Management of a difficult nodular basal cell carcinoma of lower eyelid by laser ablation

Basal cell carcinoma is a locally aggressive skin cancer arising from the basal cells of the epidermis. It is most commonly seen in Fair skin people living in sunny climates. The causative factor is presumed to be UV radiation which damages the P3 gene which is a tumor suppressor gene. It presents as an ocular problem in 20% of cases with the lower eyelid being the most common site followed by medial canthus, lateral canthus and upper eyelid. The options in case of nodular carcinoma conventionally are surgery with or without MOH’s technique, immunotherapy and radiation. Laser is increasingly being used in basal cell carcinoma in many centers around the world. We present a case of a large Nodular basal cell carcinoma which was treated by laser ablation with diode laser instead of a full excision of eyelid with quite satisfactory results cosmetically and functionally. Laser ablation is a viable method for treatment of basal cell carcinoma.