Bowenoid Actinic Keratosis and Bowen's Disease Treated Successfully with Ingenol Mebutate

Mohanna, M. T.; Hofbauer, Günther F.L.

doi:10.1159/000447390

Cited by 9 publications

(6 citation statements)

References 7 publications

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“…There are only anecdotal case reports of nine patients who were treated for BD with IM in the published work. All showed complete clearance but one case reported recurrence (Table ) . Most of them were treated with methods similar to those used for actinic keratosis.…”

Section: Discussionmentioning

confidence: 99%

Clinical experience of ingenol mebutate gel for the treatment of Bowen's disease

Lee

Ahn

Kye

et al. 2018

The Journal of Dermatology

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There are only a few anecdotal case reports about Bowen's disease (BD) treated with ingenol mebutate (IM) gel but no clinical study has been published yet. The aim of this study was to evaluate the effectiveness of IM gel in the treatment of BD and to observe the therapeutic efficacy of IM alone or IM with ablative fractional laser pretreatment. Nineteen patients with BD or squamous cell carcinoma in situ confirmed by skin biopsy were enrolled. IM was applied with 0.015% gel on facial lesions for 3 days consecutively and 0.05% gel on other sites for 2 days consecutively, with a 5-mm application margin around the visible lesion. Nine patients applied IM gel immediately following fractional CO laser treatment. Two patients were lost to follow up and a total of 17 patients were enrolled. Nine patients (9/17, 52.9%) had a clinically complete response at 2 months after treatment. Among the patients treated with the fractional CO laser before applying IM gel, eight (8/9, 88.9%) showed a complete response and one (1/9, 11.1%) showed partial response. Among the patients treated with IM gel alone, only one patient (1/8, 12.5%) showed a complete response, four (4/8, 50%) showed a partial response and three (3/8, 37.5%) did not respond to therapy. IM gel alone seems to have limited value for treatment of BD; however, a combination therapy with the ablative fractional laser can increase its therapeutic effectiveness.

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Section: Discussionmentioning

confidence: 99%

Clinical experience of ingenol mebutate gel for the treatment of Bowen's disease

Lee

Ahn

Kye

et al. 2018

The Journal of Dermatology

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“…In a previous study, the clinical clearance and recurrence rates of BD cases treated with PDT were 76.1%∼98% and 10.5%∼31%, respectively, thereby comparable to our results 7,[14][15][16][17] . Effective treatment with IMB in several cases of BD was also reported [18][19][20][21][22][23][24] , but studies on the clinical clearance and recurrence rates of BD treated with IMB are unavailable. The treatment outcome of PDT in BD was previously compared with other noninvasive treatments, mostly with cryotherapy and topical 5-fluorouracil cream.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Treatment Outcomes of Photodynamic Therapy and Ingenol Mebutate in Bowen's Disease: A Retrospective Observational Study

Shin

Kim

et al. 2020

Ann Dermatol

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Background: Bowen's disease (BD) is treated by multiple treatment modalities. Objective: To assess the effectiveness of photodynamic therapy (PDT) and ingenol mebutate (IMB) in treating BD and determine the factors affecting the treatment outcome. Methods: Patients with histologically confirmed BD from January 1, 2006, to December 31, 2017, were identified from the database of CHA Bundang Medical Center. Those treated with PDT or IMB were included. Patient, tumor characteristics, and treatment response data were retrospectively collected from the database. Results: Overall, 44 and 24 BD were treated with PDT and IMB, respectively. Mean time to the first follow-up visit was 1.2 (0.5∼4) months. Mean follow-up duration was 7.6 (1∼36) months. The mean number of treatment sessions for PDT is 2 sessions (1∼5), while that of IMB was equally 1 session. The complete response rates at the first follow-up visit were 66.7% and 53.0% and recurrence rates were 10.3% and 15.3% for PDT and IMB, respectively. However, the treatment outcome and recurrence rate between both treatment modalities were not significantly different (p=0.349 and p=0.993, respectively). In factor analysis, the complete response rate significantly decreased with older patients in IMB (p=0.012). Adverse events, occurred in 20.5% and 45.8% of patients treated with PDT and IMB, respectively. Conclusion: PDT and IMB are effective noninvasive treatment modalities for BD. However, PDT is a safer treatment modality, considering its fewer adverse events. Particularly, with age being a factor that reduces IMB outcome, in older patients, PDT can be considered as preferred treatments over IMB. (Ann Dermatol 32(1) 47∼52, 2020)

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“…BD mainly affects the elderly and the usual treatment approach is to use non-invasive topical therapies and reserve other treatments for recurrent/refractory cases. Several recent case reports suggest that IM is a potentially effective and safe treatment option for BD, with a short treating course [7][8][9][10][11][12]. However, only one study evaluating the effectiveness of IM gel in the treatment of BD has been published until now [13].…”

Section: Discussionmentioning

confidence: 99%

“…Further investigation is required to overcome these limitations and to provide additional data for the management of BD with IM. So far, since experience of IM for BD has been limited to only one study and some case reports and small series [7][8][9][10][11][12][13], there is a need for larger studies and also greater uniformity in the methodologies used to evaluate its effectiveness. The number of patients being treated, dose regimen (with or without occlusion during treatment), time of post-treatment assessment, methods for the evaluation of skin lesions, and the pretreatments performed should be considered.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Bowen’s Disease with Ingenol Mebutate: A Retrospective Study

Salleras¹

2019

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Management of BD is widely variable and there is little evidence for the most appropriate treatment. Our aim was to evaluate the effectiveness of ingenol mebutate (IM) gel in the treatment of patients with Bowen's disease (BD). We performed a retrospective analysis of 24 cases of biopsy-confirmed BD treated with IM. Data retrieved from the patients' file included age, sex, anatomic sites, clinical images of lesions, histopathological data of skin biopsies, local skin reactions, clinical and histological response to treatment, alternative treatments tried and follow-up. The majority of patients were females (18/24, 75%), with an average age of 79.5 years (range 53-90 years). Four of the 24 patients were lost to follow-up. The average duration of follow-up was 10.4 months (range 0.5-44 months). After treatment with IM, 41.7% of patients showed complete clinical resolution. Retreatment with IM of six non-responder patients led to three more cases of successful healing. Therefore, 54.2% of patients with BD lesions achieved complete resolution after treatment with one or two cycles of IM. Local skin reactions were mostly mild or moderate, and only 12.5% were regarded as severe. The results indicate that topical IM gel may be considered as a safe and beneficial non-invasive treatment option for BD, especially in patients who are poor candidates for surgery and anatomical sites that are unsuitable for other treatments. The acceptable safety profile, short treating course and easy self-application of IM gel may improve patient compliance.

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Bowenoid Actinic Keratosis and Bowen's Disease Treated Successfully with Ingenol Mebutate

Cited by 9 publications

References 7 publications

Clinical experience of ingenol mebutate gel for the treatment of Bowen's disease

Clinical experience of ingenol mebutate gel for the treatment of Bowen's disease

Comparison of the Treatment Outcomes of Photodynamic Therapy and Ingenol Mebutate in Bowen's Disease: A Retrospective Observational Study

Treatment of Bowen’s Disease with Ingenol Mebutate: A Retrospective Study

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