Fluorouracil paste treatment of thin basal cell carcinomas

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Abstract
Treatment of thin (superficial) basal cell carcinomas (BCC) with topical fluorouracil is widely accepted despite the absence of published 5-yr cure rates. The published short-term data disclose treatment failure rates substantially higher than other modalities. In trials to improve and standardize topical fluorouracil therapy, thin BCC were treated with 25% fluorouracil in petrolatum under occlusion for 3 wk using weekly dressing changes. Of 44 thin BCC treated only with 25% fluorouracil under occlusion for 3 wk the 5-yr cumulative recurrence rate was 21%. In a second series of 244 BCC, light curettage preceded the 25% fluorouracil treatment to yield a 5-yr cumulative recurrence rate of 6%. Cosmetic results were good to excellent in > 80% of both series. While fluorouracil by itself is not a satisfactory treatment for thin BCC, when combined with light curettage, topical fluorouracil therapy is capable of cure rates competitive with other modalities.

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