Korean J Dermatol.  2023 Jan;61(1):29-35.

Therapeutic Efficacy of Topical 5-Fluorouracil vs. Topical Imiquimod vs. Cryosurgery for Single-Lesion Actinic Keratosis in Korea

• Park SJ
• Kim YJ
• Cho JH
• Kim DH
• Ahn HH
• Seo SH

Abstract

Background
Actinic keratosis (AK) is a common precancerous cutaneous lesion. There are various AK treatment methods; however, no specific method is considered superior. Most existing studies on AK treatment are Caucasian-based and include patients with multiple lesions.
Objective
This study aimed to compare the treatment duration, financial costs, and success rates of topically applied 5% 5-fluorouracil (5-FU) solution, 5% imiquimod (IMIQ) cream, and cryosurgery in the treatment of histologically proven single-lesion AK in Korean patients.
Methods
We retrospectively reviewed the medical records of patients with single-lesion AK at a single Korean center from January 2018 to February 2021. Each patient was treated using the three aforementioned local treatments.
Results
The study included 58 patients. Nineteen of 23 (82.6%), 27 of 27 (100%), and eight of eight patients (100%) were successfully treated after topical 5-FU, topical IMIQ, and cryosurgery, respectively. Further analysis on treatment success by subgroup revealed the following: mean number of outpatient visits, 3.78 vs. 4.41 vs. 3.75; mean treatment duration, 5.79 vs. 6.00 vs. 9.38 weeks; and mean total treatment cost, 79,380 vs. 170,023 vs. 173,116 won; for the 5-FU, IMIQ, and cryosurgery subgroups, respectively. The total treatment cost was significantly different among the subgroups (p≤0.001).
Conclusion
Topical IMIQ and cryosurgery were superior in terms of treatment efficacy, but considering its low cost, 5-FU may also be a reasonable option. Hence, an individualized approach to treating localized AK should be taken.

Keyword

Actinic keratosis; Cryosurgery; Fluorouracil; Imiquimod