Intralesional and Laser-Assisted 5-Fluorouracil in Dermatologic Disease: A Systematic Review

J Drugs Dermatol. 2018 Mar 1;17(3):274-280.


Introduction: 5-fluorouracil has proven to be an effective therapy in the treatment of a variety of dermatologic conditions. Approved by the United States Food and Drug Administration for the topical treatment of actinic keratoses and superficial basal cell carcinoma, 5-fluorouracil has also demonstrated efficacy in the treatment of a variety of other dermatologic diseases. While best known for its use as a topical medication, 5-fluorouracil can also be delivered intralesionally for the treatment of dermatologic disease. Recently, laser-assisted modalities for increased delivery of 5-fluorouracil have also been described METHODS: A search of the MEDLINE standard computer database, MEDLINE advanced database, and EMBASE database was conducted.

Results: 38 articles met criteria for inclusion in this review. These articles represented 14 randomized controlled trials and 24 case series. Each article was reviewed and summarized. The main limitation of this review is the limited number of large randomized controlled trials, as well as the non-uniformity in treatment regimens between studies.

Discussion: Intralesional and laser-assisted 5-fluorouracil are used in a variety of dermatologic disease processes with a wide range of efficacy and levels of evidence. Based on extent and level of evidence, our disease-specific systematic review found that the evidence is strongest for intralesional 5-FU use in the treatment of keloids, hypertrophic scars, and keratoacanthomas. This review serves as a comprehensive summary of intralesional and laser-assisted 5-fluorouracil use in dermatology. <p><em>J Drugs Dermatol. 2018;17(3):274-280.</em></p>.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Animals
  • Antimetabolites, Antineoplastic / administration & dosage*
  • Cicatrix, Hypertrophic / diagnosis
  • Cicatrix, Hypertrophic / drug therapy
  • Fluorouracil / administration & dosage*
  • Humans
  • Injections, Intralesional / methods*
  • Injections, Intralesional / trends
  • Laser Therapy / methods*
  • Laser Therapy / trends
  • Photochemotherapy / methods*
  • Photochemotherapy / trends
  • Randomized Controlled Trials as Topic / methods
  • Skin Diseases / diagnosis
  • Skin Diseases / drug therapy*
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / drug therapy


  • Antimetabolites, Antineoplastic
  • Fluorouracil