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Topical Diclofenac Gel for the Management of Periocular Actinic Keratosis

Batra, Ruchika M.R.C.Ophth.; Sundararajan, Sathya F.R.C.Path.; Sandramouli, Soupramanien F.R.C.Ophth.

Ophthalmic Plastic & Reconstructive Surgery: January/February 2012 - Volume 28 - Issue 1 - p 1–3
doi: 10.1097/IOP.0b013e318224ae9b
Original Investigations
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Purpose: We sought to evaluate the efficacy of topical 3% diclofenac gel in the management of periocular actinic keratosis.

Methods: Four consecutive patients with periocular actinic keratosis who were treated with topical 3% diclofenac gel twice daily for up to 4 months were included in the study. Patients were reviewed at 1 and 2 months and then as clinically required up to 13 months after treatment.

Results: All 4 patients had biopsy-proven actinic keratosis. Three of the 4 patients tolerated the therapy well. In 1 patient, an adverse reaction developed, with erythema, crusting, and scaling after 2 months of therapy, which resolved within a month of discontinuing topical diclofenac. In all the patients, a visible decrease in lesion severity was seen after 1 month, and complete resolution, within 4 months. Recurrences occurred in 2 patients at 4 months and 7 months after treatment. These were successfully managed, in one patient, by excision, and in the other, with further 3% diclofenac gel followed by cryotherapy.

Conclusion: The use of 3% diclofenac gel in extraocular sites has been widely described in the dermatology literature. However, no published reports exist of its use in ophthalmology. It may be a useful therapeutic option when used alone in patients with localized disease or to reduce the size of larger, more-diffuse lesions before excision or cryotherapy, leading to improved cosmesis. Furthermore, it may also be useful in patients prone to actinic keratoses, such as organ-transplant recipients, to reduce the need for multiple excision procedures or uncomfortable ablative techniques.

Wolverhampton Eye Infirmary, Wolverhampton, West Midlands, United Kingdom

Accepted for publication May 10, 2011.

Financial support was not required.

Presented at the British Oculoplastic Society Meeting, Edinburgh, June 16-18, 2010.

The authors declare that no proprietary interests exist.

Address correspondence and reprint requests to Dr. Ruchika Batra, ST5/Speciality Registrar, Birmingham and Midland Eye Centre, Birmingham City Hospital, Dudley Road, Birmingham, B18 7QH, U.K. E-mail: ruchikabatra@aol.com

©2012The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.