Routine double treatments of superficial basal cell carcinomas using aminolaevulinic acid-based photodynamic therapy

Background Superficial basal cell carcinomas of the skin (sBCC) often respond poorly to single-treatment aminolaevulinic acid-based photodynamic therapy (ALA-PDT), with a number of reports indicating a relapse rate of 50% or more. Objectives To determine whether a second treatment at seven days can improve the response. Methods Twenty-six lesions were treated twice with ALA-PDT, with an interval of 7 days between the two treatment sessions. Results We observed a complete response rate of 100% 1 month after treatment. Only one lesion relapsed (16 months post-PDT), a relapse rate of 4% (median follow up 27 months; range 15-45 months), Cosmetic results were excellent. Conclusions We consider routine double treatments with ALA-PDT to be an effective approach to the management of sBCC, particularly those located in anatomically difficult, or cosmetically sensitive, sites.