title: Basic pharmacology of topical imiquimod, 5-fluorouracil, and diclofenac for the dermatologic surgeon.
abstract: BACKGROUND
  Ultraviolet radiation (UVR) contributes to the vast majority of nonmelanoma skin cancer (NMSC). As the incidence of NMSC continues to rise, topical therapies will be used with increasing frequency. Topical therapies may benefit high-risk surgical candidates as an alternative treatment modality and may improve overall cosmesis. The most commonly employed topical therapies are imiquimod, 5-fluorouracil (5-FU), and diclofenac.
  
  
  OBJECTIVE
  To review the detailed mechanism of action and side-effect profiles of each topical therapy used to treat NMSC and to explore newly discovered actions. Uncommon adverse events are also presented.
  
  
  METHODS
  An extensive literature search was performed to describe the pharmacologic actions of imiquimod, 5-FU, and diclofenac.
  
  
  CONCLUSIONS
  A keen understanding of the pharmacologic concepts of these topical therapies may aid the dermatologic surgeon in making sound choices before, during, and after surgery.
authors.affiliation: Heights Dermatology, Houston, Texas 77008, USA. drdesai910@pol.net
authors.forename: Tejas
authors.initials: T
authors.lastname: Desai
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Chen
authors.forename: Alpesh
authors.initials: A
authors.lastname: Desai
authors.forename: William
authors.initials: W
authors.lastname: Kirby
mesh_terms: D000287:Administration, Topical; D000634:Aminoquinolines / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D004008:Diclofenac / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D006801:Humans; D000077271:Imiquimod; D012878:Skin Neoplasms / Q000188:drug therapy*
chemical_list: D000634:Aminoquinolines; D000970:Antineoplastic Agents; D004008:Diclofenac; D000077271:Imiquimod; D005472:Fluorouracil