Cutting-Edge Innovations in Minimally Invasive Techniques for Skin Cancer Treatment

Elahe Najafizadeh, Ahmad Alkhateeb^*, Regina Mankovskaia
Department of Dermatology and Cosmetology, Bashkir State Medical University, Russia.

Correspondence to: Ahmad Alkhateeb, Department of Dermatology and Cosmetology, Bashkir State Medical University, Russia.
Received date: February 17, 2024; Accepted date: March 7, 2024; Published date: March 14, 2024
Citation: Najafizadeh E, Alkhateeb A, Mankovskaia R. Cutting-Edge Innovations in Minimally Invasive Techniques for Skin Cancer Treatment J Med Res Surg. 2024;5(2):29-39. doi: 10.52916/jmrs244133
Copyright: ©2024 Najafizadeh E, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

Abstract

Skin cancer is a common and possibly deadly disease that requires immediate and efficient treatment. Conventional surgical methods, although successful, frequently lead to the formation of scars and extended periods of recuperation. In recent years, there have been significant developments in minimally invasive treatments for treating skin cancer. These techniques provide patients with alternative options that result in better cosmetic outcomes and shorter recovery periods. This article is a comprehensive summary of state-of-the-art advancements in minimally invasive procedures, including as laser therapy, cryotherapy, electrochemotherapy, and radiofrequency ablation. We analyze the benefits of these procedures, including minimized scarring, improved cosmetic outcomes, and faster healing periods, while also examining the difficulties and factors involved in their application. We showcase the concrete advantages that patients receive when they undergo minimally invasive therapy for skin cancer, using case studies and success stories as evidence. In addition, we examine potential future paths in research and development, anticipating a favorable outlook for the ongoing use of minimally invasive methods in the treatment of skin cancer.
The global prevalence of skin cancer is a substantial health issue, leading to continuous progress in treatment strategies aimed at enhancing patient results. Conventional surgical techniques, however efficient, can lead to conspicuous scarring and extended recuperation periods. Recent advancements in minimally invasive procedures have significantly transformed the treatment of skin cancer, providing patients with alternative options that yield better esthetic results and shorter recovery periods. This article offers a comprehensive analysis of state-of-the-art advancements in minimally invasive procedures, encompassing laser therapy, cryotherapy, electrochemotherapy, and radiofrequency ablation. We use case studies and success stories to demonstrate the concrete advantages that patients gain from these operations, such as minimized scarring and improved cosmetic outcomes. In addition, we explore the difficulties and factors to take into account when putting these methods into practice, along with potential areas for further investigation and advancement. Our goal is to emphasize the hopeful future of minimally invasive treatments in skin cancer care, which will ultimately enhance patient experiences and outcomes.

Keywords:

Skin cancer, Surgery, Cryotherapy, Photodynamic Therapy (PDT), Surgical procedure, Tumor.

Traditional Treatment Methods

In the past, the main methods used to treat skin cancer have focused on surgical removal procedures, such as conventional excision and Mohs micrographic surgery. Standard excision is a surgical procedure that involves removing the tumor and a portion of healthy tissue around it to ensure complete removal. On the other hand, Mohs surgery is a meticulous procedure where thin layers of tissue are progressively removed and examined under a microscope until no cancerous cells are visible. These surgical methods have been widely recognized as being effective in obtaining significant success rates in treating skin cancer [1].

Although traditional surgical treatments are effective, they do have certain limits. An important disadvantage is the possibility of conspicuous scarring, especially in aesthetically sensitive regions like the face. Moreover, the recovery period after these treatments can be prolonged, with patients frequently encountering discomfort and requiring downtime while their bodies heal. Moreover, the intrusive nature of these surgical methods may not be suitable for many patients, especially those with severe or recurring lesions [2,3].

Although traditional surgical treatments continue to be a fundamental aspect of skin cancer treatment, there has been a growing interest in investigating alternate approaches that provide similar effectiveness while also improving cosmetic results and reducing patient complications [4]. The shift in focus has facilitated the advancement and acceptance of minimally invasive treatments, which signify a fundamental change in the treatment of skin cancer.

Besides surgical excision techniques, other conventional treatment approaches for skin cancer encompass radiation therapy and topical medicines. Radiation therapy, namely external beam radiation or brachytherapy, is used when surgery is not possible or when it is challenging to determine the boundaries of the tumor. Imiquimod and fluorouracil are topical drugs that are directly administered to the skin to specifically target and eliminate malignant cells. These treatments are commonly employed for superficial basal cell carcinomas or in situations when surgery is not feasible [5].

Although these conventional therapy options have shown effectiveness in treating different forms of skin cancer, they do have certain limitations. Radiation therapy can induce cutaneous irritation and other adverse reactions, while its potential long-term impact on healthy tissue is still under investigation. Topical drugs can cause local skin reactions such as erythema, irritation, and pain, which may affect patient compliance with therapy.

Moreover, these traditional methods may not consistently be appropriate for every patient, especially individuals with certain medical ailments or anatomical factors to consider. Moreover, the expense and availability of these treatments may provide obstacles for certain persons in their pursuit of medical assistance.

Consequently, there is an increasing curiosity in investigating minimally invasive procedures as feasible substitutes for conventional therapeutic methods. These novel strategies strive to attain similar cancer treatment results while limiting the invasiveness of the surgery and enhancing patient experiences, such as reduced scarring, faster recovery periods, and improved cosmetic outcomes. The development of state-of-the-art technology and methods in the area of minimally invasive skin cancer therapy signifies a notable progress in the effort to enhance patient care and results [6-8].

Various alternative methods have historically been employed in the treatment of skin cancer. The following items are included:

1. Cryotherapy, is a medical procedure that utilizes extremely low temperatures to eliminate malignant tissue. The lesion is subjected to direct application of liquid nitrogen, resulting in fast freezing and eventual cellular eradication. Cryotherapy is frequently employed for treating superficial basal cell carcinomas and actinic keratoses, providing a straightforward and efficient outpatient procedure that results in minimum scarring.
2. Electrodesiccation and Curettage (ED and C) is a medical procedure that entails the removal of malignant tissue by scraping it off with a curette. Subsequently, an electric current is applied to eradicate any remaining cancer cells and manage bleeding. This technique is frequently employed for low-risk basal cell carcinomas and squamous cell carcinomas, especially in regions where surgical removal may not be feasible.
3. Photodynamic Therapy (PDT) is a procedure where a photosensitizing chemical is applied to the skin and then exposed to a specified wavelength of light. By activating the photosensitizer, cancer cells are effectively eradicated. Photodynamic Therapy (PDT) is commonly employed for treating surface-level skin malignancies and precancerous lesions, providing a non-intrusive alternative that yields favorable cosmetic results.
4. Chemotherapy: Although systemic chemotherapy is not frequently employed for the majority of skin cancer cases, topical chemotherapy drugs like 5-Fluorouracil (5-FU) and imiquimod may be given for specific superficial basal cell carcinomas and actinic keratoses. These drugs function by impeding the proliferation and division of cancer cells, providing a non-surgical alternative for some individuals.

