Despite significant efforts in treating Basal cell carcinomas (BCC), surgical excision of the tumours is still the primary mode of treatment. The high risk of recurrence post-excision (~70% within 5 years) imposes a heavy burden on the health care system costing approximately $700 million annually in Australia. Accumulation of ultra-violet induced mutations in the basal layer of the epidermis is the primary risk factor for BCC occurrence. Therefore, we hypothesise that laser ablating the mutation bearing basal layer using dermabrasion technique will allow epidermal cells from the deeper skin layers to re-populate the dermabrased area resulting in mutation free epidermis preventing further BCC recurrence. In this study, using a UVB inducible murine BCC model (K14Cre/ER::Ptch1lox/+ mice), we analysed the efficacy of the dermabrasion technique. After epidermal ablation, a significant reduction in the number of BCC lesions was observed (0.35 bcc/mm2 ± 0.04 compared to 0.07bcc/mm2 ± 0.03). In patients with recurrent BCCs, the evaluation of tumour mutation load using next generation sequencing revealed striking differences between dermabrased and non-dermabrased epidermis. None of the screened disease associated mutations were found in all patients of the dermabrased cohort whereas on average 25 mutations per megabase were present in the non-treated skin. Overall, these data propose the potential to pave the way for large-scale clinical trials of a similar approach as an adjuvant therapy for high-risk non-melanoma skin cancer patients.

Laser dermabrasion: a potential treatment for non-melanoma skin cancers