Topical colchicine therapy for actinic keratoses

Background: The beneficial effect of topical colchicine therapy for actinic keratoses has already been described in 1968. Objective: To confirm that t he application of a 1% colchicine gel is a safe and effective treatment for actinic keratoses. Methods: Twenty patients were included in a double-blin ded protocol. They all had actinic keratoses on the scalp, most of which ha d been previously treated with 5-fluorouracil or cryotherapy. Ten patients applied twice daily on the forehead a hydrophilic gel (placebo group), whil e the other 10 where treated with the same gel containing 1% of colchicine (colchicine group). Erythema and efficacy were evaluated at each control on days 7, 30 and 60, with repetitive blood tests to exclude a possible syste mic absorption. Results: A complete healing of the solar keratoses was obse rved in 7 out of the 10 patients treated with 1% colchicine gel; these show ed no recurrence after 2 months of follow-up. Burning and itching occurred only in the colchicine group after 2 or 3 days of application, with an infl ammatory reaction on the areas where the gel was applied, while pustules an d crusts were located specifically on the actinic keratoses. Repealed blood controls showed that there was no systemic absorption. Conclusions: This d ouble-blind placebo-controlled study confirms the activity of colchicine fo r the treatment of actinic keratosis. A comparison with other topical treat ments in terms of efficacy and practicability is needed. Copyright (C) 2000 S. Karger AG, Basel.