Diclofenac Sodium 3% in Hyaluronic Acid 2.5% Gel Significantly Diminishes the Actinic Keratosis Area and Severity Index

Skin Pharmacol Physiol. 2018;31(4):206-211. doi: 10.1159/000488248. Epub 2018 May 23.

Abstract

Background/aims: Actinic keratosis area and severity index (AKASI) is a new assessment tool to quantify the severity of actinic damage on the head. Thus far, it has not been evaluated in monitoring the efficacy of field-directed topical treatments in actinic keratosis (AK) in routine clinical practice. Thus, the aim of this study was to determine treatment outcomes by using AKASI 3 months after the initiation of topical application of diclofenac sodium 3% in hyaluronic acid 2.5% gel (DFS) in patients with AKs on the head.

Methods: We performed a retrospective analysis of patients with AKs who had AKASI scores prior to and after treatment with DFS.

Results: Of the 24 patients included, 20 (83.3%) showed an improvement in AKASI, 2 (8.3%) a stable AKASI, and 2 (8.3%) a worsening of AKASI after a median (interquartile range) follow-up period of 91.5 days (89.8-104.3). The median AKASI reduction was 31.4% (16.7-59.1). The Wilcoxon test showed significant differences (p = 0.0008) between baseline and posttreatment AKASI values.

Conclusions: AKASI is an easy-to-use quantitative tool for assessing the treatment outcome of field-directed therapies. Field-directed therapies of AK should no longer be monitored by assessments based on lesion counts alone.

Keywords: AKASI; Actinic keratosis; Diclofenac sodium 3% gel; Modified AKASI; NMSC.

MeSH terms

  • Administration, Cutaneous
  • Aged
  • Aged, 80 and over
  • Dermatologic Agents / administration & dosage*
  • Dermatologic Agents / therapeutic use
  • Diclofenac / administration & dosage*
  • Diclofenac / therapeutic use
  • Female
  • Follow-Up Studies
  • Gels
  • Humans
  • Hyaluronic Acid / administration & dosage*
  • Hyaluronic Acid / therapeutic use
  • Keratosis, Actinic / drug therapy*
  • Keratosis, Actinic / pathology
  • Male
  • Retrospective Studies
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Treatment Outcome

Substances

  • Dermatologic Agents
  • Gels
  • Diclofenac
  • Hyaluronic Acid