Abstract
Background
Actinic keratoses (AK) have been described as either intraepithelial keratinocytic dysplasia that can evolve into invasive squamous cell carcinoma (SCC) or as in situ SCC that can progress into an invasive form.
Materials and Methods
A retrospective study was conducted to compare outcomes of three different topical therapies for patients with single AK (<4): cryotherapy, CO2 laser and 5‐fluorouracil 0.5% /salicylic acid 10%. We included 72 patients who presented at the Dermatology Clinic of Maggiore Hospital of Trieste between November 1st 2019 and January 31st 2020 for the treatment of AKs.
Results
All treatments led to a significant reduction in the average diameter of AK. Pain felt by patients was significantly lower after 5‐FU 0.5%/SA 10%. Side effects appeared similarly distributed among the three groups, with erythema and crusts being the most frequent. Aesthetic outcomes were highest in the 5‐FU 5%/SA 10% group, as evaluated by both the patient and the operator.
Conclusion
Cryotherapy, CO2 laser and 5‐FU 5%/SA 10% were all effective, with no significant efficacy differences among them. Additionally, 5‐FU 5%/SA 10% was proved to have the best aesthetic result and to cause the least pain, while necessitating long‐term administration. This should be taken into account for patients with low pain tolerance and low treatment adherence. Cryotherapy and CO2 laser have the advantage of requiring a single session, which might be more suitable for uncooperative patients.
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