Expedited Resolution of 5-Fluorouracil-Induced Erythema and Barrier Dysfunction with White Petrolatum

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Melody Maarouf
Bryan Kromenacker
Eric Brucks
Vivian Shi


actinic keratosis, field treatment, 5-fluorouracil, petrolatum, epidermal barrier function, transepidermal water loss, hydration, erythema


Actinic keratoses (AK) are precancerous lesions that develop on chronically sun-exposed skin. They frequently require prophylactic field treatment due to the risk of progression to squamous cell carcinoma. Topical treatment with 5-fluorouracil (5-FU) yields near complete AK resolution, yet leaves a patient with an exuberant erythematous treatment site, which may be embarrassing and/or uncomfortable. We report a case of a patient with diffuse facial AK who was treated with 5-FU twice daily for 2 weeks, resulting in fiery-red erythema and disrupted barrier indices. Application of pure ultra white petroleum jelly, an emollient preferred by dermatologists for post-operative wound healing, resulted in drastic decreased erythema and recovery time of post-treatment transepidermal water loss and hydration, compared to the contralateral, non-petrolatum-treated side. Additionally, petrolatum use did not disrupt the AK resolution endpoint. We suggest that petroleum jelly be used for the repair of 5-FU-induced barrier disruption and erythema to promote greater patient adherence. 


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