RESUMO
BACKGROUND: Five per cent 5-fluorouracil (5-FU) cream is a well-established treatment for actinic keratosis (AK), and ingenol mebutate gel (IMB) is a novel topical field-directed therapy. OBJECTIVE: To compare the tolerability and safety of IMB with that of 5-FU for the treatment of facial AK. METHODS: An open-label, prospective, randomized, controlled clinical trial with 100 patients with AKs within a 25-cm(2) contiguous field on the face was conducted. IMB was applied daily for three consecutive days. 5-FU was applied twice a day for 4 weeks. The treatment effect and the adverse events were evaluated at baseline and on days 2, 3, 4, 8, 15, 22, 29, 36 and 43 for intent-to-treat populations. RESULTS: The mean (± SD) maximum local skin reactions (LSR) for patients treated with IMB was 10.85 (± 3.12), compared with 10.86 (± 3.55) for those who received 5-FU. Patients in the IMB group presented LSR that peaked at day 4 and almost completely regressed after 15 days. Differently, in the 5-FU group, the LSR peaked at day 29 and lasted until visit 36. Additionally, the area under the curve (LSR × visit) was significantly smaller for IMB. No differences between the treatments for pruritus, pain, tearing, conjunctival hyperaemia or headaches were noted, but the eyelid oedema rate was higher for IMB group. No significant difference in the proportion of dropouts was observed between groups. Both treatments demonstrated a suitable safety profile. CONCLUSION: For treating AKs, the local skin reactions in the IMB group were more short-lived compared with those of 5-FU, but both treatments seemed to be safe and tolerable.
Assuntos
Diterpenos/administração & dosagem , Tolerância a Medicamentos , Dermatoses Faciais/tratamento farmacológico , Fluoruracila/administração & dosagem , Ceratose Actínica/tratamento farmacológico , Administração Tópica , Dermatoses Faciais/diagnóstico , Seguimentos , Géis , Humanos , Imunossupressores/administração & dosagem , Ceratose Actínica/diagnóstico , Estudos Prospectivos , Fatores de Tempo , Resultado do TratamentoRESUMO
BACKGROUND: Skin resurfacing with CO2 laser is a common surgical procedure to improve photodamaged skin. Many complications may occur after this procedure, however, common warts is relatively rare. OBJECTIVE: To report a case of multiple warts after CO2 laser resurfacing and discuss the complete involution of these lesions. METHODS: A 78-year-old woman with multiple warts after CO2 laser resurfacing is described. RESULTS: The patient developed multiple common warts on the face after resurfacing with CO2 laser. Retinoic acid was introduced and complete involution of the lesions was observed after 5 days with no scars. CONCLUSION: Although emphasis is placed on the hazards of the laser plume to the medical staff, one should be aware of this complication. We believe that the regression of the lesions was spontaneous rather than induced by the retinoic acid.