5-Fluorouracil 0.5%/salicylic acid 10% solution in the treatment of ano-genital warts

Dermatol Ther. 2022 May;35(5):e15370. doi: 10.1111/dth.15370. Epub 2022 Feb 19.

Abstract

Different therapeutic modalities for ano-genital warts (AGWs) are available but data on the efficacy of 5-fluorouracil 0.5%/salicylic acid 10% solution (5FU/SAsol) in the treatment of AGWs are scarse. We enrolled 17 patients with AGWs (14 males, 3 females with a mean age of 34.2 years) who gave written informed consent to the off-label use of topical 5FU/Sasol. Response to treatment was assessed based on the AGWs number: complete if there was complete clearance of the lesions; partial if there was >50% decrease in the lesion number and none if there was <50% decrease in the lesion number. Considering together partial and complete treatment response, 88% of the patients at 3 months and 94% at 6 months benefited from the 5FU/SAsol treatment. 5FU/SAsol was well tolerated by all the patients except one who experienced a burning sensation immediately after the application. The clearance rate that we found for 5-FU/SAsol after 3 months of treatment is comparable with that of the other commonly used therapeutic modalities (liquid nitrogen cryotherapy, imiquimod 5% cream). However, several patients on imiquimod and almost who underwent cryotherapy reported pain as adverse event while a mild pain was rarely reported with 5-FU/Sasol. In conclusion, although nowadays in Italy 5-FU/SAsol is marketed only for the treatment of actinic keratosis, our study described its effectiveness and tolerability also in the treatment of AGWs. Our data suggest that 5-FU/SAsol should be considered not only in case of resistant/recurrent AGWs but also as the first therapeutic option, especially when the number of lesions is small.

Keywords: 5-fluorouracil 0.5%/salicylic acid 10% solution; ano-genital warts; resistant/recurrent warts; response to treatment; therapeutic options.

MeSH terms

  • Adult
  • Condylomata Acuminata* / diagnosis
  • Condylomata Acuminata* / drug therapy
  • Female
  • Fluorouracil / adverse effects
  • Humans
  • Imiquimod / therapeutic use
  • Male
  • Pain / drug therapy
  • Salicylic Acid / therapeutic use
  • Treatment Outcome
  • Warts* / diagnosis
  • Warts* / drug therapy

Substances

  • Salicylic Acid
  • Imiquimod
  • Fluorouracil