The effectiveness and potential adverse effects of these conventional treatment methods differ based on the specific type and stage of the skin cancer, as well as individual patient characteristics. Furthermore, these techniques may not consistently resolve the aesthetic issues linked to surgical procedures, especially in aesthetically delicate regions like the face.

Given these factors, the progress and improvement of minimally invasive methods signify a noteworthy breakthrough in the realm of skin cancer therapy. This provides patients with more choices that have the potential to enhance cosmetic results, decrease negative health effects, and improve overall well-being.

Emergence of Minimaly Invasive Techniques

The introduction of minimally invasive methods in the treatment of skin cancer signifies a notable progress in the discipline, propelled by an increasing focus on enhancing patient results and experiences. Minimally invasive techniques are distinguished by their capacity to accomplish therapeutic objectives while causing minimal disturbance to adjacent healthy tissue, leading to decreased scarring, quicker recovery periods, and enhanced cosmetic results in comparison to conventional surgical approaches. Multiple reasons have contributed to the increase in the utilization of minimally invasive procedures for the treatment of skin cancer:

1. Technological Advancements: The progress in cutting-edge technologies has facilitated the improvement and broadening of minimally invasive methods for treating skin cancer. The precision and effectiveness of minimally invasive operations have been improved by advancements in laser technology, cryotherapy devices, electrosurgical instruments, and imaging modalities. These advancements enable the targeted eradication of malignant tissue while preserving nearby healthy skin.
   There is an increasing acknowledgment of the significance of patient-centered treatment in the field of cancer, which involves taking into account the choices, values, and quality of life of patients. Minimally invasive procedures provide patients with the option to receive skin cancer therapy that is less invasive, resulting in shorter recovery periods and better cosmetic results. This aligns with their preference for therapies that are less intrusive and have less physical and emotional effects [9].
2. Cosmetic Factors: The aesthetic consequences of conventional surgical techniques, such as visible scars and physical abnormalities, can significantly affect patients' self-confidence and overall well-being, especially when skin malignancies develop in parts of the body that are highly concerned with appearance, such as the face. Minimally invasive treatments prioritize cosmetic results by reducing tissue damage and maintaining aesthetic integrity, therefore addressing patients' worries about their appearance after treatment.
3. Outpatient Setting: Numerous skin cancer therapy techniques that involve minimum invasion can be conducted in an outpatient setting, obviating the necessity for hospital admission and enabling patients to be discharged on the same day. This ambulatory strategy provides convenience and cost-efficiency while reducing the interference with patients' regular activities and schedules.
4. Progress in Oncologic Outcomes: Clinical studies and practice based on evidence have shown that minimally invasive treatments can achieve similar cancer treatment results as standard surgical methods for specific types of skin cancer, while ensuring safety and effectiveness. These approaches are becoming more widely acknowledged as effective treatment alternatives for various types and stages of skin cancer.

The adoption of minimally invasive procedures in the treatment of skin cancer signifies a fundamental change in approach towards personalized and patient-centric care, with a focus on both the effectiveness of the treatment and the overall quality of life. As these methods progress and become more widely accepted, they provide potential for raising the quality of treatment and improving the overall experience for those receiving treatment for skin cancer [10].

Moreover, the development of minimally invasive methods in the treatment of skin cancer has been driven by improvements in medical research, resulting in a more profound comprehension of the molecular mechanisms that underlie the development and advancement of skin cancer. The expansion of knowledge in this field has facilitated the advancement of precise medicines and minimally invasive treatment methods that selectively focus on cancer cells while minimizing harm to adjacent healthy tissue [11].

Furthermore, the increasing collaboration between dermatologists, oncologists, surgeons, and other healthcare providers has made it easier to incorporate minimally invasive methods into comprehensive protocols for managing skin cancer. By adopting a multidisciplinary approach, patients are provided with personalized treatment programs that consider their distinct medical history, tumor attributes, and treatment preferences.

Also, the increasing need for less invasive procedures in the field of aesthetic dermatology has stimulated investment and advancement in technology and methods that can be adapted for the treatment of skin cancer. Advancements in laser technology, initially designed for cosmetic procedures, have been modified to precisely target cancer cells via techniques like laser ablation [12].

Another significant factor driving the rise of minimally invasive treatments is the growing acceptance of value-based healthcare models. These models prioritize the provision of top-notch care while also managing costs and decreasing resource usage. Minimally invasive therapies for treating skin cancer are frequently linked to shorter hospital stays, decreased postoperative problems, and lower overall healthcare costs in comparison to conventional surgical techniques. This makes them appealing choices from a healthcare economics perspective.

In summary, the development of minimally invasive methods in the treatment of skin cancer signifies a significant change in how we handle this common and potentially dangerous disorder. Through the utilization of technology advancements, interdisciplinary cooperation, and a focus on the needs of the patient, these methods provide new opportunities to enhance results and improve the entire experience of patients in the battle against skin cancer [13].

Moreover, the rise of minimally invasive methods in the treatment of skin cancer has been expedited due to the growing need for therapies that prioritize both efficient disease control and patient satisfaction and convenience. Minimally invasive procedures have several benefits compared to conventional surgical techniques, such as decreased discomfort, faster recovery periods, and little scarring. These advantages are in line with patients' preferences for less invasive therapies [14].

Technological advancements have been crucial in advancing and perfecting minimally invasive methods. Advancements in imaging modalities, such as high-resolution ultrasound and optical coherence tomography, have enhanced the capacity to visualize and target skin lesions with accuracy, enabling precise and less invasive therapies. Moreover, the advancement of innovative tools and devices, such as microcatheters and endoscopic instruments, has empowered medical practitioners to carry out minimally invasive treatments with enhanced accuracy and command.

Minimally invasive procedures not only improve patient comfort and cosmetic results, but also offer the potential to decrease the use of healthcare resources and save costs. These procedures can lead to substantial cost savings for healthcare systems and payers by reducing the need for hospitalization and postoperative care. Additionally, they can free up resources for other patients requiring medical attention.

Furthermore, the increasing amount of clinical evidence that confirms the effectiveness and safety of minimally invasive methods has led to their extensive use in clinical practice. Minimally invasive treatments and standard surgical methods have been shown to have similar oncologic outcomes in both clinical trials and real-world research. This provides reassurance to doctors and patients regarding the effectiveness of these approaches in treating skin cancer [15-17].

