Photodynamic therapy combined with carbon dioxide laser for successful treatment of cutaneous squamous cell carcinoma within a long-standing and huge seborrheic keratosis

Shan Fang; Zhongxia Zhou; Yuhao Wu; Zhe Zheng; Yan Zhao; Xiaofei Sun; Xiuli Wang; Guolong Zhang

doi:10.1016/j.pdpdt.2021.102536

Photodynamic therapy combined with carbon dioxide laser for successful treatment of cutaneous squamous cell carcinoma within a long-standing and huge seborrheic keratosis

Photodiagnosis Photodyn Ther. 2021 Dec:36:102536. doi: 10.1016/j.pdpdt.2021.102536. Epub 2021 Sep 15.

Authors

Shan Fang¹, Zhongxia Zhou¹, Yuhao Wu¹, Zhe Zheng¹, Yan Zhao¹, Xiaofei Sun¹, Xiuli Wang², Guolong Zhang³

Affiliations

¹ Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200092, China.
² Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200092, China. Electronic address: wangxiuli_1400023@tongji.edu.cn.
³ Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200092, China. Electronic address: glzhangtj@tongji.edu.cn.

PMID: 34536605
DOI: 10.1016/j.pdpdt.2021.102536

Abstract

Seborrheic keratosis (SK) is a common benign lesion in which malignancies like cutaneous squamous cell carcinoma (cSCC) can arise rarely. We report a case of an 81-year-old man who presented a well-demarcated reddish-brown plaque with central raised coarse nodules on the top of his head. Dermoscopy and reflectance confocal microscopy (RCM) showed the possibility of malignant transformation. cSCC was confirmed by histopathology and immunohistochemistry. Considering the fact of local low-risk cSCC within a large SK lesion, carbon dioxide (CO₂) laser was used to treat the SK lesion, and reduce the thickness of local cSCC simultaneously. Three sessions of 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) were performed after CO₂ laser. Finally, no atypical cells were found by multi-point biopsy after treatment, and follow-up was continued for one year. Therefore, malignant changes of SK are relatively uncommon, but should be suspected when abnormal appearance or symptoms occurred. ALA-PDT combined with CO₂ is a safe, effective, and minimally invasive treatment for cSCC arising from a huge SK.

Keywords: Carbon dioxide laser; Cutaneous squamous cell carcinoma; Photodynamic therapy; Seborrheic keratosis.

Publication types

Case Reports

MeSH terms

Aged, 80 and over
Carcinoma, Squamous Cell* / drug therapy
Humans
Keratosis, Seborrheic* / drug therapy
Lasers, Gas* / therapeutic use
Male
Photochemotherapy* / methods
Photosensitizing Agents / therapeutic use
Skin Neoplasms* / drug therapy

Substances

Photosensitizing Agents