{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T04:58:45Z","timestamp":1771477125072,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T00:00:00Z","timestamp":1627776000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Some basal cell carcinoma (BCC) patients are considered as a high risk regarding the site, size, histopathological variant, or recurrence. High\u2010risk BCC is a challenging therapeutic problem due to the trial to balance between complete surgical excision from one side and tissue preservation from the other side.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate the efficacy of combining ablative CO<jats:sub>2<\/jats:sub>\u00a0laser, imiquimod 5%, and diclofenac 3% as a therapeutic regimen in high\u2010risk and inoperable BCC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients\/Methods<\/jats:title><jats:p>The study was conducted on 14 patients that were assessed clinically and pathologically then categorized regarding the site, size, histopathology, and fitness for surgery as high\u2010risk inoperable BCC. They received an ablative session of CO<jats:sub>2<\/jats:sub>\u00a0laser, followed by application of diclofenac sodium 3% gel once daily for 5\u00a0days and imiquimod 5% cream for another 2\u00a0days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 11\u00a0males and 3 females. Nine lesions were located on the scalp, 4 on the face, and one lesion on the trunk. All lesions were of large size &gt;5\u00a0cm in diameter. Histopathology showed 4 patterns: nodular type in 8 patients, infiltrating type in 3 patients, metatypical type in 2 patients, and micronodular type in one patient. At the end of the treatment period, 9 patients showed significant (moderate to marked) improvement while 5 patients showed weak (poor to mild) response. Significant improvement was more observed in nodular type. Relapse was more observed during the 5<jats:sup>th<\/jats:sup> to 6th months with 2 patients showed no relapse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This combined regimen is a good alternative therapeutic modality in high\u2010risk inoperable BCC especially the nodular pathologic pattern.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.14354","type":"journal-article","created":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T19:30:45Z","timestamp":1627846245000},"page":"2049-2055","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The combined effect of CO<sub>2<\/sub> laser, topical diclofenac 3%, and imiquimod 5% in treating high\u2010risk basal cell 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