Cryosurgical methods for eyelid lesions.

Treatment of benign skin lesions commands a high demand for cosmetic outcome. Among the alternatives for the treatment of benign lesions, cryosurgery has many advantages: it is a safe office-based method, the predictable outcome is cosmetically good and the cost of treatment is relatively low compared with operative surgery or laser techniques for example. The controllability and the tissue selectivity of cryosurgery allow its use in and around the eyelids.

Cryosurgery for cutaneous malignancy. An update.

BACKGROUND: Cryosurgery is a successful modality for destruction of basal and squamous cell carcinomas. There is a trend toward more aggressive freezing of lesions and treatment of selected difficult tumors. OBJECTIVE: The indications and advantages for cryosurgery, recent treatment techniques, tissue response, complications, and results merit description. METHOD: The standard method of treatment is used with aggressive freezing of the lesion, including a greater lateral spread of freeze and attainment of lower tissue temperatures. RESULTS: The cure rate of cryosurgery is high and the cosmetic results are good to excellent. CONCLUSION: The results of cryosurgery are comparable with other modalities. It may be preferable or advantageous for some patients because of the quickness and safety of the procedure and its low cost. With changes in health care spending due to law or regulation, and within the environment of a managed care system, dermatologists may choose cryosurgery on the basis of outcome and cost.

Recurrent basal cell carcinoma treated with cryosurgery.

BACKGROUND: Although there are reports of cure rates achieved by cryosurgery for primary basal cell carcinomas (BCCs), there are few data on the cryosurgical treatment of recurrent BCCs. OBJECTIVE: Our purpose was to discuss case selection, cryosurgical management, and results of therapy. METHODS: Cryosurgery was performed in 54 patients with 56 recurrent BCCs. The treatment consisted of aggressive freezing including an adequate margin of surrounding tissue. RESULTS: Wound healing was favorable and the cosmetic results were excellent. Two recurrences were found and were referred for Mohs micrographic surgery. CONCLUSION: We conclude that cryosurgical treatment of selected recurrent BCCs yields results that compare favorably with other methods of treatment.

Cryosurgery updated.

Cryosurgery is an effective modality for treatment of many benign, premalignant, and malignant cutaneous lesions. New indications for benign lesions, new data, and recent trends towards more aggressive treatment of malignant lesions are mentioned. The differences in management between benign and malignant lesions are addressed. This article discusses cryobiology, equipment, advantages of cryosurgery, techniques of treatment, tissue response, results, complications, and contraindications.

Cryosurgery for lentigo maligna.

BACKGROUND: The need for treatment of lentigo maligna is related to the cosmetic benefits and to the potential for malignant change. The usual treatment is excision, but often lesional size or location preclude this. OBJECTIVE: Our purpose was to show that cryosurgery is an effective alternative treatment modality for lentigo maligna. METHODS: Thirty white patients were treated with cryosurgery. The lesions ranged from 1.3 to 4.5 cm in diameter. Treatment consisted of freezing with liquid nitrogen delivered by open spray. RESULTS: The lesion recurred in two patients, yielding a recurrence rate of 6.6% during the average follow-up period of 3 years. The two recurrent lesions were successfully re-treated with cryosurgery. Eleven patients observed for more than 5 years showed no recurrence. CONCLUSION: Cryosurgery provides excellent cosmetic and curative results. These results are favorably comparable to excisional surgery.

Specific indications for cryosurgery of the nail unit. Myxoid cysts and periungual verrucae.

Myxoid cysts and periungual warts are easily diagnosable yet management can be difficult and disappointing. A large series of myxoid cysts of the fingers were treated with cryosurgery using the open-spray and cryoprobe techniques. Another group of patients with periungual warts were treated with the dip-stick technique. The cure rates were high and the cosmetic results were excellent.

The five-year cure rate achieved by cryosurgery for skin cancer.

Cryosurgery was used to treat 3540 new basal cell and squamous cell carcinomas of the skin from 1971 to 1989; a cure rate of 98.4% was achieved. To determine the 5-year cure rate in more recent years, the results of treatment of 684 nonmelanotic skin cancers from 1980 to 1984 were reviewed. In the group of 628 basal cell carcinomas, the 5-year cure rate was 99.0%. In the group of 52 squamous cell carcinomas, the 5-year cure rate was 96.1%. In the series were also four patients with basosquamous cell carcinomas, all of whom were recurrence free for 5 years or more. The overall 5-year cure rate in the 684 cases was 98.8%. On the basis of these data and our cosmetic results, we conclude that cryosurgery is an effective treatment that compares favorably with other established methods of therapy.

Effects of systemic corticosteroids on post-cryosurgical edema and other manifestations of the inflammatory response.

Severe edema can occur after cryosurgical treatment of malignant lesions on the eyelids and periorbital area. In a study of 134 patients, it was found that a short course of systemic steroids was able to reduce the severity of post-cryosurgical edema. This can be beneficial for patients in whom periorbital edema can be expected to occur.