Details

Autor(en) / Beteiligte

• Miola, A.C.
• Ferreira, E.R.
• Lima, T.R.R.
• Schmitt, J.V.
• Abbade, L.P.F.
• Miot, H.A.

Titel

Effectiveness and safety of 0·5% colchicine cream vs. photodynamic therapy with methyl aminolaevulinate in the treatment of actinic keratosis and skin field cancerization of the forearms: a randomized controlled trial

Ist Teil von

• British journal of dermatology (1951), 2018-11, Vol.179 (5), p.1081-1087

Ort / Verlag

England: Oxford University Press

Erscheinungsjahr

2018

Link zum Volltext

Quelle

Wiley Online Library Journals Frontfile Complete

Beschreibungen/Notizen

• Summary Background Skin field cancerization (SFC) is a process that occurs in areas of the skin that have undergone genomic alterations induced by ultraviolet radiation. Actinic keratosis (AK) is a sign of its activity. Objectives To evaluate the effectiveness and safety of 0·5% colchicine (COL) cream vs. methyl aminolaevulinate photodynamic therapy (MAL‐PDT) in the treatment of AK and SFC. Methods We conducted a randomized, open, intrasubject controlled trial. A total of 36 participants with 3–10 AKs on each forearm were treated with either COL cream (twice daily for 10 days) or a single session of MAL‐PDT and were reassessed after 60 days. The clinical evaluation was performed using AK count, forearm photoageing scale (PAS) and AK degree (AKD). Patients underwent central forearm biopsies and histopathological evaluation by keratinocyte intraepithelial neoplasia (KIN) assessment, epithelial atrophy and immunohistochemistry (p53/Ki67). Results Overall, 50% of patients were male. The mean age was 70·9 years (SD 8·6) and phototypes I and II were predominant (89%). Total clearance was observed in six (17%) forearms treated with COL and seven (19%) forearms treated with MAL‐PDT (P = 0·76); partial clearance was observed in 44% of forearms in the COL group and 67% of forearms in the MAL‐PDT group (P = 0·07). In both COL and MAL‐PDT groups, reductions in PAS (−6% vs. −6%) and AKD (−45% vs. −40%) were observed. KIN normalized in 28% of patients treated with MAL‐PDT and 20% of those treated with COL. Epithelial atrophy reduced after treatment (P < 0·01). Expression levels of Ki67 and p53 were also assessed. Mild or moderate adverse effects were similar for both groups. Conclusions COL 0·5% cream and MAL‐PDT are safe and effective for treating SFC. What's already known about this topic? Photodynamic therapy is a known treatment for actinic keratosis and skin field cancerization. Trials have demonstrated the efficacy of topical colchicine in the treatment of actinic keratosis. There are no studies comparing colchicine with photodynamic therapy for the treatment of actinic keratosis and skin field cancerization. What does this study add? Our study demonstrates that topical colchicine is a low‐cost drug that effectively decreases the activity of skin field cancerization. Colchicine treatment has a similar level of safety and efficacy as photodynamic therapy in the treatment of skin field cancerization. Linked Comment: Ianhez. Br J Dermatol 2018; 179:1026–1027. Respond to this article