Journal of Clinical and Aesthetic Dermatology

AUG 2017

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

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36 JCAD journAl oF clinicAl And Aesthetic derMAtology August 2017 • Volume 10 • number 8 o r i G i n A L r e s e A r c h for medication effectiveness and overall satisfaction also increased from Day 3 to 59. this fi nding is consistent with improvements in signs of photoaging reported for a variety of field- based, topical, and procedural therapies for Ak. 2 2 limitations. this was a noncomparative, open-label study that evaluated a relatively small number of subjects, thus precluding any direct comparison with the results of the pivotal clinical trials. conclusions treatment of Ak on an expanded area of the chest (≤100cm 2 ) with ingenol mebutate gel 0.015% reduced the Ak lesion count by an average of 76 percent compared with baseline. signs of photoaging were reduced significantly from baseline by the end of the study, and fewer than 60 percent of subjects indicated that they were "moderately" or "completely" satisfied with improvements in signs of photoaging. ingenol mebutate gel 0.015% was well tolerated, with resolution of Lsr generally within two weeks of completing treatment. AcknoWledgMents Writing assistance was provided by William Fiedelman, from p-value communications. Leo Pharma inc. provided the funding for this assistance. reFerences 1. criscione VD, Weinstock mA, naylor mF, et al. Department of Veterans AWairs topical tretinoin chemoprevention trial Group. Actinic keratoses: natural history and risk of malignant transformation in the Veterans AWairs topical tretinoin chemoprevention trial. Cancer. 2009;115:2523–2530. 2. Feldman sr, Fleischer Ab. Progression of actinic keratosis to squamous cell carcinoma revisited: clinical and treatment implications. Cutis. 2011;87:201–207. 3. Ackerman Ab, mones jm. solar (actinic) keratosis is squamous cell carcinoma. Br J Dermatol. 2006;155:9–22. 4. touma D, yaar m, Whitehead s, et al. A trial of short incubation, broad-area photodynamic therapy for facial actinic keratoses and diWuse photodamage. Arch Dermatol. 2004;140:33–40. 5. Uhlenhake ee. optimal treatment of actinic keratoses. Clin Interven Aging. 2013;8:29–35. 6. berman b, cohen De, Amini s. What is the role of yeld-directed therapy in the treatment of actinic keratosis? Part 1: overview and investigational topical agents. Cutis. 2012;89:241–250. 7. Picato® (ingenol mebutate) gel 0.015%, 0.05% [package insert]. madison, nj: Leo Pharma inc.; september 2016. 8. Lebwohl m, swanson n, Anderson LL, et al. ingenol mebutate gel for actinic keratosis. N Engl J Med. 2012;366:1010–1019. 9. Fabi sG. Fillers for the décolletage area. Pract Dermatol. 2015;sep:29–30, 40. 10. Peterson jD, kilmer sL. three-dimensional rejuvenation of the décolletage. Dermatol Surg. 2016;42(suppl 2):s101–s107. 11. schlessinger j, Green b, edison bL, et al. A yrming neck cream containing n-acetyl glucosamine signiycantly improves signs of aging on the challenging neck and décolletage. J Drugs Dermatol. 2016;15:47–52. 12. Pellacani G, Peris k, Guillen c, et al. A randomized trial comparing simultaneous vs sequential yeld treatment of actinic keratosis with ingenol mebutate on two separate areas of the head and body. J Eur Acad Dermatol Venereol. 2015;29:2192–2198. 13. Alexiades-Armenakas m. rhytides, laxity, and photoaging treated with a combination of radiofrequency, diode laser, and pulsed light and assessed with a comprehensive grading scale. J Drugs Dermatol. 2006;5:731–738. 14. Atkinson mj, kumar r, cappelleri jc, hass sL. hierarchical construct validity of the treatment satisfaction Questionnaire for medication (tsQm version ii) among outpatient pharmacy consumers. Value Health. 2005;8(suppl 1):s9–s24. 15. rosen r, marmur e, Anderson L, et al. A new, objective, quantitative scale for measuring local skin responses following topical actinic keratosis therapy with ingenol mebutate. Dermatol Ther. 2014;4:207–219. 16. Gaide o, cattin V. ingenol mebutate 500 μg on the cheekbones with concomitant conjunctivitis. Dermatology. 2016;232(suppl 1):4–6. 17. niamtu j iii. skin resurfacing. in: niamtu j iil. Cosmetic Facial Surgery. new york: elsevier health sciences; 2011:517–603. 18. trojahn c, Dobos G, Lichterfeld A, et al. characterizing facial skin ageing in humans: disentangling extrinsic from intrinsic biological phenomena. Biomed Res Int. 2015;318586:1–9. 19. mcDaniel Dh, hamzavi ih, Zeichner jA, et al. total defense + repair: a novel concept in solar protection and skin rejuvenation. J Drugs Dermatol. 2015;14(suppl 7):s3–s11. 20. erlendsson Am, thaysen-Petersen D, bay c, et al. repeated treatments with ingenol mebutate prevents progression of UV- induced photodamage in hairless mice. PLoS One. 2016;11:e0162597. 21. braun sA, Gerber PA. cosmetic eWects of ingenol mebutate gel in the treatment of yeld-cancerized photodamaged skin. Dermatol Surg. 2015;41:1328–1329. 22. Lanoue j, Do t, Goldenberg G. therapies for actinic keratosis with a focus on cosmetic outcomes. Cutis. 2015;96:165–172, 193. jcAd

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