Management of squamous cell carcinoma on the lower legs is complicated by poor deﬁ nition of the tumours while treatment typically requires radical excision and skin grafting. Diffuse hypertrophic solar keratoses and squamous cell carcinoma in situ can be difﬁ cult to distinguish from squamous cell carcinoma in these patients. A series of six patients are described who underwent a technique of weekly topical Efudix applications under xinc oxide wraps. All patients tolerated the treatment well. During the course of 4–8 weeks there was a reduction in the number of background lesions. Invasive tumours were better deﬁ ned, limiting surgical excision size and the surrounding skin was better prepared for operative treatment. The effect appears sustained over a limited one year follow up. This paper was presented at the New Zealand Dermatological Society Meeting, Wellington 2011.