College
Rowan-Virtua School of Osteopathic Medicine
Keywords
Photodynamic Therapy, 5-Fluorouracil, Actinic Keratosis, Field Directed, Treatment, Photodynamic Therapy vs. 5 Fluorouracil
Date of Presentation
5-1-2025 12:00 AM
Poster Abstract
BACKGROUND: Actinic keratosis (AK) is a common precancerous skin condition arising from chronic UV exposure and often involves field cancerization, where visible lesions coexist with subclinical damage. Effective field-directed treatments are critical for preventing progression to squamous cell carcinoma.
HYPOTHESIS: Photodynamic Therapy (PDT) may offer superior efficacy, cosmetic outcomes, and patient adherence compared to topical 5-Fluorouracil (5-FU), despite its higher cost and clinical setting requirement.
METHODS: This literature review analyzed peer-reviewed studies from 2015–2025 comparing PDT and 5-FU for field-directed AK treatment. Outcomes assessed included lesion clearance, recurrence, tolerability, adherence, cost, and patient satisfaction.
RESULTS: PDT demonstrated high clearance rates (70–90%) and excellent cosmetic results, especially in sensitive or extensive areas. Its major advantages include single-session administration and clinical supervision, which support adherence but are offset by higher costs and pain during treatment. In contrast, 5-FU is an affordable, self-applied topical therapy with good efficacy (60–80%) but requires strict adherence over 2–4 weeks. Side effects such as inflammation, erythema, and crusting often reduce compliance. Emerging studies indicate that pre-treatment with 5-FU may enhance PDT efficacy by increasing protoporphyrin IX accumulation, supporting combination or sequential therapy approaches.
CONCLUSIONS: Both PDT and 5-FU are viable treatments for AK in field cancerization. PDT offers improved long-term outcomes and cosmetic benefits, while 5-FU remains a cost-effective choice. Treatment should be personalized based on lesion extent, patient lifestyle, tolerance, and resource availability.
Disciplines
Dermatology | Integumentary System | Medicine and Health Sciences | Neoplasms | Oncology | Pathological Conditions, Signs and Symptoms | Quality Improvement | Skin and Connective Tissue Diseases | Therapeutics
Included in
Dermatology Commons, Integumentary System Commons, Neoplasms Commons, Oncology Commons, Pathological Conditions, Signs and Symptoms Commons, Quality Improvement Commons, Skin and Connective Tissue Diseases Commons, Therapeutics Commons
Photodynamic Therapy vs. 5-Fluorouracil for Field-Directed Treatment of Actinic Keratosis: A Comparative Literature Review
BACKGROUND: Actinic keratosis (AK) is a common precancerous skin condition arising from chronic UV exposure and often involves field cancerization, where visible lesions coexist with subclinical damage. Effective field-directed treatments are critical for preventing progression to squamous cell carcinoma.
HYPOTHESIS: Photodynamic Therapy (PDT) may offer superior efficacy, cosmetic outcomes, and patient adherence compared to topical 5-Fluorouracil (5-FU), despite its higher cost and clinical setting requirement.
METHODS: This literature review analyzed peer-reviewed studies from 2015–2025 comparing PDT and 5-FU for field-directed AK treatment. Outcomes assessed included lesion clearance, recurrence, tolerability, adherence, cost, and patient satisfaction.
RESULTS: PDT demonstrated high clearance rates (70–90%) and excellent cosmetic results, especially in sensitive or extensive areas. Its major advantages include single-session administration and clinical supervision, which support adherence but are offset by higher costs and pain during treatment. In contrast, 5-FU is an affordable, self-applied topical therapy with good efficacy (60–80%) but requires strict adherence over 2–4 weeks. Side effects such as inflammation, erythema, and crusting often reduce compliance. Emerging studies indicate that pre-treatment with 5-FU may enhance PDT efficacy by increasing protoporphyrin IX accumulation, supporting combination or sequential therapy approaches.
CONCLUSIONS: Both PDT and 5-FU are viable treatments for AK in field cancerization. PDT offers improved long-term outcomes and cosmetic benefits, while 5-FU remains a cost-effective choice. Treatment should be personalized based on lesion extent, patient lifestyle, tolerance, and resource availability.
