Topical 5-fluorouracil in the treatment of Darier's disease

Two patients suffering from therapy-resistant Darier's disease were treated with topical 5-fluorouracil (5-FU). The drug was applied in a concentration of 1% in a cream base, once daily, in left-right comparison with either 7.5% salicylic acid in petrolatum or 0.05% vitamin A acid cream. Both patients were on long-term treatment with oral retinoids. After 1 week of treatment, a considerable improvement was already apparent on the 5-FU-treated side, in comparison with the salicylic acid- and vitamin A acid-treated sides. Subsequent treatment of all skin lesions with 5-FU for a further 2 weeks resulted in complete clearance of the lesions. Remission periods were of 2-6 months duration. There were no significant adverse effects of treatment. Haematological parameters remained unchanged during the therapy. Topical 5-FU is a safe and useful addition to currently available treatments for Darier's disease.