Reconstruction of Lower Eyelid in Basal Cell Carcinoma Case with Adjunctive Hyperbaric Oxygen Therapy: A Case Report
DOI:
https://doi.org/10.35790/msj.v7i1.54895Abstract
Abstract: Basal cell carcinomas (BCCs) are the most common cancers in humans, caused by exposure to ultraviolet light and are associated with PTCH1 gene mutation. Its incidence rate significantly increases per year especially in elderly people. Several modalities are available for BCC treatment but surgery is still considered as the gold standard. Oxygen is mandatory for almost all wound healing processes, and oxygen substitution can be delivered in the form of hyperbaric oxygen (HBO) therapy. We presented a 70 years old woman with a major complaint of a tumor located in the left infrapalpebral region, below the left lower lash line with 5 years of evolution. Patient had clinical presentation of solid nodular basal cell carcinoma which was the most common clinical subtype. Patient was diagnosed as having BCC based on history taking, clinical findings, and histopathological examination. Surgical wide excision, skin flap, and HBO as the adjunctive therapy were performed on this patient. With these techniques, healing time was reduced, complications rates were low, and cosmetic outcome was much better. In conclusion, closing defects of BCC case with surgical wide excision and flap yields a remarkable outcome and an adjunctive HBO therapy after surgery optimizes the oxygenation, thus, the healing potential of tissue prior to surgery, and accelerates wound healing post operatively. A good result with short healing duration was observed.
Keywords: basal cell carcinoma; hyperbaric oxygen therapy; flap; wound healing
References
Roewert-Huber J, Lange-Asschenfeldt B, Stockfleth E, Kerl H. Epidemiology and aetiology of basal cell carcinoma. Br J Dermatol. 2007;157(Suppl2):47-51. Doi: 10.1111/j.1365-2133.2007.08273.x
Rogers HW, Weinstock MA, Feldman SR, Coldiron BM. Incidence estimate of nonmelanoma skin cancer (keratinocyte carcinomas) in the US population, 2012. JAMA Dermatol 2015;151(10):1081-6. Doi: 10.1001/jamadermatol.2015.1187
Our New Approach to a Challenging Skin Cancer Statistic. The Skin Cancer Foundation. 2023. Available from: https://www.skincancer.org/blog/our-new-approach-to-a-challenging-skin-cancer-statistic/
Oh CC, Jin A, Koh WP. Trends of cutaneous basal cell carcinoma, squamous cell carcinoma, and melanoma among the Chinese, Malays, and Indians in Singapore from 1968-2016. JAAD Int. 2021;30(4):39–45. Doi: 10.1016/j.jdin.2021.05.006
Situm M, Buljan M, Bulat V, Mihic LL, Bolanca Z, Simic D. The role of UV radiation in the development of basal cell carcinoma. Coll Antropol. 2008:32(Suppl2):167-70. Available from: https:// pubmed.ncbi.nlm.nih.gov/19138022/
Martinez MF, Romano MV, Martinez AP, Gonzalez A, Muchnik C, Stengel FM, et al. nevoid basal cell carcinoma syndrome: PTCH1 mutation profile and expression of genes involved in the Hedgehog pathway in Argentinian patients. Cells. 2019;8(2):144. Doi: 10.3390/cells8020144
Pellegrini C, Maturo MG, Di Nardo L, Ciciarelli V, Garcia-Rodrigo CG, Fargnoli MC. Understanding the molecular genetics of basal cell carcinoma. Int J Mol Sci. 2017;18(11):2485. Doi: 10.3390/ijms18112485
Karagas MR, McDonald JA, Greenberg ER, Stukel TA, Weiss JE, Baron JA, et al. Risk of basal cell and squamous cell skin cancers after ionizing radiation therapy. For the Skin Cancer Prevention Study Group. J Natl Cancer Inst. 1996;88(24):1848-53. Doi: 10.1093/jnci/88.24.1848
Li C, Athar M. Ionizing radiation exposure and basal cell carcinoma pathogenesis. Radiat Res. 2016;185(3): 217-28. Doi: 10.1667/RR4284.S1
Bartos V. Development of multiple-lesion basal cell carcinoma of the skin: a comprehensive review. Med Bull Sisli Etfal Hosp. 2019;53(4):323-8. Doi: 10.14744/SEMB.2019.08058
Carucci JA, Leffell DJ, Pettersen JS. Basal cell carcinoma chapter 115 section 21. Epidermal and Appendageal Tumors. In: Fitzpatrick’s Dermatology in General Medicine (8th ed). New York: McGraw-Hill; 2012. p. 1294.
Johannessen JT, Møller MP. Metastatic basal cell carcinoma. Ugeskr Laeger. 2021;183(37):V01210110. Available from: https:// pubmed.ncbi.nlm.nih.gov/34596527/
Sharquie KE, Noaimi AA. Basal cell carcinoma: topical therapy versus surgical treatment. Journal of the Saudi Society of Dermatology & Dermatologic Surgery. 2012;16(2):41-51. Doi: https://doi.org/ 10.1016/j.jssdds.2012.06.002
Leibovitch I, Huilgol SC, Selva D, Richards S, Paver R. Basal cell carcinoma treated with Mohs surgery in Australia III. Perineural invasion. J Am Acad Dermatol. 2005;53(3):458-63. Doi: 10.1016/j.jaad.2005.04.089
Zamboni WA, Browder LK, Martinez J. Hyperbaric oxygen and wound healing. Clin Plast Surg. 2003;30(1):67-75. Doi: 10.1016/s0094-1298(02)00068-8
Undersea and Hyperbaric Medical Society. Indications for Hyperbaric Oxygen Therapy. 2023. [cited 2021 Jan 17]. Available from: https://www.uhms.org/resources/hbo-indications.html
Shinomiya N, Asai Y. Hyperbaric Oxygenation Therapy Molecular Mechanisms and Clinical Applications: Molecular Mechanism and Clinical Applications. Singapore: Springer Nature Pte. 2020. Doi: 10.1007/978-981-13-7836-2
Neuman TS, Thom SR. Physiology and Medicine of Hyperbaric Oxygen Therapy. Philadelphia: Saunders Elsevier; 2008. Doi: https://doi.org/10.1016/B978-1-4160-3406-3.X5001-X
Bhutani S, Vishwanath G. Hyperbaric oxygen and wound healing. Indian J Plast Surg. 2012;45(2):316-24. Doi: 10.4103/0970-0358.101309
Nakayama M, Tabuchi K, Nakamura Y, Hara A. Basal cell carcinoma of the head and neck. J Skin Cancer. 2011;2011(ID 496910):1-9. Doi: 10.1155/2011/496910
Codner MA, McCord CD, Mejia JD. Lalonde D. Upper and lower eyelid reconstruction. Plast Reconstr Surg. 2010;126(5):231e–245e. Doi: 10.1097/PRS.0b013e3181eff70e
Puig S, Cecilia N, Malvehy J. Dermoscopic criteria and basal cell carcinoma. G Ital Dermatol Venereol 2012;147(2):135-40. Available from: https://pubmed.ncbi.nlm.nih.gov/22481576/
Kim KP, Sim HS, Choi JH, Lee SY, Lee DH, Kim SH, et al. The versality of cheek rotation flaps. Arch Craniofac Surg. 2016;17(4):190-7. Doi: 10.7181/acfs.2016.17.4.190
Castilla DM, Liu ZJ, Velazquez OC. Oxygen: implications for wound healing. Adv Wound Care (New Rochelle). 2012;1(6):225-30. Doi: 10.1089/wound.2011.0319
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