title: Topical 3.0% diclofenac in 2.5% hyaluronic acid gel induces regression of cancerous transformation in actinic keratoses.
abstract: BACKGROUND
  Actinic keratoses (AKs) are frequently diagnosed in dermatological patients. As they represent in situ carcinomas, effective treatment is required.
  
  
  OBJECTIVE
  We investigated the effect of topical 3.0% diclofenac in 2.5% hyaluronic acid gel on AK.
  
  
  METHODS
  Sixty-five patients with AKs were clinically evaluated before and after 3 months' treatment with topical 3.0% diclofenac in 2.5% hyaluronic gel. Biopsy specimens were taken and stained with haematoxylin-eosin and immunohistological markers. Specimens were evaluated for histological type of AKs using the AK classification scheme suggested by Röwert-Huber et al. [(early) in situ squamous cell carcinoma type AK Grade I-III], number of mitoses per high-power field and expression of immunohistological markers.
  
  
  RESULTS
  Complete clinical resolution was observed in 11 patients (16.9%). A significant (P<0.001) downgrading of AK grade was observed. Complete histological resolution was achieved in 15 patients (23.1%). The number of mitoses per high-power field was reduced significantly (P<0.001). The expression of anti-p53-antibody decreased significantly (P=0.009), as did the expression of anti-MiB-1 antibody (P=0.021).
  
  
  CONCLUSIONS
  3.0% diclofenac in 2.5% hyaluronic acid gel causes regression of signs of cancerous transformation after 3 months' therapy.
authors.affiliation: Dermatological Practice Center, Wuppertal, Germany. drdirschka@aol.com
authors.forename: T
authors.initials: T
authors.lastname: Dirschka
authors.forename: E
authors.initials: E
authors.lastname: Bierhoff
authors.forename: A
authors.initials: A
authors.lastname: Pflugfelder
authors.forename: C
authors.initials: C
authors.lastname: Garbe
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage; D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D002471:Cell Transformation, Neoplastic / Q000187:drug effects* / Q000473:pathology; D004008:Diclofenac / Q000008:administration & dosage*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005782:Gels; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D055623:Keratosis, Actinic / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology / Q000517:prevention & control*; D012867:Skin / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000276:Adjuvants, Immunologic; D000894:Anti-Inflammatory Agents, Non-Steroidal; D005782:Gels; D004008:Diclofenac; D006820:Hyaluronic Acid