Topical 5-fluorouracil as primary therapy for keratoacanthoma

Area of Science:

• Dermatology
• Oncology

Background:

• Keratoacanthoma is a common, benign skin neoplasm often appearing on sun-exposed areas.
• While typically self-resolving, keratoacanthoma can rarely progress to squamous cell carcinoma.
• Treatment goals include effectiveness, patient comfort, and superior cosmetic results.

Observation:

• Two patients with keratoacanthoma were treated with topical 5-fluorouracil.
• Complete lesion resolution was observed in both patients within 8 weeks.
• Excellent cosmetic results and high patient satisfaction were reported.

Findings:

• Topical 5-fluorouracil demonstrated efficacy in resolving keratoacanthoma.
• Treatment response was rapid, with most lesions improving within 3 weeks.
• Squamous cell carcinomas showed poor response to this therapy.

Implications:

• Topical 5-fluorouracil is a viable, convenient, and cost-effective treatment for keratoacanthoma.
• Clinical diagnosis may suffice, potentially avoiding the need for biopsy.
• Lesions unresponsive after 3 weeks or unresolved by 8 weeks warrant biopsy for definitive diagnosis and treatment.