Old trumps new in solar keratoses treatment study

AN OLDER topical treatment for solar keratoses remains an effective option over a newer agent, a study shows.

German researchers compared low-dose 5-fluorouracil once daily with diclofenac in hyaluronic acid twice daily, and with 10% salicylic acid (the 5-fluorouracil vehicle) in 470 patients with solar keratoses over 12 weeks.

They showed that 0.5% 5-fluorouracil was superior to both diclofenac and the vehicle, with 72% of patients receiving 5-fluorouracil achieving histological lesion clearance compared with 59% and 45% of patients in the diclofenac and vehicle groups, respectively.

However, more than 70% of the patients in the 5-fluorouracil group experienced mild to moderate inflammation and burning, compared with 25% in the diclofenac group.

Sydney consultant dermatologist Dr Stephen Shumack, from Royal North Shore Hospital, said 5-fluorouracil (Efudix), at 5% but without salicyclic acid, was widely used in Australia and was very