Noninflammatory destruction of actinic keratoses by fluorouracil

Abstract

Sequential topical application of fluorouracil and 0.5% triamcinolone acetonide cream is as effective in the treatment of actinic keratoses as fluorouracil alone, but the combination obviates the unpleasent irritation caused by fluorouracil. Diluted (0.1%) triamcinolone acetonide cream preparations are ineffective in the suppression of the associated inflammation. There is no detectable difference in the number of new actinic keratoses between the combination therapy and fluorouracil alone. These findings demonstrate that the degree of success with fluorouracil therapy in actinic keratosis is not related to the degree of inflammation associated with the treatment and are consistent with a chemotherapeutic explanation of fluorouracil's effect on actinic keratosis.

A Trial of Short Incubation, Broad-Area Photodynamic Therapy for Facial Actinic Keratoses and Diffuse Photodamage

“…Photodamage severity was determined using the validated Griffiths scale (0-8). 30 The patients' clinical features were compared with 5 standardized photographs showing no damage (0) to severe damage (8). Exclusion criteria included a history of porphyria or photosensitivity, hyperkeratotic AKs, active infectious disease, pregnancy or lactation, or use of photosensitizing drugs (eg, tetracycline and retinoids).…”

“…Patients with relatively few AKs are most often treated with local liquid nitrogen cryotherapy, 5 a treatment modality associated with mild to moderate discomfort, and monitored at intervals of several months to a year for new and recurrent lesions that are then also treated. 7 Patients with extensive AKs are usually offered treatment with topical fluorouracil 8,9 or, more recently, diclofenac, [10][11][12] cancer chemotherapeutic agents applied twice daily for several weeks to broad areas in an effort to destroy "subclinical" as well as clinically apparent AKs. 13 However, such treatment is invariably associated with pain, pruritus, and burning, and patient compliance is poor.…”

Effect of a 1-Week Treatment With 0.5% Topical Fluorouracil on Occurrence of Actinic Keratosis After Cryosurgery

“…10,11 Clinical trials have repeatedly found topical fluorouracil to be effective for the treatment of AK lesions when applied in concentrations of 0.5%, 1%, and 5%. [12][13][14][15][16] The long-term outcomes of cryosurgery and the effect of a regimen using topical fluorouracil before cryosurgery have not been evaluated in randomized or controlled trials. A 1-week course of topical 0.5% fluorouracil is effective and well tolerated in the treatment of AK.…”

A Verrucous Lesion on Skin Grafted after Necrotizing Fasciitis in a Diabetic Patient Successfully Treated with Combined Topical 5‐FU and Tacalcitol

“…Our patient partially responded to topical 5-FU cream and tretinoin 0.1 % cream; the verrucous lesion mostly disappeared. 5-FU is a potent anti-proliferative chemotherapeutic agent which primarily affects cells actively synthesizing DNA (11,12). Topical tretinoin may also be beneficial, because, in addition to its well-known inhibitory effect on keratinocyte differentiation, it enhances percutaneous absorption of chemicals (13).…”