Abstract Background 5-Fluorouracil (5-FU) is a first-line drug to treat cutaneous field cancerization (CFC). There are few clinical trials with topical colchicine (COL). Objective To evaluate the effectiveness of 0.5% COL cream versus 5% 5-FU cream in the treatment of CFC. Method This was a randomized, open, self-controlled clinical trial. Forty-five patients (90 forearms), with three to ten actinic keratoses (AK) on each forearm, used 0.5% COL cream 2×/day for seven days on one forearm, and 5% 5-FU cream 2× /day, for 21 days, on the other forearm. The dosages were defined based on previous clinical trials for each drug. Adverse effects were evaluated after 14 days and outcomes after 90 days of inclusion. The primary outcome was complete AK clearance and the secondary outcomes were: partial clearance (≥50%), reduction in AK count, assessment of the Forearm Photoaging Scale (FPS), AK Severity Score (AKSS), and adverse effects. Results After 90 days, there was complete clearance of AK in 37% (95% CI 24%-49%) and partial clearance in 85% (95% CI 76%-93%) of the forearms treated with 5-FU,versus 17% (95% CI 7%-27%) and 78% (95% CI 66%-88%) for COL (p > 0.07). There was a percentage reduction of 75% in the AK count of the forearms treated with 5-FU (95% CI 66%-83%) and 64% in those treated with COL (95% CI 55%-72%). Regarding FPS and AKSS, there was improvement in both groups, with no difference regarding FPS (p = 0.654), and 5-FU superiority for AKSS (p = 0.012). Study limitations Single-center study. Conclusions 5-FU and COL are effective for treating CFC, with neither showing superiority regarding the reduction in AK counts. 5Fluorouracil Fluorouracil 5 5FU FU (5-FU firstline first line CFC . (CFC) COL. (COL) 05 0 0.5 randomized open selfcontrolled self controlled trial Fortyfive Forty five (9 forearms, , forearms) (AK forearm 2day day 2 /day 1 9 inclusion ≥50%, 50 ≥50% (≥50%) FPS, (FPS) (AKSS) 37 95% 95 (95 24%49% 2449 24% 49% 24 49 24%-49% 85 76%93% 7693 76% 93% 76 93 76%-93% 5FU,versus 5FUversus FUversus FU,versus 17 7%27% 727 7% 27% 7 27 7%-27% 78 66%88% 6688 66% 88% 66 88 66%-88% p 0.07. 007 0.07 07 0.07) 75 66%83% 6683 83% 83 66%-83% 64 55%72%. 5572 55% 72% 55 72 55%-72%) groups 0.654, 0654 0.654 654 0.654) 0.012. 0012 0.012 012 0.012) Singlecenter Single center study counts (CFC (COL 0. ( ≥50 (≥50% (FPS (AKSS 3 24%49 244 4 24%-49 8 76%93 769 76%-93 7%27 7%-27 66%88 668 6 66%-88 00 0.0 66%83 66%-83 55%72% 557 55%-72% 065 0.65 65 001 0.01 01 ≥5 (≥50 24%4 24%-4 76%9 76%-9 7%2 7%-2 66%8 66%-8 55%72 55%-72 06 0.6 ≥ (≥5 24%- 76%- 7%- 66%- 55%7 55%-7 (≥ 55%-

Abstract Background: Thalidomide is the drug of choice for the treatment of type 2 leprosy reactions and is often associated with corticosteroids. The use of these drugs in multiple myeloma is associated with the risk of cardiovascular events, but there have been few studies assessing this risk in leprosy patients. Objective: To evaluate the occurrence of cardiovascular events in patients with multibacillary leprosy and their correlation with the use of thalidomide and prednisone. Methods: Analytical cross-sectional study of all patients diagnosed with multibacillary leprosy treated at the Dermatology Service between 2012 and 2022, using electronic medical records. Thromboembolic vascular events, both arterial and venous, including acute myocardial infarction, were considered. The main independent variable was the concomitant use of thalidomide and prednisone during follow-up. Results: A total of 89 patients were included, of which 19 used thalidomide and prednisone concomitantly. There were five cardiovascular events (26.3%), three of which of deep venous thrombosis. The combined use of medications was associated with the events (PR = 6.46 [3.92 to 10.65]; p<0.01). Study limitations: Small number of events, single-center retrospective study. Conclusion: The hypothesis of an association between cardiovascular events and the concomitant use of thalidomide and prednisone is supported, but more robust prospective studies are required for a better assessment. Background corticosteroids Objective Methods crosssectional cross sectional 201 2022 records infarction considered followup. followup follow up. up follow-up Results 8 included 1 concomitantly 26.3%, 263 26.3% , 26 3 (26.3%) thrombosis PR 646 6 46 6.4 3.92 392 92 [3.9 10.65 1065 10 65 10.65] p<0.01. p001 p p<0.01 . 0 01 p<0.01) limitations singlecenter single center Conclusion supported assessment 20 202 26.3 (26.3% 64 4 6. 3.9 39 9 [3. 10.6 106 p00 p<0.0 26. (26.3 3. [3 10. p0 p<0. (26. [ p<0 (26 p< (2 (

Abstract Background Several treatments are available for skin with advanced photodamage, which is characterized by the presence of actinic keratoses (AK). Objectives Evaluate the efficacy of using sunscreen with photolyase compared to regular sunscreen, as well as to compare the combination of a topical formulation of antioxidants versus placebo in the treatment of advanced photodamage. Methods This was a randomized, double-blind, factorial clinical trial. Participants with AKs on their forearms were randomized to apply regular sunscreen (SC) or sunscreen with photolyase (SC+P) on both forearms during the day. One of the forearms in each group was randomized again to receive topical antioxidants (AOx), and the other forearm received a placebo cream (both for night application). The four groups were SC/AOx, SC/placebo, SC+P/AOx, and SC+P/placebo. The duration of treatment was 8 weeks. Primary outcomes were total AK clearance, decrease in Forearm Photoaging Scale (FPS), and AK severity scores. Secondary outcomes were reduction in AK count, partial clearance rate, and safety. Results Forty participants (80 forearms) were included. All groups showed significant improvement in outcomes at week eight. There were no significant differences between SC and SC+P for either outcome. AOx led to a significant reduction in AK count (22%; p < 0.05). Partial clearance was obtained in 18 (47.4%) forearms treated with AOx and in 9 (23.7%) treated with placebo (p < 0.05). All groups reduced the FPS score, without significant differences among them. Conclusions There is no difference in the treatment of advanced photodamage skin when comparing the use of sunscreen with photolyase and regular sunscreen, and topical antioxidants were more efficient in reducing AK count than placebo. Study limitations Short interval of follow-up and absence of re-evaluation in the absence of treatment were limitations of the present study.