5FU/Calcipotriol schedule

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August 1, 2026

In this monthly column, members of the DermWorld Editorial Advisory Workgroup identify exciting news from across the specialty.  

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Ashley Decker, MD, FAAD

Growing evidence supports 5-FU/calcipotriol (5-FU/C) for actinic keratoses (AKs) and superficial keratinocyte carcinomas, yet formal guidelines are lacking. To address this gap, a modified Delphi consensus was conducted by a nine-member expert panel of dermatologists and dermatologic surgeons (≥5 years’ experience) from the International Immunosuppression & Transplant Skin Cancer Collaborative (doi: 10.1016/j.jaad.2026.03.088).

Key recommendations:

Actinic keratoses

• Face/neck: BID × 4-5 days; if response is inadequate, extend to BID × 7-10 days

• Actinic cheilitis: BID × 4-5 days

• Scalp, trunk, extremities: BID × 7-10 days

• Repeat courses: Guided by clinical exam; consider treatment every 3-6 months in patients with extensive actinic damage

SCC in situ (SCCis)

• Reserve for cases not amenable to surgery or other FDA-approved therapies

• Head/neck: BID × 7-10 days

• Scalp, trunk, extremities: BID × 10-14 days

Superficial basal cell carcinomas (sBCC)

• Insufficient evidence at this time