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Preoperative Definition of Basal Cell Cancer Margins Feasible

Last Updated: April 26, 2011.

Use of topical methyl aminolevulinate as a photosensitizer in conjunction with Wood lamp examination is a feasible method for identifying tumor margins in patients with basal cell carcinoma prior to Mohs micrographic surgery, according to a study published in the May issue of the Journal of the American Academy of Dermatology.

TUESDAY, April 26 (HealthDay News) -- Use of topical methyl aminolevulinate (MAL) as a photosensitizer in conjunction with Wood lamp examination is a feasible method for identifying tumor margins in patients with basal cell carcinoma (BCC) prior to Mohs micrographic surgery (MMS), according to a study published in the May issue of the Journal of the American Academy of Dermatology.

Emily Tierney, M.D., from the Laser and Skin Surgery Center of Indiana in Carmel, and colleagues evaluated whether the margins of BCC tumors measured by MAL and Wood lamp fluorescence correlated with the post-MMS margin size recorded after the removal of the MMS defect in 20 patients with BCCs of the head, neck, and upper extremities. MAL was applied overnight for an average of 13.3 hours on five superficial and 15 nodular BCCs before measuring tumor size by clinical Wood lamp fluorescence.

The investigators found that the average tumor sizes were 263.0 mm², 239.1 mm², and 65.8 mm² by post-MMS defect, MAL with Wood lamp, and clinical examination, respectively. A high degree of consistency and absolute agreement was evident between post-MMS defect size and fluorescent examination according to interclass correlation coefficients (0.962). The post-MMS defect size and clinical examination correlation (0.703) was significantly higher than that between fluorescent and clinical examination (0.651).

"Use of topical MAL in conjunction with a Wood lamp examination is a simple and inexpensive investigation that can be used before MMS to delineate the margins of ill-defined tumors. This technique has the potential for increasing the cost-efficiency of MMS," the authors write.

Methyl aminolevulinate used in the study was provided by Galderma Laboratories.

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