Reasons for Patient Call-backs while being Treated with Topical 5-fluorouracil: A Retrospective Chart Review

Area of Science:

• Dermatology
• Oncology
• Pharmacology

Background:

• Actinic keratosis (AK) is a common precancerous skin lesion.
• 5-Fluorouracil (5-FU) is a topical chemotherapy agent used to treat AK.
• Assessing adverse events (AE) of 5-FU is crucial for patient management.

Purpose of the Study:

• To determine the frequency and nature of adverse events associated with 5-FU for AK.
• To compare the rate of 5-FU-related AEs with those of topical tacrolimus.

Main Methods:

• Retrospective chart review and patient phone interviews were conducted.
• Patients treated with 5-FU or topical tacrolimus for AK between 2015 and 2021 were included.
• AEs and reasons for contacting dermatologists were assessed.

Main Results:

• 58% of patients reported AEs with 5-FU, most commonly redness (38%) and burning (27%).
• 37% of 5-FU patients contacted their dermatologist, often regarding severe local skin reactions (LSR) or medication issues.
• Only two patients on topical tacrolimus contacted their dermatologist, primarily for medication access issues.

Conclusions:

• 5-FU causes frequent and often severe AEs in AK patients.
• The irritation from 5-FU is significantly greater than that from topical tacrolimus.
• Managing AK treatment outcomes may be improved by discussing 5-FU risks, LSR severity, and alternatives.