title: Topical 5% 5-fluorouracil in the treatment of multifocal basal cell carcinoma of the face: A novel chemotherapeutic approach.
abstract: To determine the safety and efficacy of topical 5-fluorouracil (5-FU) 5% ointment in treatment of non-syndromic multifocal basal cell carcinoma. A 55-year-old male patient, with 8 hours of daily sun exposure, having histologically proven and radiologically non-syndromic, multifocal basal cell carcinoma with involvement of 6 sites on the face, was treated with topical 5-FU 5% ointment twice daily over all sites except the site involving lid margin to prevent corneal toxicity. Left lid lesion underwent wide surgical excision with 5-mm clear margins and reconstruction with nasal septal mucoperichondrium and local skin mobilization. Pharmacologic effects first appeared at 4 weeks and by 8 weeks, the lesions had scabbed and had fallen off with no induration but residual mild perilesional erythema. Patient had post-op histopathological clear margins and recovered uneventfully. No recurrence in 6 months. A topical 5-FU 5% ointment represents a paradigm shift in the treatment of BCC from invasive and disfiguring options (surgery and chemoradiotherapy) to cheap, convenient, effective, non-invasive, non-disfiguring topical chemotherapy. Topical 5% 5-FU is a safe and effective modality of treatment of superficial spreading multifocal basal carcinoma, especially lesions larger than 10 mm, where margins cannot be identified clearly and recurrent lesions.
authors.affiliation: a Department of Ophthalmology , V.M.M.C & Safdarjung Hospital , Ansari Nagar , New Delhi , India.
authors.forename: Mayuresh P
authors.initials: MP
authors.lastname: Naik
authors.affiliation: a Department of Ophthalmology , V.M.M.C & Safdarjung Hospital , Ansari Nagar , New Delhi , India.
authors.forename: Anuj
authors.initials: A
authors.lastname: Mehta
authors.affiliation: a Department of Ophthalmology , V.M.M.C & Safdarjung Hospital , Ansari Nagar , New Delhi , India.
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Abrol
authors.affiliation: a Department of Ophthalmology , V.M.M.C & Safdarjung Hospital , Ansari Nagar , New Delhi , India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Kumar
authors.affiliation: a Department of Ophthalmology , V.M.M.C & Safdarjung Hospital , Ansari Nagar , New Delhi , India.
authors.forename: Vishnu S
authors.initials: VS
authors.lastname: Gupta
mesh_terms: D000287:Administration, Topical; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D002280:Basal Cell Carcinoma / Q000188:drug therapy* / Q000473:pathology; D005145:Face; D005472:Fluorouracil / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000188:drug therapy* / Q000473:pathology; D009824:Ointments; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000964:Antimetabolites, Antineoplastic; D009824:Ointments; D005472:Fluorouracil
keywords: 5-fluorouracil ointment; basal cell carcinoma; multifocal BCC; superficial spreading BCC; topical chemotherapy