Diclofenac Sodium 3% in Hyaluronic Acid 2.5% Gel Significantly Diminishes the Actinic Keratosis Area and Severity Index

Abstract

Background/Aims: Actinic keratosis area and severity index (AKASI) is a new assessment tool to quantify the severity of actinic damage on the head. Thus far, it has not been evaluated in monitoring the efficacy of field-directed topical treatments in actinic keratosis (AK) in routine clinical practice. Thus, the aim of this study was to determine treatment outcomes by using AKASI 3 months after the initiation of topical application of diclofenac sodium 3% in hyaluronic acid 2.5% gel (DFS) in patients with AKs on the head. Methods: We performed a retrospective analysis of patients with AKs who had AKASI scores prior to and after treatment with DFS. Results: Of the 24 patients included, 20 (83.3%) showed an improvement in AKASI, 2 (8.3%) a stable AKASI, and 2 (8.3%) a worsening of AKASI after a median (interquartile range) follow-up period of 91.5 days (89.8–104.3). The median AKASI reduction was 31.4% (16.7–59.1). The Wilcoxon test showed significant differences (p = 0.0008) between baseline and posttreatment AKASI values. Conclusions: AKASI is an easy-to-use quantitative tool for assessing the treatment outcome of field-directed therapies. Field-directed therapies of AK should no longer be monitored by assessments based on lesion counts alone.

Relative efficacy of 5‐fluorouracil compared with other treatments among patients with actinic keratosis: A network meta‐analysis

“…The drug inhibits the formation of arachidonic acid metabolites through inhibition of the enzyme cyclooxygenase and is recommended for use twice daily for 60–90 days (Ulrich, Pellacani, Ferrandiz, & Lear, ). The adverse effects include itching and dry skin (Schmitz et al, ). Another group of investigators (Stockfleth et al, ) conducted an RCT comprising 470 patients with AK to compare 5‐FU/SA with 3% diclofenac sodium (in hyaluronic acid) and the vehicle for the treatment of AK.…”

Tirbanibulin 1% Ointment Significantly Reduces the Actinic Keratosis Area and Severity Index in Patients with Actinic Keratosis: Results from a Real-World Study

“…The efficacy was measured with the AKASI, which integrates distinct facets such as anatomical region, size of the affected area, and clinical signs of AK and represents an easy-to-use quantitative measurement tool. The AKASI is more accurate than the sole counting of lesions and was previously used to assess the treatment effects of topical diclofenac sodium in HA and photodynamic therapy [10][11][12]. However, the effects of tirbanibulin on the AKASI scores of treated patients have not yet been investigated.…”

The phenomenon of phototoxicity and long-term risks of commonly prescribed and structurally diverse drugs

“…While NSAIDs might increase the long-term risk of skin cancer based on their acute UV effects, paradoxically, given their tumor-suppressive role, they reduce overall NMSC burden and serve as treatment for eliminating precancerous skin lesions. However, the reported CM risk increase suggests that caution is needed and photoprotection is crucial in patients taking NSAIDs [ 124 , 188 , 189 , 191 , 192 ].…”