Abstract
INTRODUCTION: Basal cell carcinoma (BCC) is the most common type of skin cancer worldwide, and the incidence is rising. While surgical excision remains the gold standard, it can be time-consuming and resource-intensive. Therefore, there is a growing need for simpler and more cost-effective treatment options for low-risk tumors. OBJECTIVES: This study compared the scar quality and the recurrence rate from continuous wave CO(2) laser and curettage and electrodesiccation treatments. Scar quality and the recurrence rate from the treatments were assessed. METHODS: A single-blind randomized prospective interventional trial was conducted at Odense University Hospital, Denmark, from 2017 to 2023. Patients with histologically confirmed superficial BCC were randomized 1:1 to Curettage-Electrodesiccation (CE) or continuous wave CO(2) (CW CO(2)) laser treatment. Scar quality was assessed using the Patient and Observer Scar Assessment Scale (POSAS) and a modified visual-only scale (VSAS). Recurrence within one year was a secondary outcome. RESULTS: Thirty-two patients were treated for 32 tumors: 17 with CE and 15 with CO(2) laser. There was no significant difference in scar quality or recurrence rate between the CE and CO(2) laser groups (PSAS: P = 0.422; OSAS: P = 0.747; VSAS: P = 0.522). After one year, neither group showed tumor recurrence. CONCLUSION: CO(2) laser used in continuous wave setting offers a treatment for superficial BCCs with cosmetic outcomes and recurrence rates comparable to CE. However, a larger patient sample and longer follow-up are needed for definitive conclusions.