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Topical Fluorouracil for Actinic Cheilitis

Topical (5-fluorouracil [5-FU]) as a 5% solution was used to treat isolated actinic keratoses of the lips as well as diffuse actinic damage of the lower lip. Although producing considerable temporary discomfort, final results proved excellent, with recurrences in only two of 12 patients treated. Preliminary biopsy of suspicious infiltrated areas is mandatory, as is careful follow-up to ensure complete healing. Topical fluorouracil is an alternative to surgical excision of the vermilion border of the lip in those patients with severe diffuse actinic damage of the lips.

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Mimics of Cellulitis

Distinguishing true cellulitis from its many imitators is challenging but critical if we are to avoid unnecessary use of antibiotics and delays in treatment. Common imitators of cellulitis are stasis dermatitis, lipodermatosclerosis, contact dermatitis, lymphedema, eosinophilic cellulitis, and papular urticaria. Specific criteria do not exist for the diagnosis of cellulitis, but the alert physician can find clues in the history and physical examination that point toward cellulitis.

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