title: Consensus recommendations for the treatment of basal cell carcinomas in Gorlin syndrome with topical methylaminolaevulinate-photodynamic therapy.
abstract: BACKGROUND
  Patients with Gorlin syndrome develop multiple basal cell carcinomas (BCC), for which treatment is often difficult. Methylaminolevulinate-photodynamic therapy (MAL-PDT) is approved for the treatment of superficial and nodular BCCs in Canada and several European countries.
  
  
  OBJECTIVE
  To establish consensus recommendations for the use of MAL-PDT in patients with Gorlin syndrome.
  
  
  METHODS
  The Gorlin consensus panel was comprised of 7 dermatologists who had treated a total of 83 patients with Gorlin syndrome using MAL-PDT. Consensus was developed based on the personal experience of the expert and results of literature review (on PUBMED using the keywords 'MAL' and 'PDT' and 'Gorlin' or 'naevoid basal cell carcinoma syndrome').
  
  
  RESULTS
  Consensus was reached among the experts and the literature review identified 9 relevant reports. The experts considered MAL-PDT a generally effective and safe therapy for treatment of BCC in Gorlin syndrome. For superficial BCC (sBCC), all sizes can be treated, and in nodular BCC (nBCC), better efficacy can be achieved in thinner lesions (<2 mm in thickness). MAL-PDT treatment schedule should be performed according to labelling although in individual cases, it may be adapted and performed on a monthly basis based on clinical assessment. Follow-up should be related to frequency of recurrence, and severity, number and location of lesions. Multiple lesions and large areas may be treated during the same session; however, adequate pain management should be considered.
  
  
  CONCLUSIONS
  MAL-PDT is safe and effective in patients with Gorlin syndrome. Utilization of these recommendations may improve efficacy and clearance rates in this population.
authors.affiliation: Hôpital Saint-Louis, Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Basset-Seguin
authors.forename: R
authors.initials: R
authors.lastname: Bissonnette
authors.forename: C
authors.initials: C
authors.lastname: Girard
authors.forename: M
authors.initials: M
authors.lastname: Haedersdal
authors.forename: J T
authors.initials: JT
authors.lastname: Lear
authors.forename: C
authors.initials: C
authors.lastname: Paul
authors.forename: S
authors.initials: S
authors.lastname: Piaserico
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000622:Aminolevulinic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D001478:Basal Cell Nevus Syndrome / Q000150:complications*; D002280:Basal Cell Carcinoma / Q000150:complications / Q000188:drug therapy*; D002648:Child; D006801:Humans; D008875:Middle Aged; D059408:Pain Management; D010778:Photochemotherapy / Q000009:adverse effects; D012878:Skin Neoplasms / Q000150:complications / Q000188:drug therapy*
chemical_list: D000622:Aminolevulinic Acid