光照性角化病(AK)是一种常见的恶性前皮肤病变，局部5-氟尿嘧啶(5-FU)是常用的针对病变领域的治疗方法。然而，5-FU与频繁的局部皮肤反应相关。本研究旨在定性评估拒绝以5-FU进行再治疗的AK患者的经验。我们对2017年1月1日至2020年1月1日期间接受5-FU治疗但拒绝未来治疗的10名成年参与者进行了半结构化访谈。研究结果采用定性研究方法进行分析。尽管大多数参与者在被诊断为AK时的担忧较低，但多数人认为治疗非常重要。在开始使用5-FU治疗时，大多数参与者都将其医生的建议作为最主要的动力，并且最初对治疗持较低的担忧。治疗引起的副作用对大多数参与者来说在身体和心理上都是负担，并导致暂时性的生活调整。治疗结束后，大多数参与者并不认为其医生已经为他们准备好治疗，或者他们不确定。有一半的参与者认为5-FU有助于治疗AK，而另一半要么不确定（因为提前停药），要么不认为5-FU治疗了他们的AK。5-FU是最常被用于治疗AK的方法之一，但大多数患者在治疗过程中经历了身体和心理的负担。由于由于5-FU相关反应导致的提前停药，无法评估疗效非常常见。共享决策、治疗选择的指导以及考虑患者的偏好可能对于改善依从性和预后至关重要。尽管我们的研究受到拒绝未来5-FU治疗的参与者的限制，但大多数参与者表示他们将在未来继续寻求AK的治疗，并且会考虑其他局部治疗方法，特别是如果与更轻度的耐受性相结合的话。©Rohan Singh, Sarah McCain, Steven R Feldman. 原始发表于JMIR皮肤病学（http://derma.jmir.org），2023年2月15日。

Actinic keratosis (AK) is a common premalignant skin lesion, and topical 5-fluorouracil (5-FU) is commonly used in field-directed therapy. However, 5-FU is associated with frequent local skin reactions.This study aimed to qualitatively assess experiences among patients with AK who refuse retreatment with 5-FU.Semistructured interviews were conducted with 10 adult participants who had received treatment with 5-FU for AK between January 1, 2017, and January 1, 2020, and refused future treatment with 5-FU. Results were analyzed using qualitative research methods.Although most participants had low concern upon having received a diagnosis of AK, most felt that treatment is very important. When initiating treatment with 5-FU, most cited recommendation by their health care professionals as the primary motivator and initially had low concern regarding treatment. The side effects associated with treatment were physically and psychosocially burdensome for most participants and led to temporary lifestyle adjustments. After treatment, most did not believe that their health care provider prepared them for treatment or were unsure. While half of the participants felt that 5-FU helped treat AKs, half were either unsure, due to premature discontinuation, or did not think that 5-FU treated their AKs.5-FU is one of the most commonly prescribed treatments for AKs, yet most patients experienced both a physical and psychosocial burden with the treatment. Inability to assess efficacy due to premature discontinuation secondary to 5-FU-related reactions is common, and shared decision-making, navigating treatment options, and taking into account patient preferences may be critical to help assure better adherence and outcomes. Although our study was limited by input from participants who refused future treatment with 5-FU, most stated that they would still continue to seek treatment for AKs in the future and would consider other topical treatments, especially if associated with a milder tolerability profile.©Rohan Singh, Sarah McCain, Steven R Feldman. Originally published in JMIR Dermatology (http://derma.jmir.org), 15.02.2023.