Surgical ablation of the skin lesions (ablation) is usually the last therapeutic option after other therapeutic options (e.g., topical application of imiquimod or destructive solutions or ointments such as 5-fluorouracil, podophyllotoxin, trichloroacetic acid, silver nitrate) have been exhausted. In ablative therapy are used:
- Excision (surgical removal): sharp spoons, ablation with surgical scissors (scissor cutting), curettage, conventional scalpel surgery.
- Cryosurgery (cryotherapy)
- Electrocoagulation/electrocaustic ablation (electric snare).
- Infrared coagulation
- Laser therapy (CO2 laser)
- Photodynamic therapy (PDT) with 5-aminolevulinic acid.
Surgical-apparative therapy is followed by topical follow-up with imiquimod (5% cream or sinecatechin (10% ointment) for a maximum of 16 weeks.
Anal carcinoma
- Primary radiochemotherapy (RCT) according to Nigro regimen:
- Percutaneous radiotherapy/radiotherapy (50-59.4 Gy), integrated or sequential radiation boost of 5 to 20 Gy, and
- Chemotherapy with mitomycin C and 5-fluorouracil.
