A new practice of trichloroaceticacid peeling: reduction of second primary skin cancer
PDF
Cite
Share
Request
Original Article
VOLUME: 25 ISSUE: 2
P: 56 - 61
March 2009

A new practice of trichloroaceticacid peeling: reduction of second primary skin cancer

Turk J Surg 2009;25(2):56-61
1. Çanakkale Onsekiz Mart Üniversitesi, Plastik ve Rekonstrüktif Cerrahi, Çanakkale
2. Dr. Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi, Plastik ve Rekonstrüktif Cerrahi, İstanbul
3. Dr. Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi, Patoloji, İstanbul
No information available.
No information available
PDF
Cite
Share
Request

Abstract

Purpose: Exposure to solar radiation is a major cause of nonmelanoma skin cancer. Topical application of chemical peeling agents to reverse actinic damage of skin is a well-established, accepted clinical practice. Subclinic malignant lesions are generally seen with skin cancers simultaneously. In this paper, we evaluated effectiveness of the tricholoroacetic acid peeling to treatment of subclinic lesions. Material and Methods: Between 1999 and 2004, 102 patients with skin cancer were treated surgically. In addition to the surgical treatment of malignant lesions, full-face chemical peeling with 35-40% trichloroacetic acid was applied during the same operative session to 48 patients whose faces had extensively sun-damaged skin. The ages of patients were varied between 51 and 93. They were followed- up 1-5 years. The effectiveness of the TCA treatment was evaluated with pathologic examinations. Result: Second primary skin cancer was observed in only 3 patients who were applied TCA peeling. TCA peeling causes histologic changes such as correction of epidermal atrophy and atypia as well as deposition of new subepidermal collagen. Conclusion: Trichloroaceticacid peeling provides a prophylactic effect against the development of skin malignancies.

Keywords:
Chemical peeling, skin cancer, trichloroaceticacid

References

1
Hedrick MH, Lorenz HP, Miller TA. Malignant Skin Conditions. Plastic Surgery: Indications, operations, and outcomes. Guyuron B (ed.). Missouri. Mosby, 2000;315-324.
2
Fusco FJ. The aging face and skin. Nonoperative techniques for facial rejuvenation. Clin Plast Surg. 2001;28:1-13.
3
Zbar R, Cottel W. Skin tumors 1: nonmelanoma skin tumors. Selected Readings in Plastic Surgery. 2000; 9: 1-33.
4
Butler PE, Gonzalez S, Randolph MA, Kim J, Kollias N, Yaremchuk MJ. Quantitive and qualitative effects of chemical peeling on photo-aged skin: An experimental study. Plast Reconst Surg. 2001;107:222-228.
5
Humphreys TR, Werth V, Dzubow L, Kligman A. Treatment of photodamaged skin with tricholoroaceticacid and topical tretinoin. J Am Acad Dermatol 1996 34:638-644.
6
Rubin MG. Photoaged and photodamaged skin. Manual of chemical peels: Superficial and medium depths. J.B. Lippincott Comp. 1995; 1-16.
7
Uitto J. Understanding premature skin aging. N Engl J Med. 1997;337:1463-1465.
8
Olbrich SM. Cutaneous Carcinoma. Georgiade Plastic Maxillofacial and Reconstructive Surgery. Georgiade GS, Riefkohl R, Levin LS (eds.) Pennsylvania. Williams&Wilkins. 1997;122-133.
9
Gallagher RP, Hill GB, Bajdik CD, Coldman AJ, Fincham S, McLean DI, Threlfall WJ. Sunlight exposure, pigmentation factors, and risk of nonmelanocytic skin cancer. Arch Dermatol. 1995;l3l: 164-169.
10
Marks RI, Rennie G, Seiwood TS. Malignant transformation of solar keratoses to squamous cell carcinoma. Lancet. 1988;1:795-798.
11
Callen JP, Bickers DR, Moy RL. Ac tinic keratoses. J Am Acad Dermatol. 1997;36;650-656.
12
Brodland DG, Roenigk RK. Trichloroacetic acid chemexfoliation (chemical peel) for extensive premalignant actinic damage of the face and scalp. Mayo Clin Proc. 1988;63:887-896.
13
Roenigk DR, Brodland DG. A primer of facial chemical peel. Dermatol Clin. 1993: ll:349-359.
14
Nelson BR, Fader DJ, Gillard M, Majmudar G, Johnson TM. Pilot histologic and ultrastructural study of the effects of medium-depth chemical facial peels on dermal collagen in patients with actinically damaged skin. J Am Acad Dermatol. 1995;32:472-478.
15
Benedetto AV, Griffin TD, Benedetto EA, Humeniuk HM. Dermabrasion: Therapy and prophylaxis of the photoaged face. J Am Acad Dermatol. 1992;27: 439-447.
16
Cooley JE, Casey DL, Kauffman CL. Manual resurfacing and trichloroacetic acid for the treatment of patients with wide spread actinic damage. Dermatol Surg. 1997;23:373-379.
17
Rees TD. Chemabrasion and Dermabrasion. Aesthetic Plastic Surgery. Rees TD, LaTrenta GS (eds.) Philadelphia. W.B. Saunders company. 1994;757-777.
18
Stuzin JM, Baker TJ, Baker TM. Treatment of Photoaging: Facial Chemical Peeling. Plastic Surgery: Indications, Operations, and Outcomes. Guyuron B (ed.). Missouri. Mosby, 2000; 2435-2456.
19
Moy LS, Peace S, Moy RL: Comparison of the effect of various chemical peeling agents in a mini-pig model. Dermatol Surg. 1996;22:429-432.
20
Greenbaum SS. Chemical Peeling, Injectable collagen Implants, and Dermabrasion. Grabb and Smith’s Plastic Surgery. Aston SJ, Beasley RW, Thorne CH (eds.) Philadephia. Lippincott-Raven. 1997;597 -608.
21
Frankel DH, Hanusa BH, Zitelli JA. New primary nonmelanoma skin cancer in patients with a history of squamous cell carcinoma of the skin. Implications and recommendations for follow-up. J Am Acad Dermatol 1992;26:720-726.
22
Karagas MR, Stukel TA, Greenberg ER, Baron JA, Mott LA, Stern RS. Risk of subsequent basal cell carcinoma of the skin among patients with prior skin cancer. Skin Cancer Prevention Study Group. JAMA. 1992;267:3305-3310.