Full-face carbon dioxide laser resurfacing in the management of a patient with the nevoid basal cell carcinoma syndrome.
BACKGROUND: Multiple surgical procedures are often a source of discomfort, pain, and disfigurement for patients with the nevoid basal cell carcinoma syndrome (NBCCS). OBJECTIVE: The patient with NBCCS had approximately 45 identifiable basal cell carcinomas on her face. Multiple Mohs surgeries were performed to remove the largest tumors. A tumor-free plane was not achieved in several lesions despite removal of multiple tissue layers. The treatment of the remaining tumors presented a significant challenge. METHODS: Full-face CO2 laser resurfacing was performed after curettage and local laser ablation of all visible tumors. RESULTS: The patient healed well postoperatively. She developed six basal cell carcinomas on her face during the 10-month follow-up period. These were easily treated with Mohs surgery and imiquimod cream. CONCLUSION: CO2 laser resurfacing is a useful surgical modality for treatment of multiple facial basal cell carcinomas in the patients with NBCCS. It allows treatment of all the facial lesions in a single session and minimizes suffering resulting from repeated surgical procedures. Additionally, the layer of skin damaged by ultraviolet radiation is removed, allowing for easier management after resurfacing.