title: Topical diclofenac gel for the management of periocular actinic keratosis.
abstract: OBJECTIVE
  We sought to evaluate the efficacy of topical 3% diclofenac gel in the management of periocular actinic keratosis.
  
  
  METHODS
  Four consecutive patients with periocular actinic keratosis who were treated with topical 3% diclofenac gel twice daily for up to 4 months were included in the study. Patients were reviewed at 1 and 2 months and then as clinically required up to 13 months after treatment.
  
  
  RESULTS
  All 4 patients had biopsy-proven actinic keratosis. Three of the 4 patients tolerated the therapy well. In 1 patient, an adverse reaction developed, with erythema, crusting, and scaling after 2 months of therapy, which resolved within a month of discontinuing topical diclofenac. In all the patients, a visible decrease in lesion severity was seen after 1 month, and complete resolution, within 4 months. Recurrences occurred in 2 patients at 4 months and 7 months after treatment. These were successfully managed, in one patient, by excision, and in the other, with further 3% diclofenac gel followed by cryotherapy.
  
  
  CONCLUSIONS
  The use of 3% diclofenac gel in extraocular sites has been widely described in the dermatology literature. However, no published reports exist of its use in ophthalmology. It may be a useful therapeutic option when used alone in patients with localized disease or to reduce the size of larger, more-diffuse lesions before excision or cryotherapy, leading to improved cosmesis. Furthermore, it may also be useful in patients prone to actinic keratoses, such as organ-transplant recipients, to reduce the need for multiple excision procedures or uncomfortable ablative techniques.
authors.affiliation: Wolverhampton Eye Infirmary, Wolverhampton, West Midlands, United Kingdom. ruchikabatra@aol.com
authors.forename: Ruchika
authors.initials: R
authors.lastname: Batra
authors.forename: Sathya
authors.initials: S
authors.lastname: Sundararajan
authors.forename: Soupramanien
authors.initials: S
authors.lastname: Sandramouli
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D004008:Diclofenac / Q000008:administration & dosage*; D005142:Eyelid Neoplasms / Q000188:drug therapy*; D005260:Female; D005782:Gels; D006801:Humans; D055623:Keratosis, Actinic / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000188:drug therapy*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005782:Gels; D004008:Diclofenac