Journal of Clinical and Aesthetic Dermatology

MauiDerm 2017

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

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JCAD S8 journal of clinical and aesthetic dermatology JCAD journal of clinical and aesthetic dermatology May 2017 • Volume 10 • Number 5 (Supplement 1) W eek 12 were significantly greater in a ll olumacostat glasaretil-treated groups compared with vehicle; highest efficacy was observed in the 7.5% BID group (IAL: -15.0 [-55.6%] versus -10.7 [-40.0%], p≤0.001; NIAL: -17.5 [ 47.8%] versus -9.3 [-28.7%], p<0.001 for olumacostat glasaretil 7.5% BID versus c ombined vehicle groups). Clinically meaningful changes were observed in acne severity scores, with IGA response rates at Week 12 numerically greater in all olumacostat glasaretil- treated patient groups compared with combined vehicle groups, and statistically significantly greater in the olumacostat glasaretil 7.5% BID patient group (25.9% versus 9.8%, p=0.004). Adverse events (AEs) occurred in 20.8%, 25.7%, and 27.7% versus 19.2% and 26.0% of patients treated with olumacostat glasaretil 4% QD, 7.5% QD, and 7.5% BID versus VH- QD and VH-BID, respectively. The most commonly reported AEs were nasopharyngitis, upper respiratory tract infection, and application site pruritus. Conclusion: Patients treated with olumacostat glasaretil showed reductions at Week 12 in IAL and NIAL counts, and improved IGA scores, compared with vehicle-treated patients, with olumacostat glasaretil gel 7.5% BID treatment producing the greatest response in all primary endpoints. Olumacostat glasaretil gel, at all doses tested, was well tolerated throughout the 12-week treatment period. Financial diclosures/funding: This study was funded by Dermira, Inc. Medical writing support was provided by Costello Medical Consulting Limited (Cambridge, UK) and Prescott Medical Communications Group (Chicago, IL). All costs associated with development of this abstract were funded by Dermira, Inc. ACTINIC KERATOSIS Defining Field Cancerization of the Skin Using Noninvasive Optical Coherence Tomography Imaging to Detect and Monitor Actinic Keratosis in Ingenol Mebutate 0.015%-Treated Patients —The E xtension Study Presenters: Orit Markowitz, 1–3 Katie Wang, 1–3 Amanda Levine, 1–3 Michelle Schwartz, 1–3 Sumeet Minhas, 1–3 Eleanor Feldman, 1 –3 Daniel Siegel 1 ,2 Affiliations: 1 SUNY Downstate Medical Center, New York, NY; 2 Brooklyn VA Harbor Healthcare, Brooklyn, NY; 3 Mount Sinai Hospital, New York, NY Background: Field cancerization refers to DNA damage in the keratinocytes due to chronic ultraviolet radiation. This damage can be detected by optical coherence tomography (OCT) imaging, and an original study completed in 2015 showed significant correlation between biopsied actinic keratosis as well as high clearance rate of actinic keratosis (AK) and subclinical actinic damage in patients treated with ingenol mebutate 0.015%. Given the high overall clearance rate in the original study (79.35%) and the overall patient benefit, the investigators conducted an extension study to treat the three clinical and subclinical lesions that had previously been untreated. Objective: The primary objectives of the extension study was to determine whether the actinic keratoses successfully treated during the original study remained clear one year later, and to treat the previously untreated lesions. Methods: Fifteen patients from the original 30 patient pilot study returned one year after treatment. All lesions treated and untreated were evaluated c linically, dermoscopically and with O CT at baseline and at Day 60 following treatment of their previously untreated areas. Results: The majority of the lesions that were successfully treated by the completion of the original study remained clear with a p value of less t han 0.0001 at the start of and throughout the extension study. Similar to the original study, there was a statistically significant reduction of lesions in the now treated actinic keratoses. Limitations: One limitation of this data is the fact that a large number of patients in the original study were unable to enroll in the extension study. Barriers to their enrollment included the fact that they had used another form of treatment on their AKs over the course of the year, some were traveling at the time, and others had relocated and were unable to participate. Conclusion: Our results suggest that AKs and actinic damage that are monitored adequately and respond well to treatment are likely to stay clear for at least one year following initial treatment. This is a promising finding given the fact that AKs can often be refractory and require multiple treatments with cryosurgery. Lesions in the original study that were refractory to treatment and were also present during the extension study showed features of seborrheic keratoses on noninvasive imaging, which could indicate a barrier to treatment response. Assessment of Efficacy and Irritation of Ingenol Mebutate Gel, 0.015%, Used With or Without Dimethicone Lotion for Treatment of Actinic Keratosis on the Face Presenters: Shelbi Jim On, Peter Hashim, John Nia, Mark Lebwohl

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