Lesion compression during light activation may improve efficacy of photodynamic treatment of basal cell carcinoma: Preliminary results and rationale

Roozeboom et al reported high recurrence rates at 3 years for photodynamically‐treated superficial‐BCCs, particularly on the head and neck of younger patients. Vasculature within the dermis is more prominent in these areas and flushing is more noticeable when lesions on faces are treated (personal observation) (Fig.1). Therefore, we hypothesize that haemoglobin may be interfering with treatment. We present PDT of BCCs using methylaminolevulinic‐acid (MAL) cream with a modified protocol. Activation is performed in 2 phases; a first‐phase using 630nm red‐light (Aktilite CL16, Galderma, Sweden) immediately followed by a second‐phase using intense‐pulsed‐light (IPL) (BBL, Sciton, Ca, USA) with long‐pulsed, non‐thermal settings and applied with compression to the lesion to blanch the skin. Fig.1 shows typical blanching from compression.