The efficacy and safety of topical 5% 5‐fluorouracil in renal transplant recipients for the treatment of actinic keratoses

Actinic keratoses ( AK ) occur more commonly and behave more aggressively in renal transplant recipients ( RTR ). Topical 5% 5‐fluorouracil (5‐ FU ) cream is a commonly used agent whose efficacy and safety have never been exclusively studied in the RTR population before. Eight RTR were enrolled and 5% 5‐ FU cream applied to AK lesions on their face twice daily for 3 weeks. They were reviewed at 2 and 8 weeks, and 12 months post‐commencement of treatment. Their AK were counted and their cumulative surface areas measured. Patients completed surveys monitoring adverse effects and tolerability. Complete (100%) and partial clearance (≥ 75%) rates were measured, as well as mean percentages of the reduction in AK surface area. Patients had complete clearance rates of 63 and 0% at 8 weeks and 12 months, respectively. All (100%) patients had partial clearance at week 8 and 71% had partial clearance at 12 months. Patients had on average 15 AK at week 0 and 1 and 3 at 8 weeks and 12 months, respectively. The mean AK clearance rate was 98% at week 8 and 79% at 12 months. Common side‐effects were erythema, itch and flaking or scaling, mostly mild in severity. 5‐ FU appears to be an efficacious and safe treatment for AK in RTR .