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Soo Park, MD
Soo Park, MD
Posted: Friday, July 1, 2022
Briant Burke, MD, and Jon-Eric Bailie, MD, of the Center for Biomedical Research, Boise, Idaho, compared the efficacy of a topical solution consisting of 30% ascorbic acid and 95% dimethylsulfoxide (DMSO) versus topical imiquimod in patients with basal cell carcinoma. Published in Biomedicine & Pharmacotherapy, the results of this study suggest that ascorbic acid in DMSO is an inexpensive, well-tolerated, and easy-to-use topical preparation that is more suitable as a first-line treatment than imiquimod in this patient population.
“Management of basal cell carcinoma is dependent upon a variety of factors, as tumors that arise in cosmetically or functionally important areas are best managed with treatments that minimize the amount of tissue removed while ensuring a high chance of complete cure,” stated the investigators. “Given its simplicity and lack of residual hypopigmentation, it [topical ascorbic acid in DMSO] may find particular advantage for lesions on the face, where issues of surgical scarring and cosmesis can be of paramount importance.”
This study focused on a total of 25 patients with biopsy-confirmed cases of basal cell carcinoma located on the trunk (n = 14), extremities (n = 9), and forehead (n = 6). Participants were randomly assigned to receive either topical ascorbic acid in DMSO (n = 13) or imiquimod (n = 12) twice daily for 8 weeks. Individuals were evaluated in the clinic at baseline, 4 weeks, 8 weeks, and 6 weeks after treatment for a final biopsy.
After study completion, post-treatment biopsy of lesions demonstrated a complete resolution of the majority (n = 13) of patients in the ascorbic acid group, but only about half (n = 8) of individuals in the imiquimod group (P < .05). Regarding the treatment of low-risk nodular and superficial regions, topical ascorbic acid demonstrated superiority over imiquimod at 8 weeks and was noninferior at 12 weeks. Notably, ascorbic acid was associated with fewer adverse events than imiquimod; 0% and 70% of individuals on ascorbic acid and imiquimod had residual hypopigmentation at 30 months.
Disclosure: The study authors reported no conflicts of interest.
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