New and emerging topical approaches for actinic keratoses

Actinic keratoses (AKs) are intraepidermal foci of malignancy and represent the earliest clinical stage in the continuum of squamous cell carcinoma (SCC). A variety of topical, physical, and surgical modalities are available for treatment. Until recently, topical 5-fluorouracil was the only topical agent approved by the US Food and Drug Administration (FDA) for the treatment of AK. Topical diclofenac 3% gel, an inhibitor of arachidonic acid, is the second topical approved for the treatment of AK. Although not currently approved in the United States, multiple studies have substantiated the efficacy of topical imiquimod for AKs. This article reviews the efficacy and safety of topical diclofenac and topical imiquimod for the treatment of AKs.