Oral Acitretin Combined with Topical 0.1% Tretinoin Cream for Facial Basal Cell Carcinoma in an Elderly Patient: A Case Report.

Basal cell carcinoma (BCC) is the most common skin malignancy, and surgical excision remains the first-line treatment for most lesions. However, therapeutic options for elderly patients who are unsuitable for or decline surgery are limited. Acitretin, a systemic retinoid, has shown potential antitumor effects, while topical tretinoin may enhance local therapeutic efficacy. We herein report an elderly patient with facial BCC presenting as an ulcerative lesion on the right forehead. Reflectance confocal microscopy revealed basaloid cells arranged in cord-like structures, and histopathological examination demonstrated nests of basaloid tumor cells with peripheral palisading and retraction clefts, confirming the diagnosis of nodular BCC. The patient was treated with oral acitretin in combination with topical 0.1% tretinoin cream. After 12 weeks of treatment, the ulcerative lesion showed near-complete healing with marked clinical improvement. During the treatment course, only mild adverse events, including skin dryness and cheilitis, were observed, and no significant laboratory abnormalities occurred. This case suggests that oral acitretin combined with topical 0.1% tretinoin cream may represent a feasible and well-tolerated nonsurgical option for selected elderly patients with facial BCC, and no recurrence was observed during the 4-month follow-up.