Combined Mohs Micrographic Surgery and 5-Aminolevulinic Acid Photodynamic Therapy for Nasal Ala Basal Cell Carcinoma: A Case Report

This case report describes a 46-year-old female with basal cell carcinoma (BCC) of the nasal ala who was treated with Mohs micrographic surgery (MMS) combined with 5-aminolevulinic acid photodynamic therapy (ALA-PDT). The patient presented with a slowly growing nasal lesion over nine years, accompanied by recent ulceration and crusting for the past year. A pathological biopsy confirmed the presence of basal cell carcinoma. After preoperative evaluation, surgical contraindications were excluded, and the lesion was excised using MMS. Open wound healing was allowed for 48 hours, followed by five sequential sessions of ALA-PDT. The wound healed with favorable scar formation, and no recurrence was observed during a 5-year postoperative follow-up. This case highlights that the combination of MMS and PDT may be an optimal approach for BCCs larger than 1 cm in diameter located in aesthetically sensitive regions.