title: New Topical Treatment Options for Actinic Keratosis: A Systematic Review.
abstract: This systematic review compared the relative efficacy of 5-fluorouracil 0.5% in salicylic acid 10% (5-FU/SA), ingenol mebutate (IMB) and imiquimod 2.5%/3.75% (IMI) for actinic keratosis on the face, forehead or scalp. Only 11 publications, relating to 7 randomised controlled trials, met inclusion criteria and it was only possible to compare the effect of all 3 treatments on complete clinical clearance, and the effect of 5-FU/SA and IMB on actinic keratosis recurrence rate. Despite a higher vehicle response rate for 5-FU/SA, complete clinical clearance was higher than IMB and IMI (55.4, 42.2, and 25.0-30.6/34.0-35.6%, [corrected] respectively). 5-FU/SA was also associated with lower actinic keratosis recurrence rate than IMB at 12 months post-treatment (32.7 vs. 53.9%). Although qualitative assessment suggested a numerical advantage of 5-FU/SA over IMB and IMI in terms of complete clinical clearance and sustained clearance, clinical data from longer term trials, with comparable outcome measures, are required to corroborate these findings.
authors.affiliation: Direktor der Universitätshautklinik, St. Josef-Hospital, Germany.
authors.forename: Eggert
authors.initials: E
authors.lastname: Stockfleth
authors.forename: Gillian C
authors.initials: GC
authors.lastname: Sibbring
authors.forename: Ivette
authors.initials: I
authors.lastname: Alarcon
mesh_terms: D000279:Administration, Cutaneous; D000634:Aminoquinolines / Q000008:administration & dosage; D003879:Dermatologic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004224:Diterpenes / Q000008:administration & dosage; D004338:Drug Combinations; D005148:Facial Dermatoses / Q000175:diagnosis / Q000188:drug therapy*; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D000077271:Imiquimod; D055623:Keratosis, Actinic / Q000175:diagnosis / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D020156:Salicylic Acid / Q000008:administration & dosage; D012536:Scalp Dermatoses / Q000175:diagnosis / Q000188:drug therapy*; D012867:Skin / Q000187:drug effects* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: C486592:3-ingenyl angelate; D000634:Aminoquinolines; D003879:Dermatologic Agents; D004224:Diterpenes; D004338:Drug Combinations; D020156:Salicylic Acid; D000077271:Imiquimod; D005472:Fluorouracil