Efficacy and Aesthetic Outcomes of Photodynamic Therapy for Basal Cell Carcinoma in Aesthetic-Sensitive Facial Regions: A Case Series Study.

Background: Surgical excision of basal cell carcinoma (BCC) in aesthetic facial regions (e.g., nasal, periocular) risks disfiguring scars and functional deficits, particularly for elderly patients with surgical contraindications or extensive lesions where complete tumor clearance proves challenging. Conventional approaches often carry significant perioperative burdens for this demographic.

Objective: To evaluate the clinical efficacy and aesthetic outcomes of photodynamic therapy (PDT) as a non-surgical alternative for BCC in cosmetically critical facial areas.

Methods: This case series analyzed three patients with histologically confirmed BCC (nodular, ulcerative, and infiltrative subtypes) involving nasal, periocular, and cheek regions. All subjects underwent debridement pretreatment followed by photodynamic therapy (PDT).

Results: Complete tumor clearance was achieved in all cases, confirmed by 3-month clinical and dermoscopic evaluation. Ulcerated lesions demonstrated full epithelialization with preserved nasal alar architecture, eyelid margin integrity, and natural cheek contour. Transient erythema resolved spontaneously without scarring or dyspigmentation. No recurrences were observed during the 1-year follow-up period.

Conclusion: ALA-PDT achieves precise tumor eradication while preserving critical facial anatomy, serving as a viable first-line option for anatomically complex BCCs in elderly populations.