Thompson Bobbye J, Ravits Margaret, Silvers David N
Department of Dermatology, Columbia University Medical Center, New York, New York;
Department of Dermatology, Columbia University Medical Center, New York, New York; ; Department of Pathology, Columbia University Medical Center, New York, New York.
J Clin Aesthet Dermatol. 2014 Nov;7(11):35-7.
To determine the efficacy of treating patients with a recent onset, biopsy-proven keratoacanthoma with short-contact topical 5% 5-fluorouracil cream twice daily until resolution.
Chart review of 10 patients who applied 5% 5-fluorouracil for the treatment of biopsy-proven keratoacanthoma.
Outpatient clinic of a board-certified dermatologist.
The study population was 90-percent women (9/10), 10-percent men (1/10) and ranged in ages from 52 to 92 years old with a mean age of 74.4.
Patients were followed for weekly visits for the duration of their treatment and at varying, less-frequent intervals after resolution of the lesion clinically. Photographs were taken at each visit.
The authors performed a retrospective analysis of 10 patients with biopsy-confirmed keratoacanthomas treated with topical 5-fluorouracil. One patient elected to have Mohs surgery after one week of topical 5-fluorouracil due to personal concern and cosmetic appearance and did not complain of any side effects due to the drug. Of the nine patients that remained on topical 5-fluorouracil, all patients had complete resolution of the lesion within six weeks. The range in the number of weeks to resolution was four to six weeks. Two patients required a one- to two-week drug holiday secondary to erythema, which resolved without any further complication or patient discomfort. All nine patients who continued therapy reported satisfaction with the results and showed excellent compliance with treatment.
Short-contact topical 5% 5-fluorouracil appears to provide excellent cosmetic results and is well-tolerated by patients. This should be an initial consideration for the treatment of keratoacanthomas and does not preclude future surgical intervention if deemed necessary.
确定采用短期接触外用5% 5-氟尿嘧啶乳膏每日两次直至消退来治疗近期发病、经活检证实的角化棘皮瘤患者的疗效。
对10例应用5% 5-氟尿嘧啶治疗经活检证实的角化棘皮瘤的患者进行病历回顾。
一位获得委员会认证的皮肤科医生的门诊诊所。
研究人群中90%为女性（9/10），10%为男性（1/10），年龄在52至92岁之间，平均年龄为74.4岁。
在患者治疗期间每周进行随访，并在皮损临床消退后以不同的、不那么频繁的间隔进行随访。每次就诊时均拍照。
作者对10例经活检确诊的角化棘皮瘤患者外用5-氟尿嘧啶进行了回顾性分析。1例患者因个人担忧和外观问题，在外用5-氟尿嘧啶1周后选择了莫氏手术，且未抱怨该药物有任何副作用。在继续外用5-氟尿嘧啶的9例患者中，所有患者的皮损均在6周内完全消退。消退所需周数范围为4至6周。2例患者因红斑需要停药1至2周，红斑消退且未出现任何进一步并发症或患者不适。所有继续治疗的9例患者均对结果表示满意，并对治疗表现出极佳的依从性。
短期接触外用5% 5-氟尿嘧啶似乎能提供极佳的美容效果，且患者耐受性良好。这应作为治疗角化棘皮瘤的初步考虑方法，如有必要，并不排除未来进行手术干预。