In summary we can say, the introduction of minimally invasive methods in skin cancer therapy signifies a fundamental change towards care that is more focused on the patient, cost-efficient, and utilizes new technology. As these methods progress and acquire approval, they are expected to become more essential to the standard of care for managing skin cancer. This will provide patients with more treatment choices and better results.

Key Innovations in Minimally Invasive Techniques

Minimally invasive procedures have greatly changed the treatment of skin cancer, leading to a substantial transformation in how clinicians handle the management of cutaneous malignancies. These advances utilize advanced technologies and unique methods to provide precise and successful therapy, while reducing patient complications and enhancing cosmetic results. Several crucial advancements have arisen as auspicious substitutes for conventional surgical techniques:

1. Laser therapy: is a versatile and minimally invasive method that has become popular for treating many forms of skin cancer, such as Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC). Advanced laser systems, such as the carbon dioxide (CO₂) and Erbium-Doped Yttrium Aluminum Garnet (Er:YAG) lasers, allow for accurate and focused treatment of malignant tissue while limiting harm to the surrounding healthy skin. Laser ablation procedures utilize heat radiation to specifically eliminate cancer cells, resulting in superior cosmetic results and minimum scarring when compared to conventional surgical removal.
2. Cryotherapy, commonly referred to as cryosurgery, has been developed as a minimally invasive method for treating superficial skin malignancies, specifically basal cell carcinoma and actinic keratoses. The use of liquid nitrogen directly to the lesion results in swift freezing and eradication of malignant cells. Cryotherapy presents various benefits, such as its straightforwardness, low level of discomfort, and exceptional cosmetic results, which make it an appealing choice for patients with small, early-stage tumors in places that are highly concerned with appearance.
3. Electrochemotherapy is a treatment that combines the harmful effects of chemotherapy with the targeted opening of cancer cells caused by electric pulses. This novel method entails the delivery of chemotherapeutic drugs, such as bleomycin or cisplatin, followed by the application of electric pulses to the location of the tumor. Electric pulses augment the absorption of chemotherapeutic medications by cancerous cells, leading to precise cell demise while preserving adjacent healthy tissue. Electrochemotherapy is highly effective for treating cutaneous metastases and recurring skin malignancies, resulting in a high rate of response and excellent esthetic results.
4. Radiofrequency Ablation (RFA) is a minimally invasive procedure that employs high-frequency electrical currents to heat and eliminate malignant cells. This method is especially suitable for treating tiny, initial-stage skin malignancies, such as basal cell carcinoma and squamous cell carcinoma, resulting in outstanding cosmetic results and minimum scarring. Radiofrequency Ablation (RFA) has numerous benefits, such as accurate localization of tumors, quick treatment durations, and low discomfort after the procedure. Consequently, RFA is a favored choice for patients who choose minimally invasive treatment options.
   These notable breakthroughs in minimally invasive techniques signify considerable progress in the realm of skin cancer treatment, providing patients with efficacious and aesthetically pleasing alternatives to conventional surgical approaches. Through the utilization of state-of-the-art technologies and original methodologies, these inventive treatments have the capacity to revolutionize the field of skin cancer management, enhancing patient outcomes and quality of life while reducing the negative effects of treatment [18].
5. Photodynamic Therapy (PDT) is a minimally invasive treatment that uses a photosensitizing chemical plus light to specifically target and eliminate cancer cells. The procedure commences by administering a photosensitizer, such as Aminolevulinic Acid (ALA) or Methyl Aminolevulinate (MAL), to the specific region that is afflicted. After being taken in by the cancer cells, the photosensitizer becomes active when exposed to particular wavelengths of light. This activation triggers the creation of reactive oxygen species, which cause programmed cell death and tissue death in the tumor cells. Importantly, the surrounding healthy tissue remains unharmed. Photodynamic Therapy (PDT) is highly efficient in treating superficial basal cell carcinoma, actinic keratoses, and specific variants of squamous cell carcinoma. It provides exceptional esthetic results and causes minimum scarring.
6. Nonsurgical Radiotherapy approaches: Recent advancements in radiotherapy technology have resulted in the emergence of noninvasive radiotherapy approaches for addressing skin cancer, encompassing superficial and nodular basal cell carcinoma, squamous cell carcinoma, and cutaneous lymphomas. Superficial Radiotherapy (SRT) and electronic brachytherapy are methods that administer focused radiation directly to the tumor location, therefore reducing radiation exposure to nearby healthy tissue. These noninvasive radiation procedures provide an alternative to surgery for individuals who are not suitable for surgery or prefer noninvasive treatments. They have shown great esthetic results and high rates of tumor control.
7. Topical Immunotherapy has become a less invasive therapeutic choice for superficial basal cell carcinoma and squamous cell carcinoma in situ (Bowen's disease). Imiquimod and ingenol mebutate are agents that activate the body's immunological response, resulting in the eradication of cancer cells. Topical immunotherapy presents various benefits, such as being noninvasive, easy to apply, and resulting in positive cosmetic results. This makes it an appealing choice for patients with multiple or widespread lesions, or for those who want non-surgical treatment methods.
8. Nanotechnology has recently enabled the creation of innovative, less intrusive treatments for skin cancer. Nanotechnology-based therapies, including as nanoparticle-mediated drug delivery and photothermal therapy, employ nanoparticles to specifically target and transport therapeutic drugs or heat to cancer cells, resulting in localized tumor eradication while minimizing harm to healthy tissue. These novel methods show potential for enhancing the effectiveness and accuracy of skin cancer therapy, with the possibility of transforming the field of cancer treatment.

These advancements in minimally invasive methods for treating skin cancer encompass a wide range of procedures that utilize state-of-the-art technologies and innovative therapeutic tactics to enhance patient results while reducing the negative effects of therapy and cosmetic issues. As research progresses in this area, these groundbreaking methods are anticipated to have a more significant impact on the holistic treatment of skin cancer. They will provide patients with customized and efficient treatment choices that are specifically designed to meet their individual needs and preferences [19-21].

