title: Management of actinic cheilitis using diclofenac 3% gel: a report of six cases.
abstract: BACKGROUND
  Actinic cheilitis is a frequent manifestation of actinic dysplasia and requires early therapy to prevent its progression into invasive squamous cell carcinoma (SCC). Several therapies are used, ranging from unspecific lesion-adapted destructive techniques (i.e. laser) to ambitious surgical field-management (vermillionectomy). There is increasing awareness of the effectiveness of field adapted, non destructive therapies, such as photodynamic therapy or 5% imiquimod. Diclofenac 3% gel is used in the treatment of actinic keratosis (AK), but it has not been evaluated for the treatment of actinic cheilitis.
  
  
  OBJECTIVE
  This non-blinded, uncontrolled case series study evaluated the effects of diclofenac 3% gel in the treatment of actinic cheilitis.
  
  
  METHODS
  Six patients with histologically verified actinic cheilitis were treated with diclofenac 3% gel, twice daily for 6 weeks. Clinical assessment was performed 2-4 weeks after the end of treatment.
  
  
  RESULTS
  Four out of six patients showed clinical clearing of actinic cheilitis 2-4 weeks after the end of treatment. Biopsies were taken from the treated areas at the final visit to verify clinical clearance. Side effects in most of the patients included mild erythema and mild to moderate swelling of the lips.
  
  
  CONCLUSIONS
  Topical therapy with diclofenac 3% gel may be an efficient, cosmetically more appealing alternative treatment for actinic cheilitis than currently used destructive therapies. However, future studies and long-term follow-up of patients will be needed to compare its efficacy with established forms of therapy.
authors.affiliation: Department of Dermatology, Skin Cancer Center Charité, University Hospital of Berlin, Berlin, Germany. claas.ulrich@charite.de
authors.forename: C
authors.initials: C
authors.lastname: Ulrich
authors.forename: T
authors.initials: T
authors.lastname: Forschner
authors.forename: M
authors.initials: M
authors.lastname: Ulrich
authors.forename: E
authors.initials: E
authors.lastname: Stockfleth
authors.forename: W
authors.initials: W
authors.lastname: Sterry
authors.forename: C
authors.initials: C
authors.lastname: Termeer
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D002613:Cheilitis / Q000188:drug therapy*; D004008:Diclofenac / Q000008:administration & dosage*; D005260:Female; D005782:Gels; D006801:Humans; D007642:Keratosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005782:Gels; D004008:Diclofenac