Ingenol mebutate in the treatment of actinic keratoses: clearance rate and adverse effects^*

Background:  Actinic keratoses are benign intraepithelial skin neoplasms that develop in photoexposed areas and can progress to invasive carcinoma. They are seen frequently in dermatological practice, occurring in 5.1% of consultations. Ingenol mebutate (IM) was recently approved in Brazil as a topical therapy for field cancerization in actinic keratosis.

Objective:  To evaluate the clearance rate and adverse events in the treatment of actinic keratoses with ingenol mebutate.

Methods:  A longitudinal, prospective, non-randomized, interventional, open, single-center study was conducted. Patients with actinic keratoses applied ingenol mebutate on a 25cm² area of the face and/or scalp for three consecutive days (0.015%) or on the forearm for two days (0.05%).

Results:  27 patients completed the protocol, of whom 13 on the face and/or scalp and 14 on the forearm. Complete clearance occurred in 53.8% in the first group and 42.8% in the second. Partial response was observed in 15.4% and 35.7%, respectively. The most common side effects were erythema, edema, desquamation, pruritus, and local erosion.

Study limitations:  The study had a small sample and was not randomized, double-blind, placebo-controlled, or vehicle-controlled.

Conclusion:  Ingenol mebutate is well-tolerated for the treatment of actinic keratosis, with good patient adherence thanks to the short treatment period.

Keywords:
Keratosis, actinic; Skin neoplasms; Therapeutics; Treatment outcome