Local chemotherapy with 5‐FU was investigated in premalignant and superficial malignant skin lesions in more than 700 patients. Resolution of neoplasms occurred in more than 95% of patients and lasted for observation periods of up to 6 years. Healing took place without perceptible scarring and with restoration of normal color and texture of the skin. Local side effects were minor. Systemic toxicity did not occur. Several agents, with and without cystostatic activities, produce immune reactions which are more intense at sites of epidermal premalignant and malignant neoplasms than in the normal tissues. More than 50 patients have been studied by this immunotherapeutic approach with results essentially similar to those obtained by topical chemotherapy. Chemotherapy and immunotherapy differ completely in their mechanisms of action. The 2 methods are presented as entirely different modalities, which give essentially similar results. Immunotherapy is still in the investigative stages while local chemotherapy constitutes a modality for the management of extensive skin lesions for which there has been no satisfactory treatment until now.

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