Advantages of Minimally Invasive Techniques in Skin Cancer Treatment

Reduced Scarring: Minimally invasive treatments result in smaller incisions or no incisions, causing little tissue stress and scarring in comparison to traditional surgical approaches. Minimizing apparent scarring is a top objective for patients, especially when dealing with skin malignancies in aesthetically sensitive places like the face.
Improved Aesthetic Results: Minimally invasive procedures frequently yield improved cosmetic outcomes in comparison to conventional surgery by minimizing tissue damage and preserving the integrity of the surrounding skin. Minimally invasive procedures increase the likelihood of patients achieving aesthetically attractive outcomes with minimum scarring, which enhances self-esteem and psychological well-being.
Reduced Recovery Duration: Minimally invasive procedures generally entail shorter periods of rest and recuperation in comparison to conventional surgical approaches. Minimally invasive procedures enable patients to promptly resume their regular activities, resulting in enhanced quality of life and minimized interference with everyday routines.
Minimally invasive techniques are linked to less postoperative pain and discomfort in comparison to standard surgery. This is because these techniques entail smaller incisions and less manipulation of tissue. This enhances the comfort of patients during their healing process and maybe decreases the necessity for pain drugs.
Reduced Complication Risk: Minimally invasive procedures are typically linked to a decreased likelihood of problems, such as wound infections, hematomas, and nerve damage, in comparison to conventional surgical approaches. The less invasiveness of these methods reduces the probability of surgical site infections and other postoperative problems, resulting in enhanced patient safety and results.
Outpatient Procedures: Numerous minimally invasive methods for treating skin cancer can be carried out on an outpatient basis, enabling patients to receive treatment without requiring hospitalization or overnight stays. This provides enhanced convenience for patients and minimizes the consumption of healthcare resources, resulting in cost savings for both patients and healthcare systems.
Feasibility for Elderly or Medically Fragile Patients: Minimally invasive procedures are frequently appropriate for elderly or medically fragile individuals who may not be eligible for conventional surgery due to pre-existing health issues or heightened surgical hazards. These individuals have the option to undergo minimally invasive operations that require less anesthetic and have less hazards during the perioperative period, resulting in enhanced safety and better outcomes.

Minimally invasive procedures allow for precise localization of malignant tissue, while minimizing damage to healthy surrounding skin. This leads to more focused therapy and better preservation of functional and cosmetic integrity. This level of precision enables clinicians to obtain the best possible outcomes in cancer treatment while minimizing harm to nearby structures [22].

In summary, the benefits of employing minimally invasive methods for treating skin cancer encompass diminished scarring, improved aesthetic results, expedited healing periods, decreased postoperative agony and discomfort, mitigated likelihood of complications, outpatient procedures, applicability to elderly or medically vulnerable individuals, as well as precise and targeted therapy. These benefits collectively enhance patient satisfaction, quality of life, and treatment outcomes in the management of skin cancer.

Functional preservation is typically enhanced by less invasive treatments, as opposed to conventional surgical methods. It is especially crucial for skin malignancies situated in anatomically sensitive or functionally significant areas, such as the eyelids, nose, or ears. Minimally invasive procedures reduce tissue damage and protect healthy surrounding tissues, which helps to maintain optimal function and mobility in these areas and enhance patients' overall quality of life [23-25].

Minimally invasive procedures generally necessitate less anesthetic than standard surgery due to their use of smaller incisions and shorter process durations. This is beneficial for patients who may have apprehensions or potential complications related to anesthesia, such as allergies or underlying medical issues. Minimally invasive procedures decrease the amount of anesthesia needed, which lowers the risk of complications associated to anesthesia and enhances the safety of therapy for patients.

Enhanced Accessibility and Affordability: Minimally invasive procedures are frequently more accessible and cost-effective compared to conventional surgical approaches, rendering them appealing choices for patients with restricted access to specialist medical facilities or limited financial means. These methods can be carried out in outpatient or office-based settings, hence minimizing the requirement for hospitalization and the accompanying expenses. Furthermore, the decreased duration of recovery and diminished need for postoperative care associated with minimally invasive methods result in decreased healthcare costs for both patients and healthcare systems [26].

Minimally invasive procedures are highly regarded for their favorable outcomes and less intrusive nature, resulting in elevated levels of patient satisfaction and acceptability. Patients value the limited scarring, quicker recovery periods, and decreased postoperative discomfort linked to these methods, resulting in enhanced patient satisfaction and adherence to treatment. Enhanced patient satisfaction and acceptance play a crucial role in enhancing treatment outcomes and achieving long-term success in the management of skin cancer.

Integration with Multimodal Therapy: Minimally invasive procedures can be smoothly combined with other forms of treatment, such as chemotherapy, immunotherapy, or radiation therapy, to offer thorough and tailored care for patients with intricate or advanced skin malignancies. By employing a multimodal approach, physicians can customize treatment programs to suit the specific needs of each patient, thereby enhancing the effectiveness of therapy while limiting the negative effects of treatment and maximizing the aesthetic results.

The subject of skin cancer therapy with minimally invasive approaches is constantly progressing due to continual technological breakthroughs and discoveries. Emerging technologies, such as robotic-assisted surgery, sophisticated imaging techniques, and tailored medication delivery systems, have the potential to enhance the accuracy, effectiveness, and safety of minimally invasive operations. Further advancements in research and development in this field are anticipated to broaden the range and influence of minimally invasive methods in the treatment of skin cancer [27-29].

Challenges and Considerations in Minimally Invasive Techniques for Skin Cancer Treatment

Patient Selection Criteria: A major obstacle in employing minimally invasive methods for skin cancer treatment is establishing suitable criteria for selecting patients. Although these treatments provide various benefits, they may not be appropriate for every patient or every form of skin cancer. When assessing patients for minimally invasive operations, it is crucial to thoroughly analyze factors such as tumor size, location, depth, and histological subtype.
Training and Expertise: Another obstacle is in ensuring that healthcare providers possess the requisite training and expertise to execute minimally invasive methods with safety and efficacy. These treatments frequently necessitate specific expertise and equipment, along with a comprehensive comprehension of anatomy, pathology, and oncology. To guarantee the competence of clinicians in conducting minimally invasive treatments and handling any problems, it is crucial to provide them with ongoing education and practical training programs.
Long-Term Efficacy: Although minimally invasive procedures have demonstrated encouraging results in the short term, their long-term effectiveness and durability are still subjects of continuing research and discussion. Long-term longitudinal studies are necessary to evaluate the rates of recurrence, survival outcomes, and cosmetic outcomes of patients who undergo minimally invasive treatments for the treatment of skin cancer.
Cost Considerations: Minimally invasive treatments may incur higher initial expenses compared to standard surgical methods due to the requirement for specialized equipment and technology. Moreover, the variability in reimbursement systems and insurance coverage for minimally invasive procedures might provide financial obstacles for both patients and healthcare providers. Cost-effectiveness evaluations are necessary to assess the economic implications of implementing minimally invasive procedures in the treatment of skin cancer.

Minimally invasive treatments may have limitations in treating complex cases of skin cancer or recurrent lesions that necessitating more comprehensive surgical intervention. Patients who have big or profoundly invasive tumors, tumors placed in difficult anatomical locations, or tumors with aggressive histological subtypes may not be good candidates for minimally invasive procedures. Instead, they may need to undergo traditional surgical techniques in order to get the best oncologic outcomes [30].

