Long-term disease control of disseminated superficial actinic porokeratosis (DSAP) with simvastatin 2%/ cholesterol 2% cream

Abstract

Introduction Disseminated superficial actinic porokeratosis (DSAP) is a rare keratinization disorder associated with an increased risk of cutaneous tumors.

Objectives To develop a feasible and easy-to-apply treatment regimen for long-time disease control of DSAP including prevention of new skin tumors.

Patients and Methods 19 patients with DSAP were treated with 2% simvastatin/2% cholesterol (SC) cream for a maximum period of 18 months. Disease severity was assessed via Investigator Global Assessment (IGA), and quality of life (QoL) was measured using the Dermatology Life Quality Index (DLQI). Adverse events and tumor development were documented.

Results Significant improvement in IGA scores was observed across all treated regions (p < 0.001), with most progress occurring in the first 3 months but maintained under a reduced proactive application schedule twice weekly. DLQI scores decreased significantly within the first 3 months. No new skin tumors developed during treatment.

Conclusions SC cream is a promising long-term, targeted treatment for DSAP, offering sustained efficacy, good tolerability, and improved QoL. The individual tapering from daily use to a proactive approach twice a week may be a key factor for disease control and may become an important component of skin tumor prevention in this specific patient population.