Topical Application Of 5-fluorouracil Research Articles

Application of topical 5-Fluorouracil to reduce the recurrence of odontogenic keratocyst: A prospective study with 2-year follow-up

ObjectivesThe purpose of this prospective study was to evaluate the effect of topical 5-Fluorouracil as an adjunct therapy in reducing the recurrence of odontogenic keratocyst. MethodsForty-eight patients with proven incisional biopsy as odontogenic keratocyst were included in this clinical study. The patients were divided into two equal groups, the test group patients were treated with 5-Fluorouracil cream after cyst enucleation. However, the control group patients were treated with cyst enucleation only. Recurrence (yes/no) was the primary outcome variable evaluated by clinical signs of inflammation, swelling, or pain within a 2-year follow-up. The pain was measured on a visual analogue scale, and swelling was measured pre-surgically using vertical and horizontal references, 1 week, 1 month, 3 months, 6 months, 12 months, and 24 months. Computed tomography was performed pre-surgically and 24 hours post-surgically, at 12-month, and 24-month intervals to evaluate local bone density. The T-test was used to compare between two studied groups. ResultsPost-surgical follow-up showed uneventful wound healing in both groups with no clinical signs of recurrence or swelling, pain results demonstrated that patients have decreased records throughout the observation periods with no significant difference between both groups. Normal sensation was encountered in all patients except for one patient in the control group who showed no sensation (score 2). Post-surgical radiographic findings revealed a considerable shift in bone density in all patients of both groups at the site of excised lesions during the follow-up periods compared with immediate post-surgical radiographs. However, the test group patients demonstrated a significant increase of bone density between different evaluation periods (P = 0.001) than the control group. ConclusionConservative enucleation of odontogenic keratocyst combined with topical application of 5-Fluorouracil is an effective treatment with lower recurrence rates, less morbidity, and normal bone healing.

SKIN CANCER IN CHILDREN WITH XERODERMA PIGMENTOSUM

Introduction: Xeroderma pigmentosum) is a rare disease, inherited in an autosomal recessive manner with disturbances in the repair of deoxyribonucleic acid (DNA) which often occur in malignancy. Irreversible DNA lesions and mutations also occur in the genes which regulate skin cancer development in Xeroderma Pigmentosum. Purpose: To explain the signs, symptoms, and management of skin cancer Xeroderma Pigmentosum. Case Report : A 6 year old girl with basal cell carcinoma arising from Xeroderma pigmentosum. The histopathological picture of the left nasolabial biopsy preparation was found to show basal cell carcinoma (BCC). The patient was treated with 5FU administration and were followed after 6 week In the second patient, a 3 year old boy, squamous cell carcinoma in the oocipital area. From the histopathological picture, moderately differentiated squamous cell carcinoma on the left frontalis occipital dextra and corresponds to mottled hypermegrance on the parietal dextra. In this patient, a wide excision of the occipital lump was performed and the defect was closed with a full-thickness skin graft. Provided education to the parents of both patients for direct prevention of sun exposure by using sunscreen/hats. Discussion and Conclusion: Xeroderma Pigmentosum patients who are Xeroderma Pigmentosum to ultraviolet radiation (UV) can result in the development of highly cancerous lesions consisting of squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and malignant melanoma (MM). Clinical management of Xeroderma Pigmentosum includes sun avoidance, minimizing UV eXeroderma Pigmentosumosure, early detection, skin lesions, and genetic counseling. Topical application of 5-fluorouracil or imiquimod is used for premalignant lesions, and surgical excision is performed for malignant neoplasms of the skin, tongue, eyelids, conjunctiva, and cornea.

