PDF(Pubmed)
Abstract：
BACKGROUND: Keratoacanthoma (KA) is a benign neoplasm that affects mainly photodamaged skin. It is locally destructive and may rarely spread. Surgery is not always suitable and usually disfiguring. Thus, non-operative modalities represent good alternatives.
OBJECTIVE: To assess and compare the efficacy of intralesional methotrexate (MTX) and 5-flurouracil (5-FU) in the treatment of KA.
METHODS: Randomized controlled trial included 20 patients with biopsy proven KA divided into 2 equal groups; group (A) received intralesional MTX, 25 mg/ml and group (B) received intralesional 5-FU, 50 mg/ml every 2 weeks till complete clearance or for a maximum 5 sessions.
RESULTS: In the MTX group, complete clearance was observed in 7 patients (70%) compared to 8 patients (80%) in the 5- FU group with no statistically significant difference. However, the median number of injections needed to achieve complete response in the MTX group was 3 sessions versus only 2 sessions in the 5-FU group.
CONCLUSIONS: the small sample size due to the relatively low incidence of KAs in our population.
CONCLUSIONS: Intralesional therapy is a good alternative to surgery in selected cases of KA. Both drugs showed comparable efficacy, but 5-FU may give faster results, hence increasing patient satisfaction and compliance.
OBJECTIVE: To assess and compare the efficacy of intralesional methotrexate (MTX) and 5-flurouracil (5-FU) in the treatment of KA.
METHODS: Randomized controlled trial included 20 patients with biopsy proven KA divided into 2 equal groups; group (A) received intralesional MTX, 25 mg/ml and group (B) received intralesional 5-FU, 50 mg/ml every 2 weeks till complete clearance or for a maximum 5 sessions.
RESULTS: In the MTX group, complete clearance was observed in 7 patients (70%) compared to 8 patients (80%) in the 5- FU group with no statistically significant difference. However, the median number of injections needed to achieve complete response in the MTX group was 3 sessions versus only 2 sessions in the 5-FU group.
CONCLUSIONS: the small sample size due to the relatively low incidence of KAs in our population.
CONCLUSIONS: Intralesional therapy is a good alternative to surgery in selected cases of KA. Both drugs showed comparable efficacy, but 5-FU may give faster results, hence increasing patient satisfaction and compliance.
摘要：
背景：角化棘皮瘤（KA）是一种主要影响光损伤皮肤的良性肿瘤。它具有局部破坏性，很少传播。手术并不总是合适的，通常会毁容。因此，非手术方式代表了很好的替代方案。
目的：评估和比较甲氨蝶呤（MTX）和5-氟尿嘧啶（5-FU）治疗KA的疗效。
方法：随机对照试验包括20例活检证实为KA的患者，分为2组；（A）组接受病灶内MTX，25mg/ml，（B）组接受病灶内5-FU，50mg/ml每2周直到完全清除或最多5个疗程。
结果：在MTX组中，5-FU组有7例患者(70%)完全清除率,8例患者(80%)无统计学差异.然而,MTX组达到完全缓解所需的中位注射次数为3次,而5-FU组只有2次.
结论：由于我们人群中KAs的发生率相对较低，因此样本量较小。
结论：在选定的KA病例中，病灶内治疗是替代手术的好方法。两种药物都显示出相当的疗效，但是5-FU可能会给出更快的结果，从而提高患者的满意度和依从性。
目的：评估和比较甲氨蝶呤（MTX）和5-氟尿嘧啶（5-FU）治疗KA的疗效。
方法：随机对照试验包括20例活检证实为KA的患者，分为2组；（A）组接受病灶内MTX，25mg/ml，（B）组接受病灶内5-FU，50mg/ml每2周直到完全清除或最多5个疗程。
结果：在MTX组中，5-FU组有7例患者(70%)完全清除率,8例患者(80%)无统计学差异.然而,MTX组达到完全缓解所需的中位注射次数为3次,而5-FU组只有2次.
结论：由于我们人群中KAs的发生率相对较低，因此样本量较小。
结论：在选定的KA病例中，病灶内治疗是替代手术的好方法。两种药物都显示出相当的疗效，但是5-FU可能会给出更快的结果，从而提高患者的满意度和依从性。
