Nonsurgical treatment is used frequently for superficial NMSCs. Topical 5-fluorouracil has been used for the treatment of actinic keratoses, superficial BCCs, and SCCs in situ. Fluorouracil interferes with the synthesis of DNA and to a lesser extent RNA by blocking the methylation reaction of deoxyuridylic acid to thymidylic acid, ultimately causing cell death, particularly of more rapidly dividing cells. Topical applications of 5% 5-fluorouracil usually consist of a twice daily dosing for at least 3 to 6 weeks, for up to 12 weeks. Intralesional 5-fluorouracil has also been used suc-
cessfully in treating SCC using 8 weekly injections. Imiquimod cream is another treatment option for actinic keratoses and low-risk NMSC. It is a Toll-like receptor 7 (TLR7) agonist that promotes Th1-type immunity and induces cytokines, including interferon-a. It is FDA-approved for treatment of actinic keratoses and superficial BCC. Response rates of superficial BCC with application of 5% imiquimod cream five times a week for 6 weeks range from 70% to 88%,64 with lower cures for nodular BCC.65 Imiquimod has also been shown to be an effective treatment for SCC in situ; in a placebo-controlled trial, 11 of 15 lesions resolved versus 0 in the placebo-treated group.66 The most common side effects of both 5-fluorouracil and imiquimod are erythema, itching, pain, and crusting that are mild to moderate. Finally, intralesional injection of interferon-a2b three times weekly for 3 weeks has been used to treat BCC, with cure rates up to 97%67
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Rosacea and Eczema are two skin conditions that are fairly commonly found throughout the world. Each of them is characterized by different features, and can be both discomfiting as well as result in undesirable appearance features. In a nutshell, theyre problems that many would want to deal with.