Treatment-refractory actinic keratoses successfully treated using simultaneous combination topical 5-fluorouracil cream and imiquimod cream: A case-control study

Andrew L. Ondo, R. Steven Padilla, John D. Miedler, Clay J. Cockerell, James D. Kerner, Robert L. Steiner, Steven M. Mings, Stuart D. Shanler

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15 Scopus citations

Abstract

Background: Most actinic keratoses (AKs) respond to standard treatments, but a subset persist and require further intervention. We report a series of 10 patients with AKs that failed to respond to conventional treatment with cryotherapy and topical monotherapy but responded completely to simultaneous therapy with topical 5-fluorouracil (5-FU) and imiquimod creams. Objective: To report the success of this combination therapy in refractory AKs and to determine whether any clinical or histologic features predict for treatment resistance. Methods: Case-control study with two control groups matched to each patient according to lesion location and sex. Results: Mean lesion diameter (p <.001), lesion diameter greater than 1 cm (p <.001), and the presence of pain (p =.01) were statistically associated with failure of cryotherapy and topical monotherapy. None of the histologic features evaluated were found to be statistically significant, although thicker epidermis was nearly so (p =.054). Conclusions: In patients who have failed standard therapy for AKs, combination treatment using topical 5-FU and imiquimod cream may be an effective alternative therapeutic strategy. Larger lesion diameter, specifically greater than 1 cm, and the presence of pain predict conventional treatment resistance.

Original languageEnglish (US)
Pages (from-to)1469-1476
Number of pages8
JournalDermatologic Surgery
Volume38
Issue number9
DOIs
StatePublished - Sep 1 2012

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ASJC Scopus subject areas

  • Surgery
  • Dermatology

Cite this

Ondo, A. L., Padilla, R. S., Miedler, J. D., Cockerell, C. J., Kerner, J. D., Steiner, R. L., Mings, S. M., & Shanler, S. D. (2012). Treatment-refractory actinic keratoses successfully treated using simultaneous combination topical 5-fluorouracil cream and imiquimod cream: A case-control study. Dermatologic Surgery, 38(9), 1469-1476. https://doi.org/10.1111/j.1524-4725.2012.02480.x