Erbium:YAG laser pretreatment accelerates the response of Bowen's disease treated by topical 5-fluorouracil.
BACKGROUND
Topical 5-fluorouracil (5-FU) is a standard treatment for Bowen's disease. However, its efficacy may be limited by the presence of stratum corneum. The Er:YAG laser has shown a dramatic enhancement effect on the delivery of 5-FU in vitro by ablation of the stratum corneum. The efficacy of laser-assisted delivery of 5-FU has not been tested in human.


OBJECTIVE
To see whether Er:YAG laser pretreatment can improve the efficacy of topical 5-FU in the treatment of Bowen's disease.


METHODS
Three target lesions from a patient with multiple Bowen's disease were selected for a half-side comparison study. The Er:YAG laser was used to remove the cornified layer on one side of each lesion, followed by twice-daily application of 5-FU cream to both sides. Clinical and histologic responses were compared.


RESULTS
Lesions pretreated with the Er:YAG laser showed more rapid clinical and histologic responses to topical 5-FU than those treated with 5-FU alone. Evaluation at 9 months after treatment showed no recurrences of lesions on both sides.


CONCLUSIONS
Our preliminary study demonstrates that this Er:YAG laser-assisted modality is effective and shows accelerated clinical response and shortened treatment time compared with topical 5-FU as a single treatment.
Department of Dermatology, Taipei Municipal Wan-Fang Hospital, Taipei, Taiwan.
Kuo-Hsien
KH
Wang
Jia-You
JY
Fang
Chung-Hong
CH
Hu
Woan-Ruoh
WR
Lee
D000287:Administration, Topical; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D001913:Bowen's Disease / Q000188:drug therapy* / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D005472:Fluorouracil / Q000008:administration & dosage*; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*
D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil