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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.