This pilot study represents the first application of sustained-release local chemotherapy with fluorouracil and epinephrine in an injectable gel for the treatment of psoriatic plaques. The objectives were to assess the feasibility, safety, and efficacy of three dose volumes of fluorouracil and epinephrine in an injectable gel, which was administered intralesionally as a single dose, and to determine qualitative effects in plaque appearance in given affected areas.
This gel contains fluorouracil (30 mg/mL) and epinephrine (0.1 mg/mL) in an aqueous system, using purified bovine collagen as a biocompatible, biodegradable carrier matrix. The primary mechanism of action of fluorouracil as an antimetabolite is thought to be inhibition of DNA synthesis by competitive inhibition of thymidylate synthetase.1 The collagen matrix of the gel formulation provides sustained drug release and thereby increases the exposure of diseased tissue to high drug concentrations for extended periods. The therapeutic effect is amplified by inclusion of