SOURCE of article below: http://www.emedicine.com/DERM/topic343.htm

Note: The key words below are "potential benefit"! I don't know WHO wrote this web page. First of all this article is not just about DSAP but about treatment for 4 forms of porokeratosis. Furthermore the tone of if seems to imply that these are cures when in fact there is currently no real cure for DSAP. I have only heard of ONE case of a patient who's skin completely cleared up (the German patient who tried Tacalcitol described on the main page).

If lesions are widespread and medical treatment is desired, 3 medications have potential benefit:

• Topical 5-Fluorouracil (AKA F-5, Efudex(5%), Flouroplex(1%)), : This can induce remission in all forms of porokeratosis. Treatment must be continued until a brisk inflammatory reaction is obtained. Concurrent use of topical steroids may ease discomfort without reducing long-term improvement. Recurrences may be seen. (Carl's opinion: The key word is "remission". I wonder to what extent they mean)
• Topical Vitamin D3 Analogues: Both calcipotriol and tacalcitol have been shown to be effective after 3 – 6 months of treatment for DSAP. These drugs regulate calcium-induced keratinocyte differentation. Should not be used in patients with hypercalcemia or evidence of vitamin D toxicity. Reversible elevation of serum calcium has occurred. Tacalcitol (available in Europe, NOT in the USA) is nearly identical to Dovonex(available in the US). *** read more below.
• Oral Retinoids: Isotretinoin: Oral isotretinoin 20 mg. Dailey combined with topical fluorouracil is reported to be effective for DSAP and PPPD, but caused burning, itching and painful erosions.
• More on Oral Retinoids: Etretinate: (Does not look good) There are conflicting reports of efficacy. Etretinate at doses of 75 mg/d for 1 week followed by 50 mg/d has been shown to be helpful in linear porokeratosis and symtomatic porokeratosis of Mibelli. Higher doses of 1 mg/kg/d were reported to exacerbate lesions of DSAP after 4 – 6 weeks of treatment. Even when etretinate therapy is successful, relapse may be seen. Digitate keratoses were reported to develop after the use of etretinate for DSAP.

Oral Retinoids: No studies have been reported the effect on porokeratoses of acitretin, a second-generation monoaromatic retinoid and the active metabolite of etretinate.

*** Calcipotriol, known in the US as Dovonex, and Tacalcitol are almost exactly the same analogues. There is exactly one number difference in the chain that describes their composition. In some studies this drug has been shown to be less irritating to people than calcipotriol, however adequate side-to-side comparisons of efficacy and safety remain to be done.

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