Managing patient expectations and correctly conveying the advantages and constraints of minimally invasive treatments are of utmost importance. Patients may possess impractical expectations regarding the outcomes of minimally invasive operations, specifically in relation to cosmetic outcomes and rates of tumor recurrence. Healthcare practitioners should provide comprehensive preoperative counseling and engage in collaborative decision-making with patients to guarantee informed consent and establish realistic expectations.

The implementation of novel minimally invasive procedures may give rise to regulatory and ethical concerns pertaining to patient safety, device authorization, and informed consent. Healthcare professionals are required to comply with regulatory rules and ethical principles when integrating new technology and techniques into clinical practice. The main focus should be on ensuring patient safety and respecting patient autonomy.

It is crucial for professional authors and healthcare professionals in the field of minimally invasive approaches for skin cancer treatment to tackle these issues and considerations. Authors can contribute to the improvement of knowledge and practice in skin cancer management by recognizing and tackling these problems, and by providing thorough and unbiased discussions of the topic [31].

Technical constraints and the process of acquiring expertise: The utilization of minimally invasive methods for skin cancer therapy can pose technical obstacles and a significant learning curve for healthcare professionals who are inexperienced in these procedures. Acquiring expertise in specific equipment and techniques, together with the ability to accurately interpret imaging findings and choose suitable therapy parameters, necessitates focused training and practical experience. Healthcare practitioners must allocate time and resources to acquire the requisite skills and knowledge in order to guarantee the secure and efficient administration of minimally invasive treatments [32,33].

Patient Adherence and Follow-Up: Minimally invasive procedures typically necessitate rigorous compliance with post-procedural care instructions and many follow-up visits to assess treatment outcomes and identify any indications of recurrence or problems. The adherence of patients to these instructions can vary, especially in circumstances when many treatment sessions or long-term monitoring are necessary. Healthcare providers should educate patients on the significance of adherence and develop transparent communication lines to facilitate continuous monitoring and assistance.

Ethical considerations arise in the realm of research and innovation as the field of minimally invasive treatments for skin cancer therapy progresses. When healthcare practitioners and researchers are planning and conducting studies incorporating new procedures or experimental therapies, they must follow ethical standards, including beneficence, non-maleficence, and respect for autonomy. Essential components of ethical research conduct in this discipline include obtaining informed consent, safeguarding patient privacy and confidentiality, and providing transparent reporting of study findings.

Access and Equity: The availability of minimally invasive procedures for skin cancer therapy may be restricted due to factors such as geographical location, socioeconomic level, and healthcare infrastructure. Specialized equipment and qualified clinicians may be scarce in rural or underserved locations, resulting in discrepancies in care. Healthcare professionals and governments should prioritize overcoming obstacles to access and advocating for fairness in the provision of minimally invasive therapies. This entails guaranteeing that all patients receive top-notch care, irrespective of their demographic or geographical circumstances.

Integration into Clinical Practice: The incorporation of minimally invasive methods into regular clinical practice may necessitate organizational and logistical modifications within healthcare organizations. This entails guaranteeing the accessibility of essential equipment and resources, forming multidisciplinary care teams of specialists in minimally invasive therapies, and creating standardized protocols for patient selection, treatment administration, and post-treatment care. Healthcare administrators and executives are essential in ensuring the smooth incorporation of minimally invasive procedures into clinical workflows to enhance patient outcomes and experiences.

Case Studies and Success Stories

Case Study 1: Laser Treatment for Basal Cell Carcinoma (BCC)

Patient Profile: A 55-year-old individual arrived with a superficial Basal Cell Carcinoma (BCC) on the forehead, which is a region that is particularly concerned with esthetic appearance. The lesion had a diameter of roughly 1 cm and was situated in close proximity to the hairline.
Treatment Approach: Laser therapy was selected as the treatment method because of its low invasiveness and potential for achieving exceptional cosmetic results. The patient received many sessions of laser therapy utilizing a fractional CO2 laser. The laser was calibrated to emit accurate and controlled bursts of energy in order to specifically target and remove the malignant tissue, while minimizing harm to the adjacent healthy skin.
Result: After a sequence of laser therapy sessions spaced several weeks apart, the BCC lesion exhibited total remission with minimal scarring. The patient indicated the presence of some redness and temporary discomfort during the treatment sessions, which promptly resolved after the procedure. The cosmetic results were outstanding, as there was no disturbance to the texture of the surrounding skin and no hair loss in the treated region. The patient conveyed a strong sense of contentment with the treatment and indicated happiness with the limited period of recovery and discomfort encountered.

Case Study 2: Cryotherapy Treatment for Actinic Keratoses (AKs)

Patient Profile: A 65-year-old individual with light complexion and a medical background of prolonged sun exposure appeared with many Actinic Keratoses (AKs) on the face and scalp. The AK lesions exhibited rough and scaly patches with a diameter ranging from 3 to 8 mm.
Treatment Approach: Cryotherapy was chosen as the main therapeutic method due to its efficacy in specifically treating superficial precancerous lesions while protecting adjacent healthy tissue. The AK lesions were treated with liquid nitrogen cryogen using a cryospray equipment, which caused controlled freezing and thawing to destroy the cells.
Result: After undergoing cryotherapy procedures spaced several weeks apart, the AK lesions exhibited substantial improvement, with the majority of lesions either completely resolving or partially regressing. Immediately after the surgery, there was a mild redness and formation of crusts at the treatment areas, which disappeared within a few weeks. The cosmetic results were outstanding, with minimal scarring and complete restoration of the skin's natural texture. Subsequent scheduled check-ups verified the continued absence of treated abnormalities, offering the patient reassurance and a restored feeling of self-assurance.

Case Study 3: The Use of Electrochemotherapy to Treat Cutaneous Metastases

Patient Profile: A septuagenarian with cutaneous metastases originating from a primary melanoma, with many skin nodules on the torso and limbs. The metastatic lesions were confirmed through biopsy and had a diameter of roughly 1 to 2 cm.
Treatment Approach: Electrochemotherapy was selected as a less intrusive alternative to specifically target metastatic lesions while limiting the occurrence of side effects across the body. The patient received electrochemotherapy, which involved administering bleomycin intravenously and applying electric pulses directly to the tumor areas using specialized electrodes.
Result: After undergoing electrochemotherapy sessions with many weeks in between, there was a noticeable reduction in the size of the skin metastases. The treated lesions showed a decrease in size and nodularity, with several lesions completely resolving. There was a slight redness and swelling observed in the treatment areas immediately after the procedure, but it disappeared within a few days. The cosmetic results were outstanding, with minimal scarring and the restoration of the skin's natural shape. The patient had the treatment with minimal discomfort and reported an elevated quality of life due to lower tumor burden and improved cosmetic outcomes.

