The Effectiveness and Local Skin Reactions of Ingenol Mebutate Gel in Patients with Actinic Keratosis

Abstract

Background: Actinic keratosis (AK) is a common skin disease caused by exposure to ultraviolet light that can progress to invasive squamous cell carcinoma. Ingenol mebutate (IM), a novel agent for field therapy of AK, has been widely used, but research on its effectiveness has focused more on Caucasian rather than Asian people. Objective: The effectiveness and local skin reaction of IM gel treatment in Koreans were investigated through long-term follow-up. Methods: We retrospectively reviewed 17 patients histopathologically diagnosed with AK on the face/scalp and treated with IM gel (0.015%) between 2015 and 2017. The clinical efficacy and local skin reactions were assessed from medical records. The long-term effects of IM gel treatment were evaluated after 6 months of treatment. Results: Nine of the 17 (52.9%) subjects had a complete response at day 57. Although the patients developed erythema (100%), flaking/scaling (76%), crusting (47%), swelling (64%), vesiculation/pustulation (70%), and erosion/ulceration (35%) as a local skin reactions at day 4, most of these reactions had disappeared at day 57. Most of the patients (76.5%) complained of pain or irritation as side effects. The long-term efficacy was assessed in two patients with a complete response at day 57 and the complete response was sustained for all patients at 6 months. Conclusion: IM seems to be an effective field therapy for multiple AK lesions with short-term use and stability. Further studies are needed on the effects of IM therapy in the Korean population. ? 2020 Korean Dermatological Association. All rights reserved.