WEDNESDAY, Aug. 2, 2023 -- For patients with nonfacial basal cell carcinomas (BCCs), curettage and cryosurgery with standardized protocols provide excellent clinical clearance rates with one and two freeze-thaw cycles, according to a research letter published online June 8 in the Journal of the American Academy of Dermatology.

Eva Backman, M.D., from the University of Gothenburg in Sweden, and colleagues compared clearance rates after one year for curettage and cryosurgery in one (C&Cx1) versus two free-thaw cycles (C&Cx2) for nonfacial BCCs with clinically nodular features. Curettage with a 4-mm or 7-mm curette was followed by cryosurgery with an open-cone spray technique, aiming for a halo thaw time of ≥60 seconds. The second freeze was performed after complete thawing of the lesion in lesions randomly assigned to C&Cx2. The analysis included 202 lesions in 116 patients.

The researchers identified a single recurrence in the C&Cx1 group at one year, resulting in clearance rates of 99 versus 100 percent, proving noninferiority with an absolute difference of <8 percent. For oozing wounds, the mean time was 1.0 and 1.2 weeks for C&Cx1 and C&Cx2. Overall, 71 percent of the wounds still had crusts, 13 percent still had oozing, and 11 percent were completely healed at four to six weeks, with no significant differences noted between the groups. The only relevant factor that significantly increased wound healing times was larger lesion size. After one year, 105, one, and four patients reported satisfaction with their scars, were unsatisfied, and felt neutral, respectively.

"This investigation increases the evidence for curettage plus cryosurgery, a low-cost and time-saving treatment for BCCs with nodular features," the authors write.