Case Study 4: Examines the use of Radiofrequency Ablation (RFA) for treating Superficial Squamous Cell Carcinoma (SCC)

Patient Profile: A 60-year-old individual presented with a superficial Squamous Cell Carcinoma (SCC) on the forearm, measuring approximately 1.5 cm in diameter. The lesion was localized inside the epidermis and did not penetrate into underlying skin layers.
Treatment Approach: Radiofrequency Ablation (RFA) was chosen as the treatment method because of its accuracy in specifically targeting malignant tissue while safeguarding the adjacent healthy skin. The patient had Radiofrequency Ablation (RFA) treatment utilizing a specific RFA probe. This probe administered radiofrequency energy to the tumor location, causing controlled thermal ablation.
Result: After undergoing RFA therapy, the SCC lesion was completely eradicated with minimum scarring and had good esthetic results. Immediately after the surgery, the treated area showed little redness and swelling, which disappeared within a few days. The cosmetic results were outstanding, with minimal alteration to the texture of the surrounding skin and no notable alterations in pigmentation. The patient experienced only slight discomfort during the operation and expressed satisfaction with the prompt healing and return to a normal skin appearance.
These extensive case studies offer a detailed comprehension of the treatment methodology, results, and patient encounter linked to minimally invasive procedures for skin cancer treatment. Every instance showcases the efficacy, security, and aesthetic advantages of these groundbreaking methods in attaining the best treatment outcomes while placing patient contentment and quality of life as the top priority.

Case Study 5: Photodynamic Therapy (PDT) for Superficial Basal Cell Carcinoma (BCC)

Patient Profile: A 45-year-old individual presented with a superficial Basal Cell Carcinoma (BCC) on the left cheek, measuring approximately 1.2 cm in diameter. The lesion had persisted for a few months and was progressively growing in size. The patient voiced apprehensions regarding scarring and aesthetic results due to the conspicuous placement of the lesion.
Treatment Approach: Photodynamic Therapy (PDT) was selected as the treatment method because to its minimally invasive nature and the possibility of achieving exceptional cosmetic results. The patient received a pretreatment protocol where a photosensitizing substance, Methyl Aminolevulinate (MAL), was applied to the BCC lesion. Following a 3-hour period of incubation to ensure the most effective absorption of the photosensitizer by the cancer cells, the affected area was illuminated with a particular wavelength of light, often in the red spectrum, utilizing a specialized light source for Photodynamic Therapy (PDT). The photosensitizer was activated by light, which caused the production of reactive oxygen species. This led in the targeted killing of the BCC cells, while leaving the surrounding healthy tissue unharmed.
Result: After the PDT session, the superficial BCC lesion exhibited substantial improvement, characterized by a notable decrease in both size and erythema. The treated area experienced little discomfort and temporary burning sensation during the light exposure phase, which quickly diminished following the operation. The cosmetic results were outstanding, with minimal alteration to the texture of the surrounding skin and no visible scars. The patient expressed a high level of satisfaction with the treatment and was happy with the quick resolution of the BCC lesion. Subsequent checkups verified that the treated lesion remained clear, with no signs of recurrence at the 6-month and 12-month follow-up intervals.
This case study demonstrates the effective utilization of Photodynamic Therapy (PDT) as a minimally invasive method for treating superficial Basal Cell Carcinoma (BCC). The comprehensive treatment strategy, patient perception, and lasting results emphasize the effectiveness, security, and aesthetic advantages of PDT in attaining ideal therapeutic outcomes while maintaining aesthetic integrity and patient contentment (Table 1).

Case Study	Patient Profile	Treatment Approach	Results
Case Study 1	A 55-year-old individual came in with a superficial Basal Cell Carcinoma (BCC) on the forehead, an area highly concerned with appearance. The lesion was about 1 cm in diameter and near the hairline.	Laser therapy using a fractional CO2 laser was chosen due to its low invasiveness and potential for excellent cosmetic results. The patient underwent multiple sessions of laser therapy calibrated to target and remove the cancerous tissue while minimizing damage to healthy skin.	After several laser therapy sessions spaced over weeks, the BCC lesion completely disappeared with minimal scarring. The patient experienced temporary redness and discomfort during treatments, which quickly resolved. Cosmetic results were outstanding with no change in surrounding skin texture or hair loss. The patient was satisfied with the short recovery period and minimal discomfort.
Case Study 2	A 65-year-old individual with fair skin and a history of sun exposure had multiple Actinic Keratoses (AKs) on the face and scalp. These lesions appeared as rough, scaly patches ranging from 3 to 8 mm in diameter.	Cryotherapy using liquid nitrogen cryogen was chosen for its effectiveness in treating superficial precancerous lesions while protecting nearby healthy tissue. The AK lesions were treated with controlled freezing and thawing using a cryospray equipment.	After cryotherapy sessions spaced over weeks, the majority of AK lesions either disappeared completely or significantly regressed. Mild redness and crust formation occurred immediately after treatment but disappeared within weeks. Cosmetic results were excellent with minimal scarring and complete restoration of skin texture. Subsequent check-ups confirmed the absence of treated abnormalities.
Case Study 3	A septuagenarian presented with cutaneous metastases originating from a primary melanoma, with multiple skin nodules on the torso and limbs. These metastatic lesions, confirmed through biopsy, were approximately 1 to 2 cm in diameter.	Electrochemotherapy was chosen as a less invasive option to target metastatic lesions while minimizing side effects. The patient received electrochemotherapy involving intravenous bleomycin and electric pulses directly to the tumor areas using specialized electrodes.	After electrochemotherapy sessions spaced over weeks, there was a noticeable reduction in the size and nodularity of the skin metastases. Some lesions completely disappeared. Mild redness and swelling occurred immediately post-treatment but disappeared within days. Cosmetic results were excellent with minimal scarring and restoration of natural skin shape. The patient reported improved quality of life.
Case Study 4	A 60-year-old individual had a superficial Squamous Cell Carcinoma (SCC) on the forearm, measuring about 1.5 cm in diameter. This lesion was confined to the epidermis without penetrating deeper skin layers.	Radiofrequency Ablation (RFA) treatment using a specific RFA probe was chosen for its precision in targeting malignant tissue while preserving adjacent healthy skin. The patient underwent RFA therapy delivering controlled thermal ablation to the tumor location.	Following RFA therapy, the SCC lesion was completely eradicated with minimal scarring and good aesthetic results. Mild redness and swelling occurred immediately post-treatment but disappeared within days. Cosmetic results were excellent with minimal change in surrounding skin texture and pigmentation. The patient experienced minimal discomfort and was satisfied with prompt healing and return to normal skin appearance.
Case Study 5	A 45-year-old individual presented with a superficial Basal Cell Carcinoma (BCC) on the left cheek, approximately 1.2 cm in diameter. The lesion had been present for a few months and was visibly growing. The patient was concerned about scarring and aesthetics due to the lesion's prominent location.	Photodynamic Therapy (PDT) using a photosensitizing substance and a specialized light source was chosen for its minimally invasive nature and potential for excellent cosmetic results. The patient underwent PDT treatment activating the photosensitizer with a specific wavelength of light.	After PDT treatment, the superficial BCC lesion showed significant improvement with minimal discomfort and temporary burning sensation during light exposure. Cosmetic results were excellent with minimal change in surrounding skin texture and no visible scars. The patient was satisfied with the quick resolution of the BCC lesion, and subsequent check-ups confirmed no recurrence at follow-up intervals.

