The use of topical fluorouracil to treat actinic keratosis.

Actinic keratosis (AK) is a lesion induced by UV radiation, affecting predominantly fair-skinned individuals with a history of excessive sun exposure. Because AKs are potentially cancerous, management of AKs is important for dermatologists. The most frequently performed procedure for AKs is excision or destruction of the lesion, followed by biopsy. Topical fluorouracil creams are an efficient, effective treatment, especially for large quantities of widespread lesions. However, fluorouracil can produce an inflammatory facial reaction that is associated with the destruction of AKs. A new formulation, 0.5% fluorouracil cream, is indicated for once-daily use with a duration of treatment of up to 4 weeks. This regimen may be more cost-effective than the higher concentrations of fluorouracil creams (5% and 1%, respectively), which specify twice-daily application. Less frequent applications also may improve patient compliance with topical fluorouracil treatment. The use of 0.5% fluorouracil cream may provide an effective, safe, and economical option to augment the available treatments of AK, which include liquid nitrogen cryotherapy and 5% and 1% fluorouracil creams.