%0 Journal Article
%T Intralesional methotrexate versus 5-flurouracil in the treatment of keratoacanthoma.
%A Nofal A
%A Alakad R
%A Wahid R
%A Hoseiny HAM
%J Arch Dermatol Res
%V 316
%N 7
%D 2024 Jun 15
%M 38878177
%F 3.033
%R 10.1007/s00403-024-03139-1
%X <B>BACKGROUND: </B>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.<BR><B>OBJECTIVE: </B>To assess and compare the efficacy of intralesional methotrexate (MTX) and 5-flurouracil (5-FU) in the treatment of KA.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>the small sample size due to the relatively low incidence of KAs in our population.<BR><B>CONCLUSIONS: </B>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.