Queratoacantomas, involucionan más rapido con 5fu

Published in Dermatology

Journal Scan / Research · November 14, 2019

Relative Efficacy of Nonoperative Treatment of Keratoacanthomas

Journal of cutaneous medicine and surgery

TAKE-HOME MESSAGE

• This systematic review assessed the efficacy of nonsurgical treatment of keratoacanthomas (KAs). While eradication rates were high (92%–100%) with both topical and intralesional treatments, intralesional 5-fluorouracil led to faster KA healing times compared with intralesional methotrexate (3.7 vs 4.6 weeks; P=.017). Resolution time was faster with topical 5-fluorouracil used once or twice daily for 1 to 8 weeks than with topical imiquimod used three to five times weekly for 3 to 11 weeks (P<.0001).

• Overall, resolution of KAs was high with each treatment and did not statistically differ between topical and intralesional medications. Both intralesional and topical forms of 5-fluorouracil may yield faster clearance than other studied modalities.

– InYoung Kim, MD

Abstract

BACKGROUND

Keratoacanthomas (KAs) are neoplasms of squamous epithelium which exhibit rapid growth and are often difficult to distinguish clinically from squamous cell carcinoma. Excision is the most common treatment, but in refractory cases or for KAs in cosmetically sensitive areas, nonoperative modalities may be better suited.

OBJECTIVE

To compare efficacies of topical and intralesional therapies for the treatment of KAs.

METHODS

A systematic literature review was performed using Medline, Ovid, and Embase. Studies looking at the efficacy of topical or intralesional treatments for KAs were included. To compare efficacy, 2-tailed t-tests were performed, with P < .05 considered statistically significant.

RESULTS

Forty-one studies were identified across 5 modalities. Both topical and intralesional treatments had high KA eradication rates (92%-100%). Intralesional 5-fluorouracil led to faster KA healing times when compared to intralesional methotrexate (3.7 vs 4.6 weeks, P = .017). Similarly, topical 5-fluorouracil led to faster time to heal than topical imiquimod (3.8 vs 7.6 weeks with imiquimod, P < .0001).

CONCLUSION

For nonoperative treatment of KAs, strong evidence currently exists for both topical and intralesional therapies. Decisions on which modality to use should be made on a case-by-case basis.

Journal of cutaneous medicine and surgery

Relative Efficacy of Nonoperative Treatment of Keratoacanthomas

J Cutan Med Surg 2019 Oct 08;[EPub Ahead of Print], EW Seger, IS Tarantino, BC Neill, T Wang

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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