Effect of ingenol mebutate on actinic keratosis in a Korean population: A prospective clinical, dermoscopic and histopathological study from a single center

J Dermatol. 2018 Nov;45(11):1324-1330. doi: 10.1111/1346-8138.14632. Epub 2018 Sep 8.

Abstract

Actinic keratosis (AK) is an in situ squamous cell carcinoma which is mostly found on sun-damaged skin, and it is prevalent among Caucasians. However, there is a lack of research on evaluating the treatment efficacy of ingenol mebutate (IM) on AK in Asians. This study was intended to analyze the treatment outcomes of IM on AK in Korean patients with regards to clinical, dermoscopic and histopathological aspects. A prospective study on 46 Korean patients who were diagnosed with AK and treated with IM was conducted. Clinically, 80% (24/30) of the patients showed an improvement at 8 weeks. Twenty out of the 30 (66.7%) patients were found to have achieved histopathological clearance. All local skin responses had disappeared at T4 in all patients. Patients with Fitzpatrick skin type III were proven to exhibit better treatment outcomes, both clinically (P = 0.001) and histopathologically (P = 0.001), than those with Fitzpatrick skin type IV. The clinical and histopathological clearance rate of AK with IM in Korean patients was 80% and 66.7%, respectively. The patients with Fitzpatrick skin type IV showed a tendency to have residual AK, histopathologically after treatment with IM. In conclusion, IM could be an effective and safe treatment option on AK in Korean patients. In addition, it would be helpful to carry out a cautious check-up when treating AK with IM in patients with a darker skin color.

Keywords: Korean; actinic keratosis; dermoscopy; histopathology; ingenol mebutate.

MeSH terms

  • Administration, Cutaneous
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use*
  • Carcinoma in Situ / diagnostic imaging
  • Carcinoma in Situ / drug therapy*
  • Carcinoma in Situ / pathology
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / pathology
  • Dermoscopy
  • Diterpenes / pharmacology
  • Diterpenes / therapeutic use*
  • Female
  • Humans
  • Keratosis, Actinic / diagnostic imaging
  • Keratosis, Actinic / drug therapy*
  • Keratosis, Actinic / pathology
  • Male
  • Middle Aged
  • Prospective Studies
  • Republic of Korea
  • Skin / diagnostic imaging
  • Skin / drug effects
  • Skin / pathology
  • Skin Neoplasms / diagnostic imaging
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / pathology
  • Treatment Outcome

Substances

  • 3-ingenyl angelate
  • Antineoplastic Agents
  • Diterpenes