Evaluation of Different Approaches in Managing Local Skin Reactions With the Use of Ingenol Mebutate 0.015% and 0.05% During the Treatment of Actinic Keratosis

Freeman, Scott R.; Bettencourt, Miriam S.; Corliss, Meg; Dunkelly-Allen, Nikeshia; Veverka, Karen A.

doi:10.25251/skin.4.supp.64

Cited by 2 publications

(2 citation statements)

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“…Furthermore, studies examining a role for concurrent topical corticosteroids or other adjunctive therapies to improve adherence by reducing LSRs without loss of efficacy may be reasonable. 52 Finally, additional studies further defining the efficacy of patientapplied treatments for actinic cheilitis or other regions of the body (eg, dorsal hands/forearms and chest) could provide more clarity for patient care and further fine-tune individual treatment regimens. Investigations regarding currently off-label uses for these patient-applied agents for other keratinocytic dysplastic processes such as SCC in situ, Bowenoid papulosis, vulvar dysplasias, verruca, and molluscum contagiosum would be helpful.…”

Section: Future Directionsmentioning

confidence: 99%

Advances and Considerations in the Management of Actinic Keratosis: An Expert Consensus Panel Report

Rosso¹,

Armstrong²,

Berman³

et al. 2021

JDD

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Background: Actinic keratosis (AK) is a potentially pre-malignant tumor with a poorly defined risk of progression to invasive squamous cell carcinoma (SCC). Because of the typical need for recurrent cycles of AK treatment, outcomes can be limited by both therapeutic efficacy and patient adherence. Objective: To synthesize the available and most current literature into overarching principles to provide guidance on the management of AKs, improving patient experiences and treatment outcomes. Methods: A systematic review querying epidemiology, natural history, prognosis, management of AKs as well as the mechanism of action of and adherence to current AK therapy was conducted. After reviewing the literature, an expert consensus panel consisting of 10 expert dermatologists and dermatopathologists used a modified Delphi process to develop statements regarding the pathogenesis and management of AKs. Final statements were only adopted with a supermajority vote (≥7/10). Results: The panel developed 7 consensus statements regarding AKs pathogenesis and management. Conclusion:The poorly defined risk for AK progression into invasive SCC without universally accepted clinical-histopathological factors highlights the importance of long-term efficacious treatment. To effectively counsel and treat patients with actinic keratoses, dermatologists must understand how newer therapeutic approaches with mechanisms of action that have more rapid onset of action, shorter treatment courses, and less intense local skin reaction (LSRs) may promote adherence and improve long-term outcomes.

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Section: Future Directionsmentioning

confidence: 99%

Advances and Considerations in the Management of Actinic Keratosis: An Expert Consensus Panel Report

Rosso¹,

Armstrong²,

Berman³

et al. 2021

JDD

View full text Add to dashboard Cite

show abstract

“…Dermatologists may consider off-label modifications and adjunctive therapies (such as steroidal and non-steroidal antiinflammatory agents, moisturizers and emollients, topical antibiotics, and antipruritic agents) to mitigate LSRs with the caveat that there is limited evidence for their use. 37 By being able to combine evidencedbased regimens with patient-centered values, dermatologists may potentially maximize long-term compliance and therefore achieve (near-)ideal outcomes regarding AK care. 38 AKs are a chronic condition with a still poorly defined potential for progression into invasive SCC.…”

Section: The Importance Of Actinic Keratosis Therapy and Patient Coun...mentioning

confidence: 99%

Considerations in the Management of Actinic Keratoses: The Importance of Adherence and Persistence to Therapy

Marson¹,

Rosso²,

Bhatia

et al. 2021

J of Skin

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Background: Actinic keratosis (AK) is a pre-malignant lesion with a poorly defined risk of progression to invasive squamous cell carcinoma (SCC). AKs are also associated with increased future risk of invasive SCC. However, there are many barriers to therapy adherence that may affect long-term treatment efficacy. Objective: To review the current literature reporting known known factors of AK treatment non-adherence intrinsic to patient behavior and treatment regimens and re-examine how dermatologists can navigate these challenges. Methods: A Medline literature search was performed to identify existing evidence regarding barriers to adherence with AK treatment regimens intrinsic to patient behavior, patient counseling, and treatment regimens pertinent for review. Results & Discussion: Factors intrinsic to prescribed patient-applied therapy that can exacerbate non-adherence include: 1) length of treatment duration, 2) frequency of application, 3) complexity of treatment regimen, 4) duration and 5) severity of local skin reactions (LSR) and adverse reactions. Novel mechanisms of action that induce cellular apoptosis (as opposed to necrosis) via inhibition of tubulin polymerization and cell cycle arrest, may promote treatment regimen adherence and long-term outcomes. Dermatologists should also be conscious of how they counsel patients as insufficient counseling may also lead to poor adherence. Conclusion: Dermatologists must understand the value of shorter course therapies and their positive impact on adherence and be well-versed in the mechanisms, efficacy and adverse events associated with treatment options. By doing so, dermatologists may best counsel and educate patients and devise regimens that address individualized patient concerns.

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Evaluation of Different Approaches in Managing Local Skin Reactions With the Use of Ingenol Mebutate 0.015% and 0.05% During the Treatment of Actinic Keratosis

Abstract: not available.

Cited by 2 publications

References 5 publications

Advances and Considerations in the Management of Actinic Keratosis: An Expert Consensus Panel Report

Advances and Considerations in the Management of Actinic Keratosis: An Expert Consensus Panel Report

Considerations in the Management of Actinic Keratoses: The Importance of Adherence and Persistence to Therapy

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