title: Topical diclofenac 3% gel plus cryotherapy for treatment of multiple and recurrent actinic keratoses.
abstract: This paper reviews retrospectively the results obtained in a case series of multiple refractory actinic keratoses (AKs), treated sequentially with topical diclofenac 3% gel followed by cryotherapy. In total, 29 patients were reviewed; all had >or= 5 lesions (mean 8.2; range 5-12) and a long-term history of recurrence after repeated cryotherapy. After a first-line, 12 week treatment phase with diclofenac 3% gel alone, the number of AKs per subject was reduced to an average of 1.5 AKs (range 0-5), with complete clearance of lesions in 21 cases (71%). Patients showing incomplete response to the above treatment (n = 8) then received liquid-nitrogen ablation for all residual lesions. This procedure resulted in complete clearance of all cases. Significantly, during the post-treatment follow-up period, patients had no AK recurrences for an average of 10 months (range 6-20). Sequential treatment with diclofenac 3% gel followed by cryotherapy may therefore represent an effective approach for the management of multiple refractory AKs.
authors.affiliation: Unit of Dermatology, University Hospital Ospedali Riuniti, Foggia, Italy. mariomastrolonardo@libero.it
authors.forename: M
authors.initials: M
authors.lastname: Mastrolonardo
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000379:methods; D017679:Cryotherapy / Q000379:methods*; D004008:Diclofenac / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D005782:Gels; D006801:Humans; D055623:Keratosis, Actinic / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005782:Gels; D004008:Diclofenac