Histopathological analysis of cytoreduction and slow Mohs stage 1 after electrocurettage and 5% imiquimod in high-risk basal cell carcinoma: a prospective study of 31 cases
DOI:
https://doi.org/10.47196/3zppmk55Keywords:
curettage, imiquimod, Slow Mohs, basal cel carcinoma, high-risk, cytoreductionAbstract
Introduction: curettage (EC) and 5% imiquimod are effective therapies for low-risk basal cell carcinoma (BCC). In high-risk cases, prior use of imiquimod has been shown to reduce the number of Mohs stages. There are no studies evaluating the combination of EC + 5% imiquimod with histopathological analysis of cytoreduction and the first stage of Slow Mohs.
Objectives: To analyze the histopathology of cytoreduction and the first stage of Slow Mohs after EC + 5% imiquimod in high-risk BCC and to compare the number of stages with a historical institutional series without pretreatment.
Materials y methods: a prospective, quasi-experimental study. Thirty-one high-risk BCCs treated between August 2024 and March 2025 were included. Patients received EC followed by 5% imiquimod for six weeks and subsequently underwent Slow Mohs. Tumor persistence was defined as positive cytoreduction or first stage.
Results: tumor absence was observed in 87.1% (27/31; 95% CI: 69-96%) while tumor persistence was 12.9% (4/31; 95% CI: 4.2-31%). In the nose (n=15) persistence was 26.7%, whereas in extranasal locations (n=16) it was 0%.
Conclusions: the combination of curettage + 5% imiquimod before slow Mohs surgery showed a high rate of histopathological negativity, especially outside the nose, suggesting potential savings in stages and usefulness in contexts without access to Mohs surgery or with contraindications.
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