Journal of Clinical and Aesthetic Dermatology

Ingenol Mebutate Topical Gel 2016

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

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S5 JCAD journal of clinical and aesthetic dermatology November 2016 • Volume 9 • Number 11 Ingenol mebutate use in superficial BCC. Superficial (multifocal) BCC is a histologic subtype of BCC characterized by multiple foci of basaloid budding from the involved epidermis. The neoplastic foci are spaced apart, with presence of a fibromyxoid stroma that causes downward displacement of solar elastosis present in the reticular dermis. 14 There are multiple reports of IMG used for treatment of superficial BCC, which are summarized here. • Study. IMG 0.05% was evaluated in an open-label study both with and without occlusion for treatment of superficial BCC in adult subjects (N=76; Fitzpatrick skin types I–III; mean age 60.8 years). 23,24 Daily application was completed for lesions on the trunk (76% of cases) and extremities (24% of cases) for up to three days followed by aluminum disk (full) occlusion (n=27), OpSite occlusion (n=24), or no occlusion (n=24). Twenty-four subjects with seborrheic keratosis (SK) on the trunk and extremities were also actively treated in the same manner, half with OpSite occlusion and half with no occlusion. 24 Final clinical and histologic assessments were completed at six months (Day 120). 23,24 § Among subjects treated for superficial BCC with IMG and aluminum disk occlusion, 22, 3, and 3 subjects were treated with one dose, two doses, or three doses, respectively. Among subjects treated for superficial BCC with IMG and OpSite disk occlusion, 5 and 19 subjects were treated with two doses or three doses, respectively. Among subjects treated for superficial BCC with IMG without occlusion, 1 and 23 subjects were treated with two doses or three doses, respectively. § The complete clinical clearance rates (CCCR) were 74.1, 75.0, and 75.0 percent in the aluminum disk Fi g u re 1 . Tre a t m e n t w i t h i n g e n o l m e b u t a t e g e l, 0 . 0 5 % , o n D a ys 1 an d 2 i n a p a t i e n t w i t h s u p e rf i c i al b as al c e l l c arc i n o m a. L o c al s ki n re s p o n s e s, i n c l u d i n g s e ve re f l aki n g / s c al i n g / d ry n e s s, p e ak e d o n D a y 8 an d re s o l ve d by D a y 2 9 . I m ag e s h a ve b e e n d i g i t al l y c o l o r- b al an c e d , c ro p p e d , an d re s i ze d t o ac c o u n t fo r m i n o r d i f fe re n c e s i n c am e ra p o s i t i o n i n g, b u t are o t h e rw i s e u n al t e re d . R e p r i n te d wi t h p e r m i s s i o n f r o m : S i l l e r G , R o s e n R , Fr e e m a n M , e t a l . P E P 0 0 5 ( i n g e n o l m e b u t a te ) g e l f o r t h e to p i c a l t r e a t m e n t o f s u p e rf i c i a l b a s a l c e l l c a r c i n o m a : r e s u l t s o f a ra n d o m i z e d p h a s e I I a t r i a l . A u s t ra l J D e r ma t o l. 2 0 1 0 ; 5 1 : 9 9 – 1 0 5 .

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