . This highlights the importance of thorough skin examinations, including less exposed areas, to ensure early detection and treatment.
Conclusion
Basal cell carcinoma on the nose requires a multidisciplinary approach for effective treatment and aesthetic reconstruction. Surgical excision remains the gold standard, with various reconstruction techniques available to address post-excision defects. Advances in laser treatments and alternative methods like cryosurgery and chemosurgery offer additional options for managing complications and improving cosmetic outcomes. Early detection and tailored treatment plans are crucial for achieving the best results for patients with BCC on the nose.
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Most relevant research papers on this topic
8
Basal cell carcinoma of the nose; treatment with chemosurgery.
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1956