{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:55:16Z","timestamp":1791273316284,"version":"4.1.0"},"reference-count":13,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Actinic keratosis (AK) is a common premalignant skin condition associated with chronic ultraviolet exposure and an increased risk of progression to cutaneous squamous cell carcinoma (cSCC). Its prevalence rises with age and is influenced by multiple factors, including fair skin phototype and immunosuppression. People living with human immunodeficiency virus (HIV) are at increased risk of cSCC due to impaired immune surveillance, highlighting the importance of early diagnosis and effective management of AK in this population. However, data on optimal treatment strategies in individuals with HIV remain limited. Among available therapies, topical 5\u2010fluorouracil (5\u2010FU) is considered one of the most effective field\u2010directed treatments. We describe the case of a 70\u2010year\u2010old man with well\u2010controlled HIV infection who presented with multiple facial actinic keratoses in a field of cancerization. The patient had previously undergone several treatments, including cryotherapy, diclofenac gel, and tirbanibulin, with only temporary improvement. Given the extent of the lesions and prior therapeutic failure, topical 5\u2010FU 4% cream was initiated once daily for 28\u2009days. During treatment, the patient developed a moderate inflammatory reaction characterized by erythema and pruritus, which was expected and did not require discontinuation. At the 3\u2010month follow\u2010up, complete clinical clearance of the lesions was achieved. This case supports the efficacy and acceptable tolerability of topical 5\u2010FU 4% in the treatment of AK in a patient living with HIV, even after previous treatment failure. The results are consistent with existing evidence supporting the use of 5\u2010FU as a first\u2010line field therapy. Given the increased oncologic risk in immunocompromised patients, timely and effective treatment of AK is essential. Nevertheless, the limited evidence available in this specific population underscores the need for further prospective studies to better define management strategies and long\u2010term outcomes.<\/jats:p>","DOI":"10.1002\/ccr3.73428","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T06:38:10Z","timestamp":1788331090000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["4% 5\u2010Fluorouracil Cream for Actinic Keratoses: First Report of Efficacy and Tolerability in a Person Living With Human Immunodeficiency Virus Infection"],"prefix":"10.1002","volume":"14","author":[{"given":"Gloria","family":"Hoxhallari","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venereology Mother Teresa University Hospital Center  Tirana Albania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurelio","family":"Portincasa","sequence":"additional","affiliation":[{"name":"Unit of Reconstructive and Plastic Surgery, Department of Clinical and Experimental Medicine Ospedali Riuniti di Foggia and University of Foggia  Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Fini","sequence":"additional","affiliation":[{"name":"Unit of Reconstructive and Plastic Surgery, Department of Clinical and Experimental Medicine Ospedali Riuniti di Foggia and University of Foggia  Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9530-7627","authenticated-orcid":false,"given":"Vincenzo","family":"Verdura","sequence":"additional","affiliation":[{"name":"Unit of Reconstructive and Plastic Surgery, Department of Clinical and Experimental Medicine Ospedali Riuniti di Foggia and University of Foggia  Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5718-7713","authenticated-orcid":false,"given":"Liberato Roberto","family":"Cecchino","sequence":"additional","affiliation":[{"name":"Unit of Reconstructive and Plastic Surgery, Department of Clinical and Experimental Medicine Ospedali Riuniti di Foggia and University of Foggia  Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fedele","family":"Lembo","sequence":"additional","affiliation":[{"name":"Unit of Reconstructive and Plastic Surgery, Department of Clinical and Experimental Medicine Ospedali Riuniti di Foggia and University of Foggia  Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio Lo","family":"Caputo","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Department of Medical and Surgical Sciences University of Foggia  Foggia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1319-4946","authenticated-orcid":false,"given":"Domenico","family":"Bonamonte","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Precision and Regenerative Medicine and Jonian Area University Aldo Moro of Bari  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6196-9788","authenticated-orcid":false,"given":"Caterina","family":"Foti","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Precision and Regenerative Medicine and Jonian Area University Aldo Moro of Bari  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Drago","sequence":"additional","affiliation":[{"name":"Section of Dermatology Casa di Cura Villa Montallegro  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8363-0195","authenticated-orcid":false,"given":"Giulia","family":"Ciccarese","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Precision and Regenerative Medicine and Jonian Area University Aldo Moro of Bari  Bari 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