Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Topical fluorouracil is a drug that is used
to treat conditions of the skin in which there is rapid multiplication
(division) of cells, for example, skin cancer. In order to multiply or divide,
cells must produce DNA for each new cell. The DNA is critical since it is the
genetic material that directs the activity of all cells. Production of DNA
depends on the production of RNA which serves as a messenger during the
production of DNA. Fluorouracil prevents the formation of RNA which, in turn,
prevents the formation of DNA. As a result, cells cannot multiply. With
continued treatment, the remaining cells also die. The FDA approved
fluorouracil in July 1970.
GENERIC: Yes
PRESCRIPTION: Yes
PREPARATIONS: Cream 0.5, 1 and 5%. Solution 2 and 5%.
STORAGE: Cream and solution should be stored at room temperature,
between 15-30 C (59-86 F).
PRESCRIBED FOR: Topical fluorouracil is used to treat certain skin
conditions in which cells are multiplying rapidly. It is used to treat
cancerous or precancerous conditions including
solar keratoses,
actinic keratosis, superficial basal cell carcinoma, and Bowen's disease (a type of
skin cancer). It also is used to treat some noncancerous conditions in which
cells are dividing rapidly, including psoriasis,
genital warts, and
porokeratosis (an unusual inherited skin condition causing dry patches on the
arms and legs). Fluorouracil works best on the face and scalp and is less
effective on other areas of the body. It also destroys sun-damaged skin cells
making the skin smoother and more youthful-appearing.
DOSING: The cream or solution is applied once or twice daily after
washing the area that is to be treated with plain water. The course of
treatment continues for at least 2-6 weeks depending on the condition being
treated. A tiny amount of the cream should be gently rubbed into all of the
treated areas with a fingertip. It is important to apply it to all of the skin
and not just visible lesions. Afterwards, the finger should be rinsed
thoroughly with water. (Alternatively, a glove can be used.) After a few days,
the lesion becomes red and may even blister and weep. There may be some
soreness. Tretinoin cream enhances the effect of 5-fluorouracil by peeling off
the top layer of skin. When fluorouracil is prescribed with tretinoin cream,
the combination works best if the tretinoin has been used for at least two
weeks prior to starting fluorouracil.
DRUG INTERACTIONS: There are no known
drug interactions with topical
fluorouracil.
PREGNANCY: Although very little fluorouracil is absorbed from normal
skin, about 20% can be absorbed into the blood when fluorouracil is applied to
damaged skin. Fluorouracil can cause damage to the fetus, and it should not be
used by pregnant women.
NURSING MOTHERS: It is not known whether fluorouracil passes into breast milk. Since some amount is absorbed from the skin into the body nursing
mothers should not use fluorouracil.
SIDE EFFECTS: With application of fluorouracil, initially there
usually is a mild to severe stinging or burning sensation or irritation. It
also sensitizes the skin to sun and promotes sunburn. After five to ten days of
treatment, the sun-damaged parts of treated skin can become red and irritated.
If exposure to sun is unavoidable, sunscreen with SPF of 15 or greater should
be used, especially during summer months and mid-day. Fluorouracil also may
cause prolonged hypo-pigmentation (lightening of the skin), which is more
noticeable in dark-skinned persons. Such individuals may wish to first test
fluorouracil in a cosmetically unimportant areas. Certain areas are more
sensitive to severe irritation, including skin folds, the lips, and the
eyelids. Make-up may increase the irritation. Occasionally, excessive
inflammation may result in ulcer formation, persistent white marks or scarring,
and secondary bacterial infections may occur.
Psoriasis is a long-term skin condition that may cause large plaques of red, raised skin, flakes of dry skin, and skin scales. There are several types of psoriasis, including psoriasis vulgaris, guttate psoriasis, inverse psoriasis, and pustular psoriasis. Symptoms vary depending on the type of psoriasis the patient has. Treatment of psoriasis may include creams, lotions, oral medications, injections and infusions of biologics, and light therapy. There is no cure for psoriasis.
Skin cancer is the most common form of cancer
in humans. There are three main types of skin cancer; basal cell carcinoma and
squamous cell carcinoma (the nonmelanoma skin cancers), and melanoma.
A keloid is a scar that doesn't know when to stop. When the cells keep on reproducing, the result is an overgrown (hypertrophic) scar or a keloid. A keloid looks shiny and is often dome-shaped, ranging in color from slightly pink to red. It feels hard and thick and is always raised above the surrounding skin.
Human papillomavirus (HPV) infection is the most common sexually transmitted infection in the U.S. HPV is primarily transmitted by sexual contact. While some people develop warts in the genital region after infection, others experience no symptoms. Though genital warts can be removed, there is no cure for HPV infection. There is a vaccine to prevent infection from four common HPV types.
Molluscum contagiosum is a skin infection caused by the poxvirus. Molluscum contagiosum appears as small tan or pink bumps on any part of the skin. Symptoms include a red or flushed appearance of the infected skin. Treatment may involve cryotherapy, manual extraction, surgical removal, the use of Retin-A, or the application of chemical acid.
The tendency toward developing psoriasis is
inherited in genes.
Psoriasis is not contagious.
Psoriasis gets better and
worse spontaneously and can have periodic remissions (clear skin).
Psoriasis is controllable with medication.
Psoriasis is currently not curable.
There are many promising therapies, including newer biologic drugs.
Future research for psoriasis is promising.
What is psoriasis?
Psoriasis is a noncontagious skin condition that produces red, dry plaques of thickened skin. The dry flakes and skin scales are thought to result from the rapid proliferation of skin cells that is triggered by abnormal lymphocytes from the blood . Psoriasis commonly affects the skin of the elbows, knees, and scalp.
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