Diclofenac gel in the treatment of actinic keratoses

Abstract

Actinic keratoses are areas of intraepithelial neoplasia for which treatment is necessary. Because they arise in areas of sun damage, it is desirable to treat the entire damaged field to not only treat visible lesions, but also subclinical, emerging malignancies, ie, “field therapy”, 5-fluorouracil, imiquimod, and diclofenac are all treatment options, and are discussed and compared.

Phase IV head-to-head randomized controlled trial comparing ingenol mebutate 0·015% gel with diclofenac sodium 3% gel for the treatment of actinic keratosis on the face or scalp

“…It may involve the inhibition of cyclooxygenase 2, reducing angiogenesis and cellular proliferation, as well as inducing apoptosis. 18,19 The regimen for treating AK is twice daily for 90 days, which may reduce patients' ability to tolerate local skin reactions (LSRs) and contribute to poor adherence. 14,17,20,21 Ingenol mebutate (IngMeb) gel is a field therapy indicated for the treatment of AK on the face or scalp in an area up to 25 cm 2 .…”

“…DS is a nonsteroidal anti‐inflammatory drug; however, its mechanism of action in AK has not been fully elucidated. It may involve the inhibition of cyclooxygenase 2, reducing angiogenesis and cellular proliferation, as well as inducing apoptosis . The regimen for treating AK is twice daily for 90 days, which may reduce patients’ ability to tolerate local skin reactions (LSRs) and contribute to poor adherence …”

Pharmacoeconomy of drugs used in the treatment of actinic keratoses

“…The therapeutic effect of diclofenac may therefore relate to its activity in simultaneously "starving" dysplastic keratinocytes and promoting programmed cell death, resulting in lesion clearance with minimal inflammation. 17 Due to their comparable efficacy in treating AK multiple lesions, pharmacoeconomic evaluation of cost-effectiveness of both treatments is required. For this purpose, here we performed a cost-efficacy analysis comparing 3% diclofenac sodium versus ingenol mebutate.…”

Actinic Keratosis - the Probable Cause of Squamous Cell Skin Carcinomas

“…Nonetheless, different medications are also available to treat actinic keratosis. The first approved medicine was 5-fluorouracil, followed by Imiquimod 5% and Diclofenac [3]. Very recently, a medication called Ingenol Mebulate (Picato), an active compound derived from a plant called Euphorbia peplus, is highly recommended [4].…”