Prospective Clinical Trial Comparing Curettage and Cryosurgery to Curettage and Electrodesiccation in the Management of Minimally Invasive Basal and Squamous Cell Carcinomas [Formula: see text].

BACKGROUND: Basal and squamous cell carcinomas represent the most common cancers in North America. Their management is an important issue. OBJECTIVES: The evaluation of cure rates of minimally invasive cutaneous carcinomas with curettage-cryosurgery compared to curettage-electrodesiccation, as well as the assessment of the aesthetic appearance of scars. METHODS: This prospective trial randomized 117 patients 1:1 to treatments of curettage-cryosurgery or curettage-electrodesiccation. They were then followed at 6, 12, 18, and 24 months. RESULTS: At 12-month follow-up, only one (1/49) patient had a recurrence of cutaneous carcinoma in the curettage-cryosurgery group and none (0/43) in the curettage-electrodesiccation group. Farrington-Manning analysis with a 5% margin of error showed the non-inferiority of the first method (P = .04). For the aesthetic appearance of scars after 12 months, better results with curettage-cryosurgery procedure has been observed, but this was not statistically significant (P = .80 and P = .27 for evaluations of patients and clinicians respectively). LIMITATIONS: This study was mainly limited by its small sample size. CONCLUSION: We have demonstrated that curettage-cryosurgery compared to curettage-electrodesiccation for the treatment of minimally invasive carcinomas is noninferior (comparable) with regards to cure rates at 12-month follow-up. No significant difference has been demonstrated for the appearance of scars.

Primary Cutaneous Carcinosarcoma of the Basal Cell Subtype Should Be Treated as a High-Risk Basal Cell Carcinoma.

BACKGROUND: Cutaneous carcinosarcoma is a rare primary tumor of the skin, characterized by biphasic epithelial and mesenchymal differentiation. OBJECTIVE: Due to the limited number of cases reported, there is no consensus regarding treatment and prognosis. Some authors suggest that cutaneous carcinosarcomas should be viewed as aggressive tumors, with ancillary imaging used to evaluate potential metastatic disease. Other reports demonstrate an indolent disease course, especially with epidermal-type cutaneous carcinosarcomas. METHODS: We report a case of cutaneous carcinosarcoma, which we treated with electrodessication and curettage following a shave biopsy. The tumor had an epithelial component resembling a basal cell carcinoma and a fibrosarcomatous stroma. RESULTS: At 1-year follow-up, our patient did not show evidence of recurrence or metastasis. CONCLUSIONS: Our case suggests that a cutaneous carcinosarcoma with an epithelial component composed of basal cell carcinoma can be regarded as a high-risk nonmelanoma skin cancer.

Intralesional methotrexate treatment for keratoacanthoma tumors: a retrospective case series.

BACKGROUND: Intralesional methotrexate (IL-MTX) is an effective treatment for keratoacanthoma. OBJECTIVE: We sought to determine the response rates and adverse events in KA treated with intralesional methotrexate. METHODS: All cases of KA treated with intralesional methotrexate at our institutions from 2001 to 2009 were systematically reviewed. RESULTS: Forty-six cases of KA treated with IL-MTX were identified. A complete resolution was achieved in 74% of patients, requiring an average of 1.8 injection sessions, for a mean total dose of 10 mg. Adverse events did not occur. LIMITATIONS: The follow-up period was short, and there was no histologic confirmation of the initial diagnosis. CONCLUSION: IL-MTX is an effective and well-tolerated alternative to surgery for the treatment of KA.