Epstein E
Department of Dermatology, University of California, San Francisco, USA.
J Am Acad Dermatol. 1998 Jan;38(1):77-80. doi: 10.1016/s0190-9622(98)70542-0.
Topical 5-fluorouracil (5-FU) is effective in removing actinic keratoses but causes unsightly and painful erosions. Intermittent "pulse" 5-FU therapy has been described as being an effective and comfortable technique for destroying actinic keratoses.
The purpose of this study was to determine the efficacy and cutaneous side effects of intermittent 5-FU therapy.
Efficacy of treatment was evaluated by three experienced dermatologists separately comparing randomly arranged before and after photographs. Degree of skin reaction was graded from photographs taken during treatment.
Of 13 patients treated with intermittent 5-FU, two had an excellent result, three a good result, but eight failed to show discernible improvement. Efficacy was linked to the degree of skin irritation.
Pulse 5-FU failed to clear actinic keratoses in most patients. Intermittent 5-FU treatment does not dissociate its therapeutic efficacy from its undesirable erosive effects. Pulse therapy is a less intensive way of employing 5-FU and may be of value in patients unwilling to accept the erosions and discomfort that accompany the traditional course of daily 5-FU applications.
