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Liquid nitrogen cryotherapy for limited # or thick lesions. Electrodessication and curettage, CO2 laser esp. for actinic cheilitis ; . Topical 5-fluorouracil e.g., Efudex ; cream applied bid for 24 wk. Imiquimod AldaraTM 5% cream ; applied qd three to five times weekly for 12 wk. Patients must be warned that the treated areas will become irritated, inflamed, and eroded with both 5-fluorouracil and imiquimod; follow-up visit in 12 wk evaluate severity of side effects. Photodynamic therapy, dermabrasion, & chemical peels for numerous AKs ; . Multiple lesions are a harbinger of sun damage; patients should be checked annually for AKs and other skin cancers. Biopsy thick lesions or those not responding to above treatment as they may represent invasive squamous cell carcinoma. Sun-awareness and protection advice.
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Dihydrodiol dehydrogenase DD ; EC 1.3.1.20 ; catalyses the NADP + -linked oxidation of trans-dihydrodiols of aromatic hydrocarbons to the corresponding catechols. The enzyme exists in multiple forms in mammalian tissues [15], and major forms of the enzyme purified from several mammalian livers have been demonstrated, or suggested, to be identical to 3-, 17- and\or 3 20 ; -hydroxysteroid dehydrogenases HSDs ; , some of which exhibit additional oxidoreductase activity for prostaglandins [2, 4]. Thus DD plays a role not only in the metabolism of xenobiotic hydrocarbons, but also in the metabolism of endogenous steroids and prostaglandins. The enzymes in several mammalian tissues have been shown to be members of the aldoketo reductase AKR ; superfamily [6, 7], including aldose reductase and 3-HSD, which are therapeutic targets for the development of drugs for diabetic complications [8] and prostatic diseases [9]. We previously purified four forms DD1DD4 ; of human liver DD with molecular masses of approx. 36 kDa [5]. The minor form DD3 ; is aldehyde reductase and the other forms show distinct specificity for 3- and\or 20-hydroxysteroids and prostaglandins [5, 1012]. DD1 shows 3 20 ; -HSD activity, DD2 oxidizes some 3-hydroxysteroids, and DD4 exhibits broad and high 3-HSD activity for various steroids, including bile acids. They also differ in inhibitor sensitivity ; 1, 10phenanthroline, bile acids and steroidal anti-inflammatory drugs.
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