Background: Topical 5-fluorouracil (5-FU) cream is widely used in the treatment of actinic keratoses (AKs) but the optimumtreatment regimen that provides efficacywhileminimizing side-effects remains unclear. Objective...Background: Topical 5-fluorouracil (5-FU) cream is widely used in the treatment of actinic keratoses (AKs) but the optimumtreatment regimen that provides efficacywhileminimizing side-effects remains unclear. Objectives A randomized trial to compare the efficacy and side-effects of daily vs. weekly application of 5%5-FU in the treatment of AKs of the scalp and face. Patients/methods Twenty patients were recruited and randomized to two groups. Group 1 (13 patients) appl ied 5%5-FU twice daily for 3 weeks, group 2 (seven patients) applied 5%5-FU twice daily for 1 day per week for 12 weeks. Patients were reviewed at weeks 3, 12, 24 and 52. At each review a lesion count and lesion map were completed and p atients were asked to score efficacy and inflammation. Results At week 0 the med ian lesion count was the same in both groups, 17.5 lesions. At 12 weeks the medi an lesion count in group 1 had fallen to 0 where it remained for the duration of follow-up. In group 2 the median lesion count fell to 6 at 12 weeks, 5.5 at 24 weeks and was 3 at 52 weeks. The difference in the lesion count was significant at all time points after week 0: P < 0.05 at weeks 12 and 52, and P < 0.01 at w eek 24. The mean inflammation score was higher in patients clear of AKs at 12 we eks compared with those who had not cleared, 3.8 compared with 1.9. This differe nce was statistically significant (P < 0.05) suggesting that inflammation is nec essary for efficacy. Conclusions We conclude that daily application of 5%5-FU cream is more effective than weekly application at clearing AKs from the scalp a nd face. Our results also suggest that inflammation is likely to be required to achieve a therapeutic effect.展开更多
文摘Background: Topical 5-fluorouracil (5-FU) cream is widely used in the treatment of actinic keratoses (AKs) but the optimumtreatment regimen that provides efficacywhileminimizing side-effects remains unclear. Objectives A randomized trial to compare the efficacy and side-effects of daily vs. weekly application of 5%5-FU in the treatment of AKs of the scalp and face. Patients/methods Twenty patients were recruited and randomized to two groups. Group 1 (13 patients) appl ied 5%5-FU twice daily for 3 weeks, group 2 (seven patients) applied 5%5-FU twice daily for 1 day per week for 12 weeks. Patients were reviewed at weeks 3, 12, 24 and 52. At each review a lesion count and lesion map were completed and p atients were asked to score efficacy and inflammation. Results At week 0 the med ian lesion count was the same in both groups, 17.5 lesions. At 12 weeks the medi an lesion count in group 1 had fallen to 0 where it remained for the duration of follow-up. In group 2 the median lesion count fell to 6 at 12 weeks, 5.5 at 24 weeks and was 3 at 52 weeks. The difference in the lesion count was significant at all time points after week 0: P < 0.05 at weeks 12 and 52, and P < 0.01 at w eek 24. The mean inflammation score was higher in patients clear of AKs at 12 we eks compared with those who had not cleared, 3.8 compared with 1.9. This differe nce was statistically significant (P < 0.05) suggesting that inflammation is nec essary for efficacy. Conclusions We conclude that daily application of 5%5-FU cream is more effective than weekly application at clearing AKs from the scalp a nd face. Our results also suggest that inflammation is likely to be required to achieve a therapeutic effect.
