Background and Objectives: Many treatment modalities exist for actinic keratoses (AK). Topical 5-fluorouracil (5-FU) has been one of the standard treatments. Laser resurfacing is a more recent treatment option. In the literature prospective randomized studies comparing these treatments are lacking. Study Design/Patients and Methods: Prospective randomized study to compare topical 5-FU with Er:YAG laser resurfacing. Fifty-five patients with multiple AK on the scalp and or the face were included. Clinical and histopathological evaluation took place at 3, 6, and 12 months after treatment. Results: At 3, 6, and 12 months after treatment, there were significantly less recurrences in the laser group compared to the group of patients treated with 5-FU. Side effects did occur more frequently in the laser group, especially erythema and hypopigmentation. Conclusions: Compared to treatment with topical 5-FU, Er:YAG laser resurfacing is more effective regarding recurrence rates. Although significantly more side effects occur, laser resurfacing is a useful therapeutic option especially in patients with widespread AK.

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Lasers in Surgery and Medicine
Department of Dermatology

Ostertag, J.U, Quaedvlieg, P, van der Geer-Rutten, S, Nelemans, P, Christianen, M.E.M.C, Neumann, H.A.M, & Krekels, G.A.M. (2006). A clinical comparison and long-term follow-up of topical 5-fluorouracil versus laser resurfacing in the treatment of widespread actinic keratoses. Lasers in Surgery and Medicine, 38(8), 731–739. doi:10.1002/lsm.20379