title: Does progression from actinic keratosis and Bowen's disease end with treatment: diclofenac 3% gel, an old drug in a new environment?
abstract: Progression from actinic keratosis (AK) and Bowen's disease (BD) to invasive disease involves a complex cascade of events. The preparation of diclofenac 3% gel (Solaraze; Shire Pharmaceuticals) has been shown to be efficacious and well tolerated in AK. The inhibition of the COX enzymes results in a decrease in downstream by-products of arachidonic acid metabolism. These metabolites have been shown to play a pivotal role in promoting epithelial tumour growth. Given its mechanism of action, we hypothosize that diclofenac 3% gel may have potential to halt the progression of actinic keratoses (AKs) in the setting of field cancerisation and BD. We report a series of five patients with BD, all treated with diclofenac 3% gel with clinical and histological clearance.
authors.affiliation: Department of Dermatology, Skin Cancer Center Charité, University Hospital of Berlin, Berlin, Germany.
authors.forename: M J
authors.initials: MJ
authors.lastname: Patel
authors.forename: E
authors.initials: E
authors.lastname: Stockfleth
mesh_terms: D000287:Administration, Topical; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001913:Bowen's Disease / Q000188:drug therapy*; D004008:Diclofenac / Q000008:administration & dosage*; D018450:Disease Progression; D005782:Gels; D006801:Humans; D007642:Keratosis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005782:Gels; D004008:Diclofenac