Clinical efficacy of short contact topical 5-Fluorouracil in the treatment of keratoacanthomas: a retrospective analysis

OBJECTIVE

To determine the efficacy of treating patients with a recent onset, biopsy-proven keratoacanthoma with short-contact topical 5% 5-fluorouracil cream twice daily until resolution.

DESIGN

Chart review of 10 patients who applied 5% 5-fluorouracil for the treatment of biopsy-proven keratoacanthoma.

SETTING

Outpatient clinic of a board-certified dermatologist.

PARTICIPANTS

The study population was 90-percent women (9/10), 10-percent men (1/10) and ranged in ages from 52 to 92 years old with a mean age of 74.4.

MEASUREMENTS

Patients were followed for weekly visits for the duration of their treatment and at varying, less-frequent intervals after resolution of the lesion clinically. Photographs were taken at each visit.

RESULTS

The authors performed a retrospective analysis of 10 patients with biopsy-confirmed keratoacanthomas treated with topical 5-fluorouracil. One patient elected to have Mohs surgery after one week of topical 5-fluorouracil due to personal concern and cosmetic appearance and did not complain of any side effects due to the drug. Of the nine patients that remained on topical 5-fluorouracil, all patients had complete resolution of the lesion within six weeks. The range in the number of weeks to resolution was four to six weeks. Two patients required a one- to two-week drug holiday secondary to erythema, which resolved without any further complication or patient discomfort. All nine patients who continued therapy reported satisfaction with the results and showed excellent compliance with treatment.

CONCLUSION

Short-contact topical 5% 5-fluorouracil appears to provide excellent cosmetic results and is well-tolerated by patients. This should be an initial consideration for the treatment of keratoacanthomas and does not preclude future surgical intervention if deemed necessary.

Solar urticaria. Clinical features and wavelength dependence

Solar urticaria, an uncommon photosensitivity disorder, may be disabling for affected patients, especially those who react after short exposures to artificial or natural light. The spectrodermograph, a newly developed instrument, permits rapid, accurate determination of the action spectrum of solar urticaria. It consists of a xenon arc lamp with an emission dispersed into used to establish the wavelengths responsible for solar urticaria in 12 patients during the past four years. Knowledge of the wavelengths responsible for producing the urticarial reaction has implications for selecting appropriate therapy. The clinical course of these patients is also reviewed.