Miscellaneous topical therapies

A variety of other topical therapies have been assessed as treatment for actinic lesions, with varied success. These include Solaraze™ (3% diclofenac sodium in 2-5% hyaluronan gel) Curaderm (0-005% solasodine glycosides (BEC), 10% salicylic acid, 5% urea, 0-1% melaleuca oil, 0-05% linolenic acid in cetomacrogol-based cream) and the nucleoside tubercidin (7-deaza-adenosine).

Quality of evidence: IV

We found no systematic reviews for any of these three topical therapies. We found one RCT for Solaraze™, but only the abstract was accessible. Although complete and partial responses were reported, neither was defined; time of final assessment was also not defined.102 In an open-label study,103 the responses in 29 patients were graded on a seven-point scale, ranging from "complete response" to "much worse", 30 days after treatment. The parameters used to determine this response grading, the degree of change required to increase or decrease a grading, as well as location of lesions, were not specified. Clearance rates for 90-day treatment are also available from two placebo-controlled trials reported in the package insert for Solaraze, but details of the trials were unavailable to us.

A case series used tubercidin to treat five patients with facial and scalp AK lesions.104

A single open-label trial treated 56 AK lesions using Curaderm,105 with follow up at 3 months post-treatment.

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