Evaluation of the therapeutic results of actinic keratosis treated with topical 5% fluorouracil by reflectance confocal laser microscopy: preliminary study

Abstract

Topical treatment for actinic keratosis with 5% fluorouracil has a recurrence rate of 54% in 12 months of follow-up. This study analyzed thirteen actinic keratoses on the upper limbs through confocal microscopy, at the time of clinical diagnosis and after 4 weeks of treatment with fluorouracil. After the treatment was established and evidence of clinical cure was achieved, in two of the nine actinic keratoses, confocal microscopy enabled visualization of focal areas of atypical honeycomb pattern in the epidermis indicating therapeutic failure. Preliminary data suggest the use of confocal microscopy as a tool for diagnosis and therapeutic control of actinic keratosis.

Updates on the Management of Non-Melanoma Skin Cancer (NMSC)

“…In contrast, SLNB may play a significant role in the management of SCC. An association of positive SNL and poor prognosis of cutaneous SCC has been previously demonstrated in several studies, showing a 96% 5-year survival with no regional lymph node involvement [ 206 , 207 , 208 , 209 , 210 , 211 , 212 , 213 , 214 , 215 ]. The 5-year survival decreases to 72% with adequate treatment, and 25–35% with no treatment [ 207 , 208 , 209 , 210 , 211 , 212 , 213 , 214 , 215 , 216 ].…”

“…Topical 5-FU has been approved for treatment of AK and superficial BCC for many years, although its use for treatment of SCCis is off-label [ 202 , 203 , 204 ]. Some studies suggest a 90–96% cure rate of AK and superficial BCC with topical 5-FU [ 205 , 206 ]. Imiquimod is another agent that is approved by FDA for treatment of AK and superficial BCC, while diclofenac and ingenol mebutate are FDA approved for AK only [ 202 ].…”

In vivo Confocal Laser Microscopy for monitoring of actinic keratosis treatment: a comparison with histopathologic assessment after treatment with topical 5% 5‐fluorouracil

“…13 More recently, it has been used in monitoring AK treatment. 13,[22][23][24][25][26][27][28][29][30] AK treatment aims to prevent progression to more aggressive malignancy, relieve symptoms and improve cosmetic appearance. 31 Therapeutic options include 5-fluorouracil (5-FU), cryotherapy, diclofenac, imiquimod, ingenol mebutate, photodynamic therapy, resurfacing and trichloroacetic acid peel.…”

In vivoconfocal microscopy efficacy assessment of daylight photodynamic therapy in actinic keratosis patients

“…These limitations have led to the development of new noninvasive diagnostic methods that offer real‐time in vivo results without scarring . Among these techniques, in vivo reflectance confocal microscopy (RCM), which is a technique that has been actively developed in recent years, with a sensitivity of 80% and specificity of 98·6% for the diagnosis of AK, allows real‐time visualization of the skin up to a depth of 200 μm with the best imaging–histological correlation . Once AK is diagnosed, dermatologists have several management options for a patient, which include topical medications (e.g.…”

“…11 Among these techniques, in vivo reflectance confocal microscopy (RCM), which is a technique that has been actively developed in recent years, with a sensitivity of 80% and specificity of 98Á6% for the diagnosis of AK, allows real-time visualization of the skin up to a depth of 200 lm with the best imaging-histological correlation. 1,[10][11][12][13][14] Once AK is diagnosed, dermatologists have several management options for a patient, which include topical medications (e.g. diclofenac, 5-fluorouracil, ingenol mebutate, imiquimod), chemical peels (e.g.…”