Conflict of interest Dr Girard has worked as a consultant for Galderma. Drs Debu, Bessis, Blatière, Dereure and Guillot have no conflicts of interest to declare.
Treatment of Gorlin syndrome (nevoid basal cell carcinoma syndrome) with methylaminolevulinate photodynamic therapy in seven patients, including two children: interest of tumescent anesthesia for pain control in children
Version of Record online: 16 APR 2012
© 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology
Journal of the European Academy of Dermatology and Venereology
Volume 27, Issue 2, pages e171–e175, February 2013
How to Cite
Girard, C., Debu, A., Bessis, D., Blatière, V., Dereure, O. and Guillot, B. (2013), Treatment of Gorlin syndrome (nevoid basal cell carcinoma syndrome) with methylaminolevulinate photodynamic therapy in seven patients, including two children: interest of tumescent anesthesia for pain control in children. Journal of the European Academy of Dermatology and Venereology, 27: e171–e175. doi: 10.1111/j.1468-3083.2012.04538.x
Funding sources None.
Financial disclosure None.
- Issue online: 22 JAN 2013
- Version of Record online: 16 APR 2012
- Received: 16 December 2011; Accepted: 7 March 2012
Objective To report our experience of methylaminolevulinate photodynamic therapy (MAL-PDT) in the treatment of multiple basal cell carcinoma (BCC) in adults and children with Gorlin syndrome (GS).
Design Report of cases.
Setting University of Montpellier, Department of Dermatology.
Patients Seven Gorlin patients (41 superficial or nodular carcinomas), including two children.
Interventions Prior superficial curettage for superficial BBCs or debulking for nodular BCCs was systematically performed. Methylaminolevulinic acid was applied topically to lesions 3 h before illumination with 635 nm red light for 10 min (37 J/cm2). To prevent treatment discomfort, analgesics and/or cooling by sprayed water were most often provided, and occasionally 1% lidocaine local anesthesia. A ropivacaine-lidocaine tumescent anesthesia was performed on the youngest patient.
Main outcome measures The initial response rate; tolerance, particularly in children; cosmetic outcome.
Results Overall clearance in patients was 60% after one session of MAL-PDT and 78% after three sessions. Resolution of the lesions was accompanied by an excellent cosmetic outcome in all patients. Treatments were well tolerated in adults with moderate pain sensation during illumination. In a child, tumescent anesthesia assured excellent tolerance in all treatment stages.
Conclusion We add our experience to previous articles that consider PDT as an interesting option in the treatment of GS. To our knowledge, this study is the first report of MAL-PDT in GS children using tumescent anesthesia. Specific guidelines for adult and pediatric patients remain to be established.