From the Research
There is no specific maximum area of Bowen's disease that can be treated with Efudix (5-fluorouracil), and treatment can be tailored to the individual patient's needs, with the goal of minimizing morbidity, mortality, and improving quality of life. Efudix can be used to treat large areas of Bowen's disease, though treatment of extensive areas may need to be done in stages to minimize side effects, as supported by a study from 1. The standard regimen involves applying a thin layer of Efudix cream (5% 5-fluorouracil) to the affected area twice daily for 3-8 weeks, depending on the response. For larger areas, treatment may be limited to one body region at a time to manage local skin reactions, which typically include erythema, erosion, and crusting. These reactions are expected and indicate the treatment is working. Patients should be advised to avoid sun exposure during treatment as it can intensify skin reactions. Efudix works by interfering with DNA synthesis in rapidly dividing cells, preferentially affecting abnormal cells in Bowen's disease. For very extensive disease or areas where side effects might be particularly problematic (such as the face), alternative treatments like photodynamic therapy might be considered, as shown in a meta-analysis from 2. Regular follow-up is essential to assess response and manage side effects. Some key points to consider when treating Bowen's disease with Efudix include:
- The importance of early diagnosis and treatment to prevent progression to invasive epidermoid carcinoma, as highlighted in a study from 3
- The need for individualized treatment plans, taking into account the size and location of the affected area, as well as the patient's overall health and preferences
- The potential for combination therapy, such as using Efudix in conjunction with other treatments like photodynamic therapy, to improve outcomes and minimize side effects, as suggested by a study from 2
- The importance of regular follow-up and monitoring to assess response to treatment and manage any side effects that may arise.