Topical application of 5-fluorouracil 5 percent cream associated with severe neutropenia: discussion of a case and review of systemic reactions after topical treatment with 5-fluorouracil

5-fluorouracil, a fluoropyrimidine antineoplastic drug, is used to topically treat actinic keratoses. Local skin reactions to the medication are common and anticipated. However, severe adverse events from topical 5-fluorouracil are rare and unexpected. A 69-year-old man with a lower lip actinic keratosis developed severe neutropenia on day 11 of topical 5-fluorouracil treatment - after 14 applications. After receiving a subcutaneous injection of filgrastim, his neutrophil count normalized. The PubMed database was used to search the following terms: agranulocytosis, cream, 5-fluorouracil, granulocytopenia, neutropenia, severe, systemic, topical, and toxicity. The papers, and relevant cited references, generated were reviewed. Systemic reactions to topical 5-fluorouracil included angioedema, melanonychia, neurologic conditions (such as acute cerebellar syndrome, headaches, and peripheral neuropathy exacerbation), taste alteration, and systemic toxicity requiring hospitalization (including severe neutropenia). One of the individuals (a man with severe neutropenia and other symptoms) also had a deficiency of dihydropyrimidine dehydrogenase, the enzyme that catalyzes the rate-limiting step in 5-fluorouracil metabolism. Evaluation for dihydropyrimidine dehydrogenase deficiency is not routinely performed in patients receiving systemic or topical 5-fluorouracil. Also, the incidence of potentially severe 5-fluorouracil-induced toxicity associated with topical application of the drug may be greater than documented.

Giant extragenital Bowen’s disease

Giant extragenital forms of Morbus Bowen are extremely rare. The already described cases in the word literature are most commonly with periungual localization, as well as located on the foot and neck area. The clinical manifestation is presented most commonly by non-specific erythematous to erythematous-squamous plaques or papules, which is confusing to the clinician. From the pathogenic point of view, it is important to be confirmed or rejected the presence of human papilloma viruses (HPVs) in each case of affected patient, as this information is mandatory in respect to the adequate selection of the subsequent regimen. If HPVs are detected, systemic antiviral therapy could be initiated to reduce the size of the lesions before subsequent surgical eradication. A postoperative prevention through vaccination could be also considered additionally. In cases of HPV-negative giant extragenital forms of Morbus Bowen (as in the described patient), the focus should be on local immunomodulation by substances such as imiquimod, which reduce the size of the lesions, thereby creating optimal opportunities for their future surgical eradication. Other possible options described in the literature include topical application of 5-fluorouracil, photodynamic therapy, cryotherapy, and laser therapy (carbon dioxide laser). The choice of the most appropriate regimen should have been an individual decision of the clinician, considering also the location and the extent of the lesion.

Radyoterapi iyi yanıt veren Bowen hastalığı olgusu

Bowen"s disease is a form of intraepidermal squamous cell carcinoma which is known as carsinoma in situ. The head, neck, and extremities are the most commonly affected anatomic locations. Treatment options for Bowen"s disease include observation, surgery, cryotherapy, electrodesiccation and curettage, topical application of 5-fluorouracil or imiquimod, Moh"s micrographic surgery, photodynamic therapy, and radiotherapy. Radiation therapy is advantageous in patients who refuse surgery, for large or multiple lesions, for lesions in cosmetically sensitive areas, and in patients who are predisposed to formation of keloids, with a high cure rate cited in the literature. Here we report a 70-year-old man who was diagnosed as Bowen"s disease and completely healed with the treatment of radiotherapy. By means of this case report, we will review the current literature and empasize that radiotherapy is an effective treatment alternative for Bowen's disease in the suitable lesions.

Behandlung eines Carcinoma in situ bei Erythema ab igne mittels photodynamischer Therapie

Erythema ab igne (EAI) occurs at skin locations that have been repeatedly exposed to heat or infrared radiation, a single dose of which results in erythema but the intensity of which does not suffice to cause a burn. The clinical picture of EAI is characterized by reticulate erythema, desquamation, and teleangiectasias. Complications of EAI include increasing cutaneous atrophy and predisposition to malignant tumors. The paramount goal of therapy is to eliminate the cause. Individual case reports of EAI with established epithelial dysplasia in the sense of carcinoma in situ have described good response of the neoplastic alterations to topical application of 5-fluorouracil or imiquimod. In our case we achieved successful results with photodynamic therapy.

