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Journal of the American Academy of Dermatology
Volume 38, n° 1
pages 77-80 (janvier 1998)
Doi : 10.1016/S0190-9622(98)70542-0
Does intermittent “pulse” topical 5-fluorouracil therapy allow destruction of actinic keratoses without significant inflammation?
 

Ernst Epstein, MD

Abstract

Background: Topical 5-fluorouracil (5-FU) is effective in removing actinic keratoses but causes unsightly and painful erosions. Intermittent “pulse” 5-FU therapy has been described as being an effective and comfortable technique for destroying actinic keratoses. Objective: The purpose of this study was to determine the efficacy and cutaneous side effects of intermittent 5-FU therapy. Methods: Efficacy of treatment was evaluated by three experienced dermatologists separately comparing randomly arranged before and after photographs. Degree of skin reaction was graded from photographs taken during treatment. Results: Of 13 patients treated with intermittent 5-FU, two had an excellent result, three a good result, but eight failed to show discernible improvement. Efficacy was linked to the degree of skin irritation. Conclusion: Pulse 5-FU failed to clear actinic keratoses in most patients. Intermittent 5-FU treatment does not dissociate its therapeutic efficacy from its undesirable erosive effects. Pulse therapy is a less intensive way of employing 5-FU and may be of value in patients unwilling to accept the erosions and discomfort that accompany the traditional course of daily 5-FU applications. (J Am Acad Dermatol 1998;38:77-80.)

The full text of this article is available in PDF format.

 From the author's private practice and the Department of Dermatology, University of California, San Francisco.
 Reprints not available from the author.
 16/1/86508



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