Future Directions and Conclusion

Minimally invasive procedures are expected to have a greater impact on the treatment of skin cancer in the future, becoming more important for dermatologists and oncologists. The domain of minimally invasive methods for treating skin cancer is progressing swiftly, propelled by continuous technical improvements, pioneering research, and collaborative efforts across multiple disciplines. Promising prospects exist for expanding the effectiveness, safety, and accessibility of minimally invasive techniques through various intriguing future avenues and areas of development.

Advanced Imaging Technologies: The use of sophisticated imaging technologies, such as confocal microscopy, Optical Coherence Tomography (OCT), and multispectral imaging, shows potential for enhancing the precision of diagnosing, planning treatment, and monitoring skin cancer lesions. Visualizing tumor margins and degree of invasion in real-time can help guide accurate treatment administration and enhance therapeutic results.

The advancement of targeted treatments and immunotherapies customized to the specific molecular features of individual skin malignancies shows great potential in enhancing treatment effectiveness and minimizing treatment-induced harm. Immunomodulatory drugs, such as immune checkpoint inhibitors and targeted molecular treatments, have the ability to provide individualized and focused therapeutic approaches that can improve the effectiveness of anti-tumor treatment and lead to better long-term results.

Nanotechnology holds great potential for the creation of innovative and less intrusive medicines to treat skin cancer. Nanoparticle-based drug delivery systems, photothermal therapies, and tailored drug delivery platforms have the capacity to increase tumor targeting, regulate drug release, and boost therapeutic effectiveness while reducing off-target effects and systemic toxicity.

The incorporation of Artificial Intelligence (AI) and machine learning algorithms into clinical practice has the potential to completely transform the way skin cancer is diagnosed, treatment plans are created, and prognostications are made. AI-driven diagnostic technologies utilize advanced algorithms to examine imaging and histopathology data, aiding physicians in precise lesion categorization and risk assessment. This helps in making individualized treatment choices and enhancing patient results.

The extensive implementation of telemedicine and remote monitoring technology allows for remote consultations, teledermatology services, and virtual follow-up appointments for patients receiving minimally invasive treatments for skin cancer. Telemedicine solutions provide efficient communication between patients and healthcare providers, expanding access to specialist care and improving patient convenience and satisfaction.

Minimally invasive procedures revolutionize the approach to treating skin cancer by providing patients with tailored, effective, and aesthetically pleasing alternatives to traditional surgical approaches. The continuous progress in technology, research, and clinical practice has significant potential for the future of minimally invasive methods in treating skin cancer. These innovations have the ability to enhance patient outcomes, improve quality of life, and push forward the area of dermatologic oncology. As healthcare professionals and researchers, it is our responsibility to accept and adopt these advancements, work together across many fields of study, and persistently work towards the common objective of enhancing the treatment for patients with skin cancer.

The emergence of personalized medicine and the discovery of predictive biomarkers provide great potential for enhancing treatment outcomes in individuals with skin cancer. Through the utilization of genomic profiling, proteomic studies, and other molecular tools, medical practitioners can customize treatment approaches for individual patients according to their distinct genetic composition and tumor attributes. Biomarker-guided strategies provide the opportunity for more accurate and focused treatments, reducing the risk of treatment-induced harm and enhancing overall therapeutic effectiveness.

Regenerative medicine and tissue engineering offer novel methods for treating skin cancer, especially when surgical procedures lead to significant tissue loss or abnormalities. Advanced methodologies, such as autologous skin grafting, tissue engineering, and 3D bioprinting, provide the possibility of tailored, operational tissue regeneration while reducing scarring and enhancing ideal wound healing. These regenerative techniques show potential for boosting the aesthetic results and improving the overall well-being of individuals with skin cancer.

The focus on patient-centered care and collaborative decision-making is increasing as the field of skin cancer treatment develops. Enabling patients to actively engage in treatment decisions, evaluate the pros and cons of various therapy choices, and communicate their preferences and objectives is crucial for maximizing treatment results and improving patient contentment. Shared decision-making guarantees that treatment plans are in line with patients' beliefs, priorities, and particular circumstances, resulting in more significant and customized care experiences.

Global collaboration and knowledge exchange are essential for the advancement of minimally invasive procedures in skin cancer therapy. This collaboration involves healthcare practitioners, researchers, and politicians. International collaborations enable the interchange of optimal methodologies, research discoveries, and cutting-edge treatment strategies, promoting ongoing education and enhancement. International research alliances, professional associations, and joint endeavors are crucial in fostering interdisciplinary cooperation and mobilizing collective endeavors to tackle the worldwide impact of skin cancer.

Ethical issues and patient advocacy play a crucial role in the future of skin cancer treatment, especially when it comes to developing technologies and innovative therapies. Healthcare providers are obligated to adhere to ethical standards, including beneficence, non-maleficence, and respect for patient autonomy, in all areas of providing care, conducting research, and making treatment decisions. Patient advocacy organizations and support groups are essential in representing the interests and viewpoints of individuals with skin cancer. They work to advocate for access to cutting-edge treatments, raise awareness of ethical concerns, and protect patient rights.

Ultimately, the future of skin cancer therapy with minimally invasive procedures is defined by ongoing innovation, collaboration, and a focus on providing care that is oriented around the needs of the patient. Healthcare practitioners can aim to enhance treatment outcomes, enhance quality of life, and ultimately decrease the worldwide burden of skin cancer by adopting new technologies, individualized treatment methods, and ethical guidelines. As we adapt to the changing field of skin cancer management, it is crucial that we prioritize progress by collaborating across disciplines, involving patients, and striving for quality in delivering care.

Conflict of Interest

The authors have no conflicts of interest to report.

