Patch test.

Did you know the oral antifungal itraconazole is a weak inhibitor of the hedgehog pathway? Given the proclivity of patients with mutations in Ptch1 to develop countless basal cell carcinoma (BCC) lesions, not to mention the liver toxicity associated with prolonged oral itraconazole, a topical solution sounds like a great solution. Among 9 patients with 114(!) BCC lesions, regular application of a novel topical itraconazole resulted in excellent intratumoral concentrations with very low systemic concentrations. So it’s really too bad it appeared to have no impact on tumor response. | Sohn, JAMA Dermatol 2019