In vivo reflectance confocal microscopy characterization of field-directed 5-fluorouracil 0.5%/salicylic acid 10% in actinic keratosis.

Abstract

Actinic keratosis (AK), a frequently diagnosed cutaneous neoplasm in individuals with chronic sun exposure or fair skin, is a risk factor for squamous cell carcinoma. AK presents as clinically visible lesions and/or as subclinical lesions where an entire field of area (field cancerization) contains lesions of various grades. The diagnosis and surveillance of subclinical AK is challenging. We report a new AK management approach, including subclinical AK, with noninvasive in vivo reflectance confocal microscopy (RCM) monitoring of field-directed topical 5-fluorouracil 0.5%/salicylic acid 10.0% (5-FU/SA; currently approved for single lesions). In this case series, eight patients with primarily recurrent, multiple AKs received ≤ 6 weeks of field-directed 5-FU/SA; complete clearance of clinical/subclinical AKs on various body areas was shown in most patients using RCM. RCM facilitated the detection/characterization of subclinical AKs in the setting of field cancerization. Topical field-directed 5-FU/SA monitored with RCM is a promising management approach for subclinical AKs.

• Authors: Martina Ulrich, Ivette Alarcon, Josep Malvehy, Susana Puig
• Journal: Dermatology (Basel, Switzerland) (Dermatology) Vol. 230 Issue 3 Pg. 193-8 ( 2015) ISSN: 1421-9832 [Electronic] Switzerland
• PMID: 25721522 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antimetabolites, Antineoplastic
• Dermatologic Agents
• Keratolytic Agents
• Salicylic Acid
• Fluorouracil

Topics

• Administration, Topical
• Aged
• Aged, 80 and over
• Antimetabolites, Antineoplastic (administration & dosage)
• Dermatologic Agents (administration & dosage)
• Female
• Fluorouracil (administration & dosage)
• Humans
• Keratolytic Agents (administration & dosage)
• Keratosis, Actinic (drug therapy, pathology)
• Male
• Microscopy, Confocal
• Middle Aged
• Salicylic Acid (administration & dosage)
• Skin Neoplasms (drug therapy, pathology)