Sonidegib and Subsequent Photodynamic Therapy for Recurrent Nodular-Ulcerative Basal Cell Carcinoma of the Right Nose Post-Surgical Resection: A Case Report

We present a 62-year-old female with recurrent nodular ulcerative basal cell carcinoma (NU-BCC) of the nose, who achieved clinical cure with sequential sonidegib, surgery, and photodynamic therapy (PDT) as salvage therapy, while preserving nasal aesthetics. Two years prior, she underwent surgical excision of a black nasal lesion, pathologically confirmed as BCC, but did not adhere to regular follow-ups. Two months before presentation, a bean-sized asymptomatic lesion emerged at the surgical margin, later enlarging to ulceration with crusting. Repeat biopsy confirmed recurrent NU-BCC. Concerned about facial aesthetics and fearful of surgery, the patient refused extensive reoperation. She received 6-month oral sonidegib phosphate capsules plus 4 PDT sessions. Six months post-treatment, pathological examination showed no residual tumor cells, confirming clinical cure. One-year follow-up revealed no recurrence, with excellent preservation of nasal anatomical integrity and favorable aesthetic outcomes.