Rivers J K, McLean D I
Division of Dermatology, University of British Columbia and Vancouver Hospital and Health Sciences Centre, Canada.
Arch Dermatol. 1997 Oct;133(10):1239-42.
Actinic keratoses are potential precursors of invasive squamous cell carcinoma; therefore, treatment is often recommended. Current topical treatments may cause considerable discomfort, pain, or skin irritation. This study was established to explore the role, if any, of topical 3% diclofenac in 2.5% hyaluronic acid gel in the management of actinic keratoses.
An open-label study was conducted of topical 3% diclofenac in 2.5% hyaluronic acid gel applied to 1 or more actinic keratoses. Patients were instructed to apply 1.0 g of the gel twice daily for as many as 180 days. Treatment was stopped earlier than 180 days if lesions were assessed as cleared. Twenty-nine adults were treated for periods of 33 to 176 days (median, 62 days). Of the 29 subjects, 27 were reevaluated 30 days after drug therapy discontinuation. Of the 27 patients, 22 (81%) had a complete response and another 4 (15%) showed marked clinical improvement. The preparation was generally well tolerated, although in 7 patients (24%) an irritant-type contact dermatitis developed, which was confined to the treatment site.
Topical 3% diclofenac in 2.5% hyaluronic acid gel may be a clinically useful topical agent for the treatment of actinic keratoses.
光化性角化病是侵袭性鳞状细胞癌的潜在前驱病变;因此,通常建议进行治疗。目前的局部治疗可能会引起相当大的不适、疼痛或皮肤刺激。本研究旨在探讨3%双氯芬酸2.5%透明质酸凝胶在光化性角化病治疗中的作用(若有)。
对应用于1个或多个光化性角化病的3%双氯芬酸2.5%透明质酸凝胶进行了一项开放标签研究。患者被指示每天两次涂抹1.0 g凝胶,最长可达180天。如果病变被评估为清除,则治疗提前于180天停止。29名成年人接受了33至176天(中位数为62天)的治疗。在这29名受试者中,27人在停药30天后进行了重新评估。在这27名患者中,22人(81%)有完全缓解,另外4人(15%)显示出明显的临床改善。该制剂总体耐受性良好,尽管有7名患者(24%)出现了刺激性接触性皮炎,且局限于治疗部位。
3%双氯芬酸2.5%透明质酸凝胶可能是一种临床上用于治疗光化性角化病的有用局部用药。