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Sequential Treatment of Multiple Actinic Keratoses with Solaraze and Actikerall

Interest is increasing in the use of sequential or combined therapeutic modalities for spot or area treatment of actinic keratoses (AKs) to achieve complete sustained remission. For multiple lesions in a contained area, topical treatment offers less discomfort, better cosmesis and greater patient co...

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Autores principales: Dirschka, Thomas, Lear, John T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127541/
https://www.ncbi.nlm.nih.gov/pubmed/25120467
http://dx.doi.org/10.1159/000365070
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author Dirschka, Thomas
Lear, John T.
author_facet Dirschka, Thomas
Lear, John T.
author_sort Dirschka, Thomas
collection PubMed
description Interest is increasing in the use of sequential or combined therapeutic modalities for spot or area treatment of actinic keratoses (AKs) to achieve complete sustained remission. For multiple lesions in a contained area, topical treatment offers less discomfort, better cosmesis and greater patient convenience than destructive/ablative techniques. Twelve patients with multiple grade I and II AK lesions of the scalp (cases 1–10) or the dorsum of the hand (cases 11 and 12), most with a history of recurrence, were treated with Solaraze gel (3% diclofenac sodium in 2.5% hyaluronic acid) twice daily for 12 weeks, followed by a 2-week treatment-free interval, then Actikerall cutaneous solution (5-fluorouracil 5 mg/g and salicylic acid 100 mg/g) once daily for up to 6 weeks as required. Sequential treatment provided complete (clinical and histological) clearance in 8/10 male patients. Two patients with numerous lesions had partial clearance (significant improvement) and the remaining few lesions were treated with erbium laser. Both female patients achieved complete clinical clearance with sequential treatment. Solaraze/Actikerall were well tolerated. A case of contact dermatitis with Solaraze resolved after discontinuation and the patient progressed to treatment with Actikerall. Local application site reactions resolved upon treatment completion. Topical lesion-directed sequential treatment with Solaraze/Actikerall is a rational approach to treat patients with multiple AKs. Sequential treatment produces excellent clearance rates which are accompanied by relevant improvement in patients’ quality of life.
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spelling pubmed-41275412014-08-12 Sequential Treatment of Multiple Actinic Keratoses with Solaraze and Actikerall Dirschka, Thomas Lear, John T. Case Rep Dermatol Published online: July, 2014 Interest is increasing in the use of sequential or combined therapeutic modalities for spot or area treatment of actinic keratoses (AKs) to achieve complete sustained remission. For multiple lesions in a contained area, topical treatment offers less discomfort, better cosmesis and greater patient convenience than destructive/ablative techniques. Twelve patients with multiple grade I and II AK lesions of the scalp (cases 1–10) or the dorsum of the hand (cases 11 and 12), most with a history of recurrence, were treated with Solaraze gel (3% diclofenac sodium in 2.5% hyaluronic acid) twice daily for 12 weeks, followed by a 2-week treatment-free interval, then Actikerall cutaneous solution (5-fluorouracil 5 mg/g and salicylic acid 100 mg/g) once daily for up to 6 weeks as required. Sequential treatment provided complete (clinical and histological) clearance in 8/10 male patients. Two patients with numerous lesions had partial clearance (significant improvement) and the remaining few lesions were treated with erbium laser. Both female patients achieved complete clinical clearance with sequential treatment. Solaraze/Actikerall were well tolerated. A case of contact dermatitis with Solaraze resolved after discontinuation and the patient progressed to treatment with Actikerall. Local application site reactions resolved upon treatment completion. Topical lesion-directed sequential treatment with Solaraze/Actikerall is a rational approach to treat patients with multiple AKs. Sequential treatment produces excellent clearance rates which are accompanied by relevant improvement in patients’ quality of life. S. Karger AG 2014-07-02 /pmc/articles/PMC4127541/ /pubmed/25120467 http://dx.doi.org/10.1159/000365070 Text en Copyright © 2014 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Users may download, print and share this work on the Internet for noncommercial purposes only, provided the original work is properly cited, and a link to the original work on http://www.karger.com and the terms of this license are included in any shared versions.
spellingShingle Published online: July, 2014
Dirschka, Thomas
Lear, John T.
Sequential Treatment of Multiple Actinic Keratoses with Solaraze and Actikerall
title Sequential Treatment of Multiple Actinic Keratoses with Solaraze and Actikerall
title_full Sequential Treatment of Multiple Actinic Keratoses with Solaraze and Actikerall
title_fullStr Sequential Treatment of Multiple Actinic Keratoses with Solaraze and Actikerall
title_full_unstemmed Sequential Treatment of Multiple Actinic Keratoses with Solaraze and Actikerall
title_short Sequential Treatment of Multiple Actinic Keratoses with Solaraze and Actikerall
title_sort sequential treatment of multiple actinic keratoses with solaraze and actikerall
topic Published online: July, 2014
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127541/
https://www.ncbi.nlm.nih.gov/pubmed/25120467
http://dx.doi.org/10.1159/000365070
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