{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T16:48:37Z","timestamp":1788281317849,"version":"build-2803163510"},"reference-count":37,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,5,28]],"date-time":"2023-05-28T00:00:00Z","timestamp":1685232000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Actinic keratosis (AK) is one of the most common skin diseases, with a low risk of progression into invasive squamous cell carcinoma. We aim to assess efficacy and safety of a novel formulation of 5-Fluorouracil (5-FU) 4% with once daily application for the treatment of multiple AKs. Methods: A pilot study was performed on 30 patients with a clinical and dermoscopic diagnosis of multiple AKs, enrolled between September 2021 and May 2022 at the Dermatology Departments of two Italian hospitals. Patients were treated with 5-FU 4% cream once daily for 30 consecutive days. The Actinic Keratosis Area and Severity Index (AKASI) was calculated before starting therapy, and at each follow-up, to assess objective clinical response. Results: The cohort analyzed included 14 (47%) males and 16 (53%) females (mean age: 71 \u00b1 12 years). A significant decrease in AKASI score at both 6 and 12 weeks (p &lt; 0.0001) was observed. Only three patients (10%) discontinued therapy, and 13 patients (43%) did not report any adverse reactions; no unexpected adverse events were observed. Conclusions: In the setting of topical chemotherapy and immunotherapy, the new formulation of 5-FU 4% proved to be a highly effective treatment for AKs and field cancerization.<\/jats:p>","DOI":"10.3390\/cancers15112956","type":"journal-article","created":{"date-parts":[[2023,5,28]],"date-time":"2023-05-28T15:29:52Z","timestamp":1685287792000},"page":"2956","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Actinic Keratoses: A Prospective Pilot Study on a Novel Formulation of 4% 5-Fluorouracil Cream and a Review of Other Current Topical Treatment Options"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3319-6604","authenticated-orcid":false,"given":"Ludovica","family":"Toffoli","sequence":"first","affiliation":[{"name":"Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, 34125 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Dianzani","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Unit, Section of Dermatology, University Campus Biomedico of Rome, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7349-0296","authenticated-orcid":false,"given":"Serena","family":"Bonin","sequence":"additional","affiliation":[{"name":"Department of Medical Science, Cattinara Hospital, University of Trieste, 34149 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Guarneri","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Dental Sciences and Morpho Functional Imaging, University of Messina, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0805-8496","authenticated-orcid":false,"given":"Fabrizio","family":"Guarneri","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Dermatology, University of Messina, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5492-3033","authenticated-orcid":false,"given":"Roberta","family":"Giuffrida","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Dermatology, University of Messina, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Zalaudek","sequence":"additional","affiliation":[{"name":"Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, 34125 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5126-8873","authenticated-orcid":false,"given":"Claudio","family":"Conforti","sequence":"additional","affiliation":[{"name":"Dermatology Clinic of Trieste, Maggiore Hospital, University of Trieste, 34125 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1111\/ijd.14147","article-title":"Actinic Keratosis\u2014Review for Clinical Practice","volume":"58","author":"Pantoja","year":"2019","journal-title":"Int. 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