مرض بوين مع آفة جلدية صغيرة (أقل من 2 سم) عندما لم يحقق علاج الخط الأول النقاء

Offer* cryotherapy as a first-line treatment option to people with small (< 2 cm) SCC in situ lesions (see R15).

Lesions are considered large if > 2 cm and are considered high risk at periocular and digital (and penile) sites.

SCC in situ that is small (< 2 cm) and at a low-risk site (such as the trunk and limbs) may be managed in primary care by a general practitioner who is capable of establishing a clinical diagnosis and initiating treatment options as per the guideline in the first instance.

Consider topical imiquimod (5%) in people with SCC in situ at low-risk sites, when there is no suitable alternative. Consider once-daily application, three times per week for 4 weeks, although prolonged treatment for 12 weeks may be required.

Where this service is available, consider laser treatment in people with SCC in situ where other treatments have failed or are not suitable. Ablative CO2 laser may be more effective than nonablative neodymium:YAG.