Skroza N, Proietti I, Bernardini N, Balduzzi V, Mambrin A, Marchesiello A, Tolino E, Zuber S, La Torre G, Potenza C. Factors influencing response to ingenol mebutate therapy for actinic keratosis of face and scalp. World J Clin Oncol 2017; 8(5): 405-411 [PMID: 29067277 DOI: 10.5306/wjco.v8.i5.405]
Corresponding Author of This Article
Nevena Skroza, MD, Dermatology Unit “Daniele Innocenzi”, Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Via Firenze snc Polo Pontino, 04019 Terracina, Italy. nevena.skroza@uniroma1.it
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Oct 10, 2017; 8(5): 405-411 Published online Oct 10, 2017. doi: 10.5306/wjco.v8.i5.405
Factors influencing response to ingenol mebutate therapy for actinic keratosis of face and scalp
Nevena Skroza, Ilaria Proietti, Nicoletta Bernardini, Veronica Balduzzi, Alessandra Mambrin, Anna Marchesiello, Ersilia Tolino, Sara Zuber, Giuseppe La Torre, Concetta Potenza
Nevena Skroza, Ilaria Proietti, Nicoletta Bernardini, Veronica Balduzzi, Alessandra Mambrin, Anna Marchesiello, Ersilia Tolino, Sara Zuber, Concetta Potenza, Dermatology Unit “Daniele Innocenzi”, Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04019 Terracina, Italy
Giuseppe La Torre, Department of Public Health and Infectious Diseases, Sapienza University of Rome, 04019 Terracina, Italy
Author contributions: Skroza N, Proietti I, Bernardini N and Potenza C designed the research; Balduzzi V, Mambrin A, Marchesiello A, Tolino E and Zuber S performed the research; La Torre G analyzed the data.
Institutional review board statement: The study was reviewed and approved by the Ospedale A. Fiorini Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The author reports no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Nevena Skroza, MD, Dermatology Unit “Daniele Innocenzi”, Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Via Firenze snc Polo Pontino, 04019 Terracina, Italy. nevena.skroza@uniroma1.it
Telephone: +39-773-708811 Fax: +39-773-708399
Received: October 20, 2016 Peer-review started: October 23, 2016 First decision: December 20, 2016 Revised: July 6, 2017 Accepted: September 1, 2017 Article in press: September 1, 2017 Published online: October 10, 2017 Processing time: 339 Days and 7.3 Hours
Abstract
AIM
To determine factors independently influencing response to ingenol mebutate therapy and assess efficacy on clinical setting of non-hypertrophic non-hyperkeratotic actinic keratosis (AK).
METHODS
Consecutive patients affected by non-hypertrophic non-hyperkeratotic AKs of the face or scalp were enrolled to receive ingenol mebutate 0.015% gel on a selected skin area of 25 cm2 for 3 consecutive days. Local skin reactions were calculated at each follow up visit using a validated composite score. Efficacy was evaluated by the comparison of clinical and dermoscopic pictures before the treatment and at day 57, and classified as complete, partial and poor response.
RESULTS
A number of 130 patients were enrolled, of which 101 (77.7%) were treated on the face, while 29 (22.3%) on the scalp. The great majority of our study population (n = 119, 91.5%) reached at least a 75% clearance of AKs and, in particular, 58 patients (44.6%) achieved a complete response while 61 (46.9%) a partial one. Logistic backward multivariate analysis showed that facial localization, level of local skin reaction (LSR) at day 2, the highest LSR values and level of crusts at day 8 were factors independently associated with the achievement of a complete response.
CONCLUSION
Ingenol mebutate 0.015% gel, when properly applied, is more effective on the face than on the scalp and efficacy is directly associated to LSR score.
Core tip: Ingenol mebutate 0.015% gel is an effective treatment for non-hypertrophic non-hyperkeratotic actinic keratosis of face and scalp. Facial lesions are more prone to achieve a complete response to this therapy than those located on the scalp. Facial localization and the highest levels of local skin reaction, in particular the amount of crusting, are predictive for complete response to ingenol mebutate 0.015% gel therapy in a real clinical setting.
