Dilute Intralesional 5-Fluorouracil for the Treatment of Squamous Cell Carcinomas and Keratoacanthomas: A Case Series

J Drugs Dermatol. 2023 May 1;22(5):507-508. doi: 10.36849/JDD.5058.

Abstract

Background: Intralesional 5-fluorouracil (5-FU) is a promising, yet sparsely studied alternative to surgical treatment for nonmelanoma skin cancer (NMSC).1 Previous studies of intralesional 5-FU have reported concentrations ranging from 30 to 50 mg/mL. To the best of our knowledge, this case series represents the first reported use of intralesional 5-FU 10.0 mg/mL and 16.7 mg/mL for NMSC.

Methods: A retrospective chart review identified 11 patients who received intralesional 5-FU 10.0 mg/mL and 16.7 mg/mL for 40 cutaneous squamous cell carcinomas and 10 keratoacanthomas. We describe the characteristics of these patients and calculate the clinical clearance rate of dilute intralesional 5-FU therapy for NMSC at our institution.

Results: Dilute intralesional 5-FU successfully treated 96% (48/50) of the study lesions, providing complete clinical clearance in 82% (9/11) of patients across a mean follow-up time of 21.7 months. All patients tolerated their treatments well with no reported adverse effects or local recurrences.

Discussion: The use of more dilute preparations of intralesional 5-FU for NMSC may be a means of reducing cumulative dose and dose-dependent adverse reactions while maintaining clinical clearance. J Drugs Dermatol. 2023;22(5): doi:10.36849/JDD.5058.

MeSH terms

  • Carcinoma, Squamous Cell* / pathology
  • Fluorouracil
  • Humans
  • Injections, Intralesional
  • Keratoacanthoma* / chemically induced
  • Keratoacanthoma* / diagnosis
  • Keratoacanthoma* / drug therapy
  • Retrospective Studies
  • Skin Neoplasms* / chemically induced
  • Skin Neoplasms* / diagnosis
  • Skin Neoplasms* / drug therapy
  • Treatment Outcome

Substances

  • Fluorouracil