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Fluorouracil Cream Offers Long Term Efficacy for Reducing Actinic Keratosis


Although the vast majority of actinic keratosis (AK) remain benign, some studies suggest that up to ten percent may advance to skin cancers. Topical fluorouracil has previously demonstrated effectiveness in reducing the number of AKs and increasing the complete AK clearance rates compared with placebo. However, these randomized trials followed up the study participants no longer than 6 months after a course of topical fluorouracil application. A new, randomized controlled trial shows that a single course of fluorouracil cream 5% (5FU) reduces actinic keratosis (AK) count and patients’ need for spot treatments for up to three and a half years.


In the recent study, reported in JAMA Dermatology, a randomized, double-blinded, placebo-controlled trial was conducted with patients from dermatology clinics at 12 VA medical centers recruited from 2009 to 2011 and followed up until 2013. The study population comprised 932 veterans with 2 or more keratinocyte carcinomas (KC) in the 5 years prior to enrollment.


The study findings indicate that topical fluorouracil cream has long term efficacy in treating and preventing AKs. A single course of topical fluorouracil cream, 5%, treatment led to a sustained reduction of the number of AKs and subsequent AK treatments in the population at high risk for KC. Treating patients with a single course of fluorouracil would reduce the subsequent number of spot treatments and benefit care of patients with multiple AKs for longer than 2 years.


By: Wendy Meltzer, MPH


[image by Ed Uthman]

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