Topical treatment of actinic keratoses with potassium dobesilate 5% cream. A preliminary open-label study

Potassium dobesilate 5% cream was applied twice daily for 16 weeks to actinic keratosis lesions in 30 patients. The lesions were evaluated clinically at an initial baseline visit, at intermediate visits, and at 16 weeks of treatment.The use of potassium dobesilate 5% cream for 16 weeks induced complete regression in 70% of evaluated actinic keratoses, corresponding to grade I, II and III clinical variants, and a partial response (at least 75% reduction of lesions) in 20% of the cases.Our preliminary trial shows that potassium dobesilate exerts anti-tumorigenic effects and may play a useful role in the chemoprevention of skin cancers.Actinic keratoses (AKS) are rough, scaly lesions that commonly occur on sun-exposed areas of the skin. AK represents the most common carcinoma in situ of the skin, showinga continuously increasing incidence worldwide [1]. AK has been previously referred to as preneoplastic lesions, but is nowadays defined as intra-epidermal carcinoma progressing towards invasive squamous cell carcinoma (SCC) [2]. Histologically, AK lesions are characterized by an epidermal proliferation of atypical keratinocytes starting from the basal cell layer. According to the epidermal involvement of dysplasia, three subtypes of AK lesions may be differentiated: in situ SCC type AK I (mild), in situ SCC type AK II (moderate) and in situ SCC type AK III (severe) [3].Until now, the decision to treat AK lesions was based on cosmetic reasons and to relieve symptoms. However, a general consensus currently exists to treat AK lesions for prevention of malignancy and metastasis. Treatment options include ablative (destructive) therapies such as cryosurgery, curettage with electro-surgery and photodynamic therapy, and topical therapies generally used in patients with multiple lesions.For topical treatment, fluorouracil has been a traditional topical treatment for AK, although imiquimod 5% cream and diclofenac 3% gel are effective alternative therapies. Fluorouracil is useful