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Cryotherapy/Cryosurgery: techniques used

  • Cryotherapy is more effective when an appropriate technique is used. This depends on the specific effect (lien) one wishes to obtain, the shape of the lesion as well as the “strength” of the freezing.

 

 

Open spray technique:

  • method: directly spraying the lesion
  • indication flat lesions (macular)
  • examples: lentigos, actinic keratosis, superficial basal cell carcinoma, bowen’s disease, seborrheic keratosis, condyloma, flat and verrucous warts

 

 

Semi open technique (cone):

  • method: surround the lesion with a limitation device (cone) before directly spraying the lesion
  • indication: dome-shaped lesions
  • examples: molluscum contagiosum, verrucous warts, dermatofibroma

 

 

Closed technique (with a probe)

  • method: apply a metallic probe on the lesion before cooling the probe with the cryogen
  • indication: flat lesions (naturally or after curettage), vascular lesions
  • examples: sebaceous hyperplasia, squamous cell carcimona (SCC), basal cell carcinoma (BCC)

 

 

Chamber (semi-closed) technique:

  • method: cryogen is accumulated in a chamber before the cold is channeled to the lesion. It is a very powerful way of freezing
  • indication: large lesions such as large BCC or SCC, palliative treatment.

 

 

Metal tweezers (a type of closed technique):

  • method: pinch the lesion before cooling it
  • indication: benign lesions such as skin tags and filliform warts and premalignant lesions sur as hyperkeratotic actinic keratosis

 

 

Intralesional technique(needle)

  • method: insert a needle into the lesion and then freeze
  • indications: benign lesions such as keloids, malignant lesions: metastasis (palliative treatment) and/or for large tumors

 

 

Source of information: 2014 (03) – Pasquali P, new approaches to cryosurgery. 72nd AAD (American Academy of Dermatology) Annual Meeting (Denver, CO, United States of America)

Original article: here