Discover how pre-treatment with topical 5-fluorouracil can significantly enhance the effectiveness of daylight photodynamic therapy in managing actinic keratoses, as revealed by a groundbreaking randomized controlled trial.
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Pre-treatment with topical 5-fluorouracil increases the efficacy of daylight photodynamic therapy for actinic keratoses – a randomized controlled trial.
Wiegell et al., Photodiagnosis Photodyn Ther 2024
<!– DOI: 10.1016/j.pdpdt.2024.104069 //–>
https://doi.org/10.1016/j.pdpdt.2024.104069
This study evaluates the effectiveness of combining 4% 5-fluorouracil (5-FU) cream with daylight photodynamic therapy (dPDT) versus dPDT alone for treating actinic keratoses (AKs). Involving 60 patients with a total of 1547 AKs, treatments were applied to symmetrical areas of the face or scalp. The combination treatment cleared 87% of all AKs, significantly outperforming dPDT monotherapy, which cleared 74%. Notably, for grade II AKs, the response rate improved from 55% with dPDT alone to 79% with the combination therapy. Although moderate to severe erythema was more common in the combination therapy group (88% vs. 41% in the dPDT group), patient satisfaction was high, with 75% very satisfied with both treatments after 12 weeks. This study highlights the superior efficacy of sequential 5-FU and dPDT, particularly for grade II AKs, while maintaining high compliance and patient satisfaction despite increased local skin reactions.