Comparison of 5% 5-fluorouracil cream and 5% imiquimod cream in the management of actinic keratoses on the face and scalp.
It is timely to compare the efficacy and tolerability of 2 actinic keratosis (AK) therapies--5% 5-fluorouracil (5-FU) cream and imiquimod cream. Thirty-six patients with 4 or more AKs were randomly assigned to receive 5% 5-FU cream twice daily for 2 to 4 weeks or 5% imiquimod cream twice weekly for 16 weeks. Five percent 5-FU was more effective than imiquimod in exposing what were presumed to be subclinical AKs, reducing the final AK count (total AK count declined during the 24-week study by 94% vs. 66%, P < .05), achieving complete clearance (incidence of 84% vs. 24% by week 24, P < .01), and achieving clearance rapidly. Tolerability was similar except for erythema, which was initially significantly higher with 5-FU than imiquimod but resolved rapidly and was significantly lower than imiquimod by week 16. Five percent 5-FU remains the gold standard field therapy for AKs.
Tanghetti
Emil
E
Center for Dermatology and Laser Surgery, Sacramento, CA, USA. et@mgci.com
Werschler
Philip
P
D000287:Administration, Topical; D000328:Adult; D000634:Aminoquinolines / Q000008:administration & dosage* / Q000633:toxicity; D019468:Disease Management; D004890:Erythema / Q000139:chemically induced; D005148:Facial Dermatoses / Q000188:drug therapy*; D005472:Fluorouracil / Q000008:administration & dosage* / Q000633:toxicity; D006801:Humans; D000077271:Imiquimod; D007642:Keratosis / Q000188:drug therapy*; D012536:Scalp Dermatoses / Q000188:drug therapy*; D016896:Treatment Outcome
D000634:Aminoquinolines; D000077271:Imiquimod; D005472:Fluorouracil