Use of Topical Calcipotriol Plus 5-Fluorouracil in the Treatment of Actinic Keratosis: A Systematic Review

Mohney, Lindsey; Singh, Rohan; Grada, Ayman; Feldman, Steven R.

doi:10.36849/jdd.6632

Cited by 6 publications

(9 citation statements)

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“…The addition of calcipotriol has been shown to result in a greater reduction in AKs, improved tolerability, and a lowered risk of future cSCC development on the face and scalp. 103 , 109 , 110 , 112 IMI is currently FDA approved for the treatment of superficial BCCs and AKs, with the highest BCC clearance rates in truncal tumors. IMI has been shown to be a more effective superficial therapy for BCCs as compared to 5-FU cream.…”

Section: Discussionmentioning

confidence: 99%

“…103,109 Data from a systematic review published in 2022 reviewing studies investigating calcipotriol plus 5-FU in the treatment of AKs showed a greater reduction in AKs compared to treatment with 5-FU alone, as well as a lowered risk of cSCC on the face and scalp over a 3-year period. 103,[109][110][111][112] The lasting effects may be due in part to resident memory T cells conferring long-term protection against AKs and cSCC following T cell activation during treatment.…”

Section: -Fluorouracilmentioning

confidence: 99%

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Immunomodulators for Non-Melanoma Skin Cancers: Updated Perspectives

Russomanno¹,

Azim²,

Patel³

2023

CCID

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Non-melanoma skin cancers (NMSCs) are the most common cancers worldwide and may be associated with significant morbidity and mortality, especially in immunosuppressed populations. Successful management of NMSC must take primary, secondary and tertiary prevention strategies into consideration. In response to an improved understanding of the pathophysiology of NMSC and associated risk factors, multiple systemic and topical immunomodulatory drugs have been developed and integrated into clinical practice. Many of these drugs are efficacious in the prevention and treatment of precursor lesions (actinic keratoses; AKs), low-risk NMSC, and advanced disease. The identification of patients at high risk for the development of NMSC is critical in reducing disease morbidity. Understanding the various treatment options available and their comparative effectiveness is paramount for developing a personalized treatment regimen for such patients. This review article provides an updated overview of the various topical and systemic immunomodulatory drugs available for the prevention and treatment of NMSC, and the published data supporting their use in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Section: -Fluorouracilmentioning

confidence: 99%

Immunomodulators for Non-Melanoma Skin Cancers: Updated Perspectives

Russomanno¹,

Azim²,

Patel³

2023

CCID

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“…It was discovered in 1965 that 6% of the 5-FU administered topically was absorbed systemically. However, a later study found that applying 5-FU topically to sick skin has a potential for up to 75 times more systemic absorption than applying it to healthy skin (3) .…”

Section: Systemic Absorptionmentioning

confidence: 99%

“…Topical 5-FU has been used extensively in a range of dermatological disorders marked by excessive epidermal cell proliferation, with normal skin cells remaining mostly unaffected. When traditional treatments are not suitable, it was used topically to treat actinic keratosis (AK) and superficial basal cell carcinomas in the USA (3) .…”

Section: Systemic Absorptionmentioning

confidence: 99%

Different Uses of 5-FLUROURACIL in Dermatology: Review Article

Mahdy¹,

Nofal²,

Khater³

2022

The Egyptian Journal of Hospital Medicine

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Background:The 5-FLUROURACIL (5-FU) is easily absorbed by all tissues after intravenous injection, even those with active cell proliferation such the spleen, small intestine, and bone marrow. Topical administration of 5-FU is the recommended method for treating dermatological diseases because of the significant cytotoxicity of 5-FU for growing cells. 5-fluorouracil is offered as creams or solutions with concentrations ranging from 0.5 percent to 5 percent. Treatment requires two daily applications, although a controlled-release 0.5 percent microsphere formulation should only be used once daily. Objective: Assessment of uses of 5-FLUROURACIL in Dermatology practice. Methods: The 5-FLUROURACIL, transfer ribonucleic acid and dermatology were all looked for in PubMed, Google scholar, and Science direct. References from relevant literature were also evaluated by the authors, but only the most recent or complete study from March 2003 to November 2021 was included. Due to the lack of sources for translation, documents in languages other than English have been ruled out. Papers that did not fall under the purview of major scientific investigations, such as unpublished manuscripts, oral presentations, conference abstracts, and dissertations were omitted. Conclusion: The data we reviewed suggested that 5-FU might be useful for a variety of noncancerous cutaneous causes, including the treatment of scars, pigmentary diseases, cutaneous infections (viral warts, molluscum contagiosum), inflammatory dermatoses, and cosmetics purposes.

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“…98 Combination of calcipotriol and 5-FU is an emerging combination recently evaluated by a systematic review of the literature, including studies that assessed treatment of AK and prevention of cSCC. 99 A secondary exploratory analysis of a previous randomized trial investigated treatment with 0.005% calcipotriol ointment plus 5% 5-FU cream versus baseline plus 5% 5-FU cream (control) twice daily for 4 days in patients with 4-10 AKs in a 25 cm 2 contiguous area of the face, scalp and upper extremities. It showed a significantly higher complete (62% vs. 8%, p < 0.0001) and partial (82% vs. 11%, p < 0.0001) AK clearance at all sites than control, also for facial hypertrophic AKs (54.0% vs. 14.7%, p = 0.002).…”

Section: Expert Consensusmentioning

confidence: 99%

European consensus‐based interdisciplinary guideline for diagnosis, treatment and prevention of actinic keratoses, epithelial UV‐induced dysplasia and field cancerization on behalf of European Association of Dermato‐Oncology, European Dermatology Forum, European Academy of Dermatology and Venereology and Union of Medical Specialists (Union Européenne des Médecins Spécialistes)

Kandolf,

Peris,

Malvehy

et al. 2024

Acad Dermatol Venereol

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A collaboration of multidisciplinary experts from the European Association of Dermato‐Oncology, the European Dermatology Forum, the European Academy of Dermatology and Venereology, and the European Union of Medical Specialists was formed to develop European recommendations on AK diagnosis and treatment, based on current literature and expert consensus. This guideline addresses the epidemiology, diagnostics, risk stratification and treatments in immunocompetent as well as immunosuppressed patients. Actinic keratoses (AK) are potential precursors of cutaneous squamous cell carcinoma (cSCC) and display typical histopathologic and immunohistochemical features of this malignancy in an early stage. They can develop into cSSC in situ and become invasive in a low percentage of cases. AK is the most frequent neoplasia in white populations, frequently occurring within a cancerous field induced by ultraviolet radiation. Since it cannot be predicted, which lesion will progress to cSCC and when treatment is usually recommended. The diagnosis of AK and field cancerization is made by clinical examination. Dermatoscopy, confocal microscopy, optical coherence tomography or line‐field confocal‐OCT can help in the differential diagnosis of AK and other skin neoplasms. A biopsy is indicated in clinically and/or dermatoscopically suspicious and/or treatment‐refractory lesions. The choice of treatment depends on patients' and lesion characteristics. For single non‐hyperkeratotic lesions, the treatment can be started upon patient's request with destructive treatments or topical treatments. For multiple lesions, field cancerization treatment is advised with topical treatments and photodynamic therapy. Preventive measures such as sun protection, self‐examination and repeated field cancerization treatments of previously affected skin areas in high‐risk patients are advised.

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Use of Topical Calcipotriol Plus 5-Fluorouracil in the Treatment of Actinic Keratosis: A Systematic Review

Cited by 6 publications

References 0 publications

Immunomodulators for Non-Melanoma Skin Cancers: Updated Perspectives

Immunomodulators for Non-Melanoma Skin Cancers: Updated Perspectives

Different Uses of 5-FLUROURACIL in Dermatology: Review Article

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