Topical application of 5-fluorouracil on attic cholesteatoma results in downregulation of keratinocyte growth factor and reduction of proliferative activity

To investigate the cell-biological effect of topically applied 5-fluorouracil (5-FU) on middle ear cholesteatoma, 12 attic cholesteatomas were treated with topical application of 5-FU cream, two to five times with an interval of 2 weeks (5-FU group). The control group comprised 65 cholesteatoma that were not treated with 5-FU. All lesions were later excised surgically and processed for immunohistochemical analyses of Ki-67, keratinocyte growth factor (KGF) and its receptor (KGFR). 5-FU significantly reduced the expression of KGF, did not change KGFR expression, and significantly reduced the Ki-67 labeling index, relative to the control group. The effect of 5-FU on cholesteatoma seems to be mediated, at least in part, through downregulation of KGF in stromal cells and reduction of the proliferative activity of epithelial cells.

Melanonychia induced by topical 5-fluorouracil

Melanonychia was induced by the topical application of 5-fluorouracil in the treatment of periungual warts affecting two fingers. The pigmentation, involving the lunula of the nails of all fingers, was identical to that induced by systemically administered cytotoxic drugs.

Actinic keratosis and capecitabine therapy

Topical application of 5-fluorouracil (5-FU) is one of the most effective clinical strategies available to treat actinic keratosis (AK). During treatment, an apparent toxic skin reaction occurs before dermal quiescence ensues. We report a case of a typical flare of AK in a woman treated with capecitabine for advanced breast cancer.

Salvage of stage IV intraoral squamous cell carcinomas with preoperative 5-fluorouracil.

A regimen for improving the salvage rate for Stage IV squamous cell carcinoma of the tongue, alveolar ridge and floor of mouth is presented. This method utilizes pre-operative sensitization of the tumor and regional lymph nodes by the topical application of 5-fluorouracil (5-FU) in the form of Efudex (Roche). The drug must be used topically at the tumor skin or tumor-mucous membrane interface to utilize the sensitizing properties of skin or mucous membrane. Further response is obtained by direct injections of 5-FU into the tumor. Later intravenous (IV) drip of 5-FU can be used particularly at the time of surgical resection. During the period of preparation until sensitized to 5-FU, patients must be restored to positive nitrogen balance and concurrent infections are controlled. Because of the importance of nutrition in restoring immunity, a feeding gastrostomy for these patients is recommended. The definitive surgery must include all bone that is involved, as 5-FU alone will not sterilize the bone. Of 15 patients who underwent the regimen outlined in this study, 12 of the patients with Stage IV intra-oral squamous cell carcinoma have had their primary tumor controlled for 17 months to 5 years at the time of this report.

Microinvasive squamous-cell carcinoma of the vulva

THERE ARE many articles on the treatment Of’ in SitU and invasive squamous-cell carcinoma of the vulva. Radical vulvectomy and bilateral inguinal lymphadenectomy with or without pelvic nodes dissection is generally accepted treatment for invasive carcinoma of the vulva. Many methods of treatment for in situ squamous-cell carcinoma of the vulva have been used. They range from topical application of 5-fluorouracil or local excision of the lesion to radical vulvectomy, but literature is lacking so far in reports on microinvasive carcinoma of the vulva. Whether this is due to the fact that microinvasive carcinoma of the vulva is a relatively rare finding or it is considered as a frank invasive carcinoma is not clear. Wharton and associates’ reported 25 cases of microinvasive squamous-cell carcinoma of the vulva (invasion of stroma to a depth of 5 mm. or less) treated at the University of Texas M. D. Anderson Hospital between 1944 and 1969. Ten patients in their series had lymphadenectomies. None of the nodes was positive. They believed that the result of their study justified further investigation regarding the treatment of the patients with microinvasive vulvar carcinoma by conservative surgery. We used to consider radical vulvectomy (without node dissection) as an adequate therapy for microinvasive squamous-cell carcinoma of the vulva until we found positive inguinal and pelvic nodes 19 months after vulvectomy in the following case.

Peripheal blood toxicity of topical 5-fluorouracil on the Syrian hamster cheek pouch.

Toxicological studies on the peripheral blood after topical application of 5-fluorouracil to the buccal pouch of the Suriam hamster showed that a daily application of 10 mul (9.5 mg) was the maximum ideal dose for this animal. This dose did not depress to a significant degree the white blood cell count, red blood cell count, hemoglobin leve., hematocrit value, or the peripheral differential blood counts after 14 daily applications. Doses of increased concentration either daily or periodically were less effective and toxic.