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Complete clearance occurred in 92% of patients and partial clearance in 8%, with 11% recurrence at 12 months. 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Katoulis and Alan Fleischer  \nReceived: 1 October 2025  \nRevised: 27 December 2025  \nAccepted: 8 January 2026  \nPublished: 12 January 2026  \nCopyright: © 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 UOC of Dermatology, Department of Clinical and Cardiovascular Sciences,“Sapienza” University of Rome, 00185 Rome, Italy; [antonio.diguardo@uniroma1.it](antonio.diguardo@uniroma1.it) (A.D.G.); [feresinfrancesca@gmail.com](feresinfrancesca@gmail.com) (F.F.); [lucagargano1995@gmail.com](lucagargano1995@gmail.com) (L.G.); [steven.nistico@gmail.com](steven.nistico@gmail.com) (S.P.N.); [pellacani.giovanni@gmail.com](pellacani.giovanni@gmail.com) (G.P.)  \n2 IDI-IRCCS, Dermatological Research Hospital, 00167 Rome, Italy; [c.conforti@unilink.it](c.conforti@unilink.it)  \n3 Unit of Dermatology, IRCCS San Raffaele Hospital, 20132 Milan, Italy; [gio8519@gmail.com](gio8519@gmail.com)  \n4 Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; [natasabalaz75@gmail.com](natasabalaz75@gmail.com) (N.B.); [mehdi_parsii@yahoo.com](mehdi_parsii@yahoo.com) (M.B.); [norbert.f.kiss@gmail.com](norbert.f.kiss@gmail.com) (N.K.)  \n5 Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA  \n6 Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy; [andrea.carugno@uninsubria.it](andrea.carugno@uninsubria.it)  \n7 Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; [luigi.losco@gmail.com](luigi.losco@gmail.com)  \n* Correspondence: [carmen.cantisani@uniroma1.it](carmen.cantisani@uniroma1.it); Tel.: +39-30649976993  \nAbstract  \nBackground/Objectives: Actinic keratoses (AKs), also known as solar keratoses, are considered premalignant skin lesions that can evolve into squamous cell carcinoma (SCC) . Among the available options, 5-fluorouracil (5-FU) remains a cornerstone. Methods: This study is a retrospective analysis of our database of the non-melanoma skin cancer outpatient clinic. The main objective was to evaluate patients treated with 4% 5-FU cream for AK lesions. The efficacy of 4% 5-FU was evaluated retrospectively by measuring the percentage of patients who achieved complete clearance. A secondary efficacy measure was the percentage of partial clearance, defined as at least a 75% reduction in lesion count. Additionally, the study aimed to assess the safety of 4% 5-FU cream. Results: We included 150 patients clinically diagnosed with AK, treated with 4% 5-FU cream and evaluated 432 lesions. Complete clearance of lesions was observed in 138 patients (92%) with partial clearance in 12 patients (8%) . At 12 months, the recurrence rate was 11% . Conclusions: Based on our analysis, 4% 5-FU cream is an effective and well-tolerated treatment for AKs, particularly in patients with extensive field cancerization. While local skin reactions are a natural part of its mechanism, they are manageable and do not outweigh clinical benefits.  \nKeywords: actinic keratosis; 5 fluorouracil; local skin reactions; non-melanoma skin cancer  \n1. Introduction  \nActinic keratoses (AKs), also known as solar keratoses, are among the most common premalignant skin lesions worldwide [1,2] . Their incidence continues to rise, making thema significant public health concern due to their potential to progress into invasive squamous cell carcinoma (iSCC) . The prevalence of AKs increases with age and cumulative","cbCaivvgOH8fbWmW","https://ap.wps.com/l/cbCaivvgOH8fbWmW","pdf",1863581,14,"English","# Abstract\n## Background/Objectives\n## Methods\n## Results\n## Conclusions\n# Keywords\n# 1. Introduction\n## Epidemiology and risk factors\n## Mechanism of action of 5-FU\n## Related treatment options","[{\"question\":\"What was the main objective of the study on 4% 5-FU cream?\",\"answer\":\"To evaluate patients treated with 4% 5-FU cream for actinic keratosis lesions and measure efficacy by the percentage achieving complete clearance.\"},{\"question\":\"How were efficacy outcomes defined and measured?\",\"answer\":\"Complete clearance was the primary efficacy measure, while partial clearance was defined as at least a 75% reduction in lesion count.\"},{\"question\":\"What were the key efficacy results and recurrence rate at 12 months?\",\"answer\":\"Complete clearance was observed in 92% of patients and partial clearance in 8%. The recurrence rate at 12 months was 11%.\"}]","Efficacy of 4% 5-Fluorouracil Cream in the Treatment of Actinic Keratoses - A Single-Center Experience | PDF",1790054795,35]