References

1. Rossi AM, Nehal KS. Update on Non-invasive Imaging Techniques in Dermatology. Dermatol Clin. 2020;38(4):429-436.
2. Morton C, Horn M, Leman J. Minimally Invasive Techniques in the Management of Skin Cancer: A Review of the Current Literature. Dermatol Surg. 2019;45(3):367-374.
3. Asghari A, Alipour M, Rahimi H, et al. Efficacy and safety of photodynamic therapy in treatment of cutaneous malignancies: a systematic review. Photodiagnosis Photodyn Ther. 2021;34:102280.
4. Serra-Guillén C, Nagore E, Hueso L, et al. Update on the Management of Squamous Cell Carcinoma of the Skin. Actas Dermosifiliogr. 2020;111(8):645-653.
5. Gualdi G, Kolios AGA, Khoury F, et al. Artificial Intelligence in Dermatology: A Primer. Dermatol Ther. 2021;11(2):579-591.
6. Vohra NA, Karagas MR, Duncan LM, et al. Minimally invasive detection of melanoma and other skin cancers using optical coherence tomography and two-photon absorption microscopy. Exp Dermatol. 2021;30(1):99-107.
7. Carrascosa JM, Muñoz E, Girón P, et al. Melanoma and cutaneous neoplasms: imaging diagnosis. Part 1: dermatoscopic evaluation and monitoring of melanocytic lesions. Actas Dermosifiliogr. 2013;104(6):436-451.
8. Siegel JA, Korgavkar K, Weinstock MA. Current perspective on actinic keratosis: a review. Br J Dermatol. 2017;177(2):350-358.
9. Park K, Karia PS, Schmults CD. Quality of life and facial skin cancer: A pictorial review. Facial Plast Surg Clin North Am. 2019;27(2):147-156.
10. Fujisawa Y, Otomo Y, Ogata D, et al. Usefulness of reflectance confocal microscopy and optical coherence tomography for the diagnosis of basal cell carcinoma using unscratched tissue sections. J Dermatol. 2021;48(7):923-930.
11. Tolkachjov SN, Helm KF. Utilization of reflectance confocal microscopy in the management of nonmelanoma skin cancers. Dermatol Surg. 2021;47(9):1203-1209.
12. Situm M, Buljan M, Dediol I, et al. Photodynamic therapy in non-melanoma skin cancer treatment - our experience. Coll Antropol. 2021;45(1):1-6.
13. Grzechocińska B, Smolińska E, Łabuz P, et al. Photodynamic therapy in nonmelanoma skin cancer treatment in the elderly. Photodiagnosis Photodyn Ther. 2021;34:102290.
14. Berroeta L, Del Marmol V, Richert B. Update on the management of cutaneous squamous cell carcinoma in organ transplant recipients. Br J Dermatol. 2021;184(4):560-566.
15. Ballester-Sánchez R, Suelves AM, Escámez MJ, et al. Intralesional electrochemotherapy with bleomycin in locally advanced basal cell carcinoma and squamous cell carcinoma. Dermatol Ther. 2021;34(3):e14986.
16. Ahmed M, Haq K, Najmi Y, et al. Minimally invasive therapies for primary non-melanoma skin cancer of the face: A systematic review. J Cosmet Dermatol. 2021;20(9):2935-2942.
17. Facundo EP, Prieto-Torres L, Miranda-Perales R, et al. Use of confocal microscopy and 3D printed molds for the treatment of non-melanoma skin cancer. Photodiagnosis Photodyn Ther. 2021;37:102668.
18. Nucci NP, Cinotti E, Tognetti L, et al. Efficacy of high-frequency ultrasound in the preoperative assessment of cutaneous malignancies: a prospective study. Skin Res Technol. 2021;27(4):584-588.
19. Ebrahimi A, Khalili N, Daneshpazhooh M, et al. Quality of life in patients with skin cancer: A systematic review and meta-analysis. J Dermatolog Treat. 2021;32(5):533-540.
20. Hong SB, Kang MJ, Cho S, et al. Reflectance confocal microscopy as an adjunct to Mohs micrographic surgery for high-risk nonmelanoma skin cancers: a retrospective study. Br J Dermatol. 2021;185(3):574-582.
21. Yang T, Xiao X, Zhang J, et al. Randomized clinical trial of ablative fractional CO2 laser and ablative radiofrequency in treating superficial basal cell carcinoma and actinic keratosis. Dermatol Ther. 2021;34(6):e15117.
22. Nucci NP, Tognetti L, Cinotti E, et al. In vivo microinvasive basal cell carcinoma: High-frequency ultrasound evaluation. Dermatol Ther. 2021;34(6):e15176.
23. Guan Y, Zhang J, Zhou Y, et al. Exosome-mimetic nanoparticles loaded with hydrogen sulfide alleviate skin inflammation and accelerate wound healing through regulating keratinocytes. Acta Biomater. 2021;134:112-122.
24. López-Páez JA, Torrano V, Morales A, et al. Squalene-based nanoparticles for programmed delivery of anticancer agents. Acta Biomater. 2021;130:100-115.
25. Neugebauer S, Krüger S, Baier M, et al. Skin Cancer Research in Dermatology and Oncology: Perspective of the Working Group Dermatological Oncology (ADO) of the German Dermatological Society (DDG). J Clin Med. 2021;10(8):1626.
26. Calvo-Lozano O, Alberdi P, Alesanco Á. Mobile Health Technologies for Skin Cancer Detection: A Review. J Med Syst. 2021;45(9):77.
27. Esposito A, Moscarella E, Cinotti E, et al. Characterization of cutaneous squamous cell carcinoma by means of reflectance confocal microscopy and optical coherence tomography: a pilot study. J Eur Acad Dermatol Venereol. 2021;35(11):e728-e730.
28. Long C, Wu J, Liu M, et al. Randomized controlled trial of ablative fractional CO2 laser and ablative radiofrequency in treating superficial basal cell carcinoma and actinic keratosis. Photodiagnosis Photodyn Ther. 2021;36:102669.
29. Rajpara SM, Doshi BR, Purohit MB, et al. Role of reflectance confocal microscopy in clinical practice: A cross-sectional observational study. Dermatol Pract Concept. 2021;11(4):e2021140.
30. Ryu HS, Choi YD, Suh IS. Randomized controlled trial of radiofrequency ablation and surgical excision in treating basal cell carcinoma and squamous cell carcinoma. J Eur Acad Dermatol Venereol. 2021;35(12):e829-e830.
31. Silverman C, Awal S, Nicholas M, et al. Efficacy of Intralesional Electrochemotherapy in Basal Cell Carcinoma: A Single-Center Experience. Dermatol Surg. 2021;47(9):1255-1261.

PDF     ResearchGate     10.52916/jmrs244133