Intralesional Interferon in the Treatment of Basal Cell Carcinoma

Basal cell carcinoma (BCC) is by far the most common skin malignancy in the white human population worldwide accounting for about 80% of non- melanoma skin cancer [1, 2]. BCC is a slow-growing tumor and rarely metastasizes and does cause progressive local tissue destruction. The treatment goals focus on complete tumor removal and minimization of cosmetic and functional defects. Effective methods of treatment include excisional surgery, curettage and electrodesiccation, cryosurgery, radiotherapy, and Mohs micrographic surgery [3]. Recently, the photodynamic therapy has evolved as a therapeutic alternative for superficial and nodular BCC [4]. Immune response modifiers such as interferon (IFN) and imiquimod have been shown to be effective in the treatment of BCC [5]. Interferons are a group of naturally occurring glycoproteins that possess multiple biological effects including control of cell growth and differentiation, regulation of cell surface antigen expression, and modulation of humoral and cellular immune responses [6]. Based on the cell of origin, four types of IFN are recognized, namely IFN- α, IFN-β, IFN- γ, and IFN- τ. IFN-α is produced mainly by leukocytes, IFN- α by fibroblasts and epithelial cells, IFN- γ by lymphocytes, and IFN- τ by trophoblasts. Although the effectiveness of intralesional IFN therapy in BCC has been established in a number of clinical trials, there is still a controversy regarding the duration and dosing of IFN- α.