Selective cytotoxic effect of topical 5-fluorouracil.

As an investigative procedure, a hydrophilic ointment containing 20% 5-fluorouracil (5-FU) was applied to the skin of patients with extensive actinic keratoses of the face and neck, for a period of four weeks. This resulted in a selective inflammation, erosion, and disappearance of the keratoses without significant alteration of the normal skin. Transitory adverse reactions included corneal and conjunctival irritations, phototoxic reactions, and erosion of the lower lip border. No evidence of systemic absorption was detected. Only preliminary follow-up observations are available, and no conclusion can be drawn as to the long-term results.

Wedge resection of the pinna.

In the treatment of large carcinomas whose local removal would be mutilating to a greater or lesser extent, wedge resection of the ear can preserve the normal appearance and function of the pinna. No significant complications have occurred in any of the patients so treated.

Snuff dippers keratosis (snuff-induced leukoplakia).

Patients with chronic snuff-induced keratosis associated with mucosal ulcerations were treated with topically applied vitamin A acid. In each case, after a marked, local inflammatory response initially, topical vitamin A acid showed a definite beneficial effect in promoting healing and involution of the precancerous snuff-induced leukoplakic keratosis. In one patient there was distinct involution of the oral lesions with complete healing and restoration of a normal-appearing mucosa within five weeks after beginning of treatment. In four patients there was healing of superficial ulcerations and regression in the size of the luekoplakic lesions.