Patient assessment of 5-fluorouracil and imiquimod for the treatment of actinic keratoses: a retrospective study of real-world effectiveness

Figures & data

Table 1. Phone survey questionnaire.

Our records indicate that between January 2017 and January 2019, you were prescribed a topical treatment for actinic keratoses and that you filled this prescription.
1.	Did you start using this treatment for your actinic keratosis(es)?
2.	If you started treatment, did you complete the treatment course as prescribed?
3.	Did you experience any irritation or local skin reactions as a result of this treatment? If so, how severe were these reactions?
4.	Did you experience any inconvenience or stress due to local skin reactions?
5.	Did you experience any other adverse effects as a result of treatment?
6.	Did the treatment affect your daily life activities, such as work and social engagements?
7.	If you completed the treatment course as prescribed, was it successful in treating your actinic keratosis(es)?
8.	If treatment was not successful, did you require further therapy (for example, cryosurgery) for resolution of your actinic keratosis(es)?
9.	If treatment was not successful, did you switch to a different topical medication? If so, what medication did you switch to?
10.	Would you use 5-FU or imiquimod again for treatment of actinic keratosis(es)?

Table 2. Characteristics and survey responses of study participants.

	5-Fluorouracil (N = 27)		Imiquimod (N = 24)
	N	%	N	%
Gender
Male	21	78	12	50
Female	6	22	12	50
Age
50–59	1	3.7	6	25
60–69	5	19	6	25
70–79	18	67	7	29
80–89	3	11	4	17
90+	0	0	1	4.2
Completed treatment
Yes	21	78	20	83
No	6	22	4	17
Any reaction
Yes	19	70	15	63
No	8	30	9	38
Specific reactions
Redness	15	56	11	46
Irritation	9	33	6	25
Itch	0	0	3	13
Photosensitivity	2	7.4	0	0
Scaling	2	7.4	0	0
Blistering	1	3.7	1	4.2
Swelling	0	0	1	4.2
Reaction severity
Mild	12	44	7	29
Moderate	1	3.7	3	13
Severe	6	22	5	21
Inconvenience/Stress
Yes	3	11	2	8.3
No	24	89	22	92
Affected work/Social life
Yes	4	15	2	8.3
No	23	85	22	92
Treatment successful
Yes	22	81	18	75
No	4	15	5	21
Unsure	1	3.7	1	4.2
Would use again
Yes	23	85	20	83
No	3	11	3	13
Unsure	1	3.7	1	4.2

Table 3. Dermatological procedures and non-melanoma skin cancers one year before and after initiation of therapy.

	5-Fluorouracil	Imiquimod
	N	N
Procedures before treatment
Cryosurgery	251	129
Excision	7	3
MMS	4	1
Other	2	6
Procedures after treatment
Cryosurgery	162	81
Excision	1	0
MMS	4	2
Other	4	4
NMSCs before treatment
Total	18	26
NMSCs after treatment
Total	18	10

NMSC: non-melanoma skin cancer; MMS: Mohs micrographic surgery.