Cryotherapy of Nodular Basalioma on the Skin of the Back

Cryotherapy of nodular basalioma on the skin of the back. Cryotherapy (so-called intense cryotherapy technique) may be an option for the treatment of basal cell carcinomas but it should only be performed by a medical specialist or by a physician with special expertise in cryotherapy. The technique should basically not be used for lesions in the head or neck area at all in primary health care. The technique must never be applied below knee level, as it can easily lead to chronic ulceration in this area. When using the intense cryotherapy technique, the cosmetic and functional results and risk of recurrence should be carefully considered. Follow-up is important.

1. Mark the borders of the basal cell carcinoma (line) and the freeze margin (dots, 3 mm), then disinfect the area to be treated and infiltrate a local anaesthetic.
2. When the area is numb, carefully remove any abnormal tissue with a curette. Basal cell carcinoma tissue can be easily detached with a curette. Oozing of blood can be stopped by pressing gently with a cotton swab dipped in ferric chloride or aluminium chloride solution.
3. Freeze the lesion white to establish a halo thaw time of one minute. Allow the entire lesion to thaw properly, and then repeat freezing.
4. There will be a weeping superficial ulcer and a clear blister. Intense cryotherapy (for basal cell carcinoma) practically always leaves a permanent light scar that will be quite visible on dark skin but in people with very light skin rather unnoticeable.

Picture Tea Lassila, text Alexander Salava