title: [Treatment of actinic keratoses with birch bark extract: a pilot study].
abstract: BACKGROUND
  Birch bark contains a variety of apoptosis-inducing and anti-inflammatory substances such as betulinic acid, betulin, oleanolic acid and lupeol. Therefore, birch bark extract may be effective in the treatment of actinic keratoses. To address this issue, a pilot study using a standardized birch bark ointment was performed.
  
  
  METHODS
  Twenty-eight patients with actinic keratoses were enrolled in this prospective, non-randomized pilot study. Fourteen patients were treated with birch bark ointment only; fourteen patients received a combination therapy with cryotherapy and birch bark ointment. Treatment response was assessed clinically after two months.
  
  
  RESULTS
  Clearing of more than 75 % of the lesions was seen in 79 % of the patients treated with birch bark ointment monotherapy. The response rate of the combined treatment modality was 93 %. Therapy with birch bark ointment was well tolerated.
  
  
  CONCLUSIONS
  In this pilot study, a standardized birch bark extract was effective in the treatment of actinic keratoses. This therapy is easy to perform and it has no side effects. Birch bark ointment may be a new therapeutic option for actinic keratoses.
authors.affiliation: Universitäts-Hautklinik, Hauptstr. 7, D-79104 Freiburg.
authors.forename: Constance
authors.initials: C
authors.lastname: Huyke
authors.forename: Melanie
authors.initials: M
authors.lastname: Laszczyk
authors.forename: Armin
authors.initials: A
authors.lastname: Scheffler
authors.forename: Reinhard
authors.initials: R
authors.lastname: Ernst
authors.forename: Christoph M
authors.initials: CM
authors.lastname: Schempp
mesh_terms: D000368:Aged; D029662:Betula; D003131:Combined Modality Therapy; D017679:Cryotherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009824:Ointments; D010787:Photosensitivity Disorders / Q000188:drug therapy*; D008517:Phytotherapy; D010865:Pilot Projects; D010936:Plant Extracts / Q000627:therapeutic use*; D011446:Prospective Studies
chemical_list: D009824:Ointments; D010936:Plant Extracts