title: Topical 5-fluorouracil as primary therapy for keratoacanthoma.
abstract: Keratoacanthoma is a common, benign cutaneous neoplasm that displays rapid growth on sun-exposed skin. Keratoacanthomas usually involute spontaneously after several months but rarely progress to squamous cell carcinoma. Because this is a benign, self-limited lesion of exposed skin, effective treatment should emphasize patient comfort and cosmetic results in addition to effectiveness. The authors present 2 patients with keratoacanthomas treated with topical 5-fluorouracil. Both patients had complete resolution of their lesions within 8 weeks. The cosmetic result was superb in both patients. Patient satisfaction with this therapy was excellent. Treatment can be instituted based on a clinical diagnosis; no diagnostic biopsy is necessary. Most keratoacanthomas respond to topical 5-fluorouracil therapy within 3 weeks, whereas squamous cell carcinomas respond poorly. Any lesion that shows a poor response after 3 weeks of therapy or that does not resolve within 8 weeks should undergo prompt excisional biopsy for definitive diagnosis and treatment. Topical 5-fluorouracil is an effective, convenient, relatively inexpensive treatment for keratoacanthoma that produces excellent cosmetic results. It should be added to the therapeutic armamentarium of all physicians who treat keratoacanthoma.
authors.affiliation: Department of Surgery, Mayo Clinic Scottsdale, AZ 85259, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Gray
authors.forename: N B
authors.initials: NB
authors.lastname: Meland
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000963:Antimetabolites / Q000008:administration & dosage*; D005472:Fluorouracil / Q000008:administration & dosage*; D006801:Humans; D007636:Keratoacanthoma / Q000188:drug therapy*; D008297:Male; D017060:Patient Satisfaction; D012871:Skin Diseases / Q000188:drug therapy*
chemical_list: D000963:Antimetabolites; D005472:Fluorouracil