Topical 3.0% diclofenac in 2.5% hyaluronic acid gel induces regression of cancerous transformation in actinic keratoses.
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.
Dirschka
T
T
Dermatological Practice Center, Wuppertal, Germany. drdirschka@aol.com
Bierhoff
E
E
Pflugfelder
A
A
Garbe
C
C
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
D000276:Adjuvants, Immunologic; D000894:Anti-Inflammatory Agents, Non-Steroidal; D005782:Gels; D004008:Diclofenac; D006820:Hyaluronic Acid