pep005 and Cheilitis

Actinic cheilitis (AC) is part of a spectral disease of keratinocyte carcinomas considered by some authors an early stage of. This study enrolled patients with AC to receive IM gel 0.015% for self-application on the lower lip for 3 consecutive days. A biopsy was performed before and after treatment for histopathological and immunohistochemical evaluation. Local skin reactions (LSR) were evaluated. The level of significance considered was 5%.. Fourteen patients were enrolled. All LSR had a complete resolution for up to 2 weeks. The most common adverse events were burning sensation, angular cheilitis, and pain. There was an improvement of more than 80% in patients' subjective evaluation. There was no statistically significant histopathological response since all patients remained with mild dysplasia. No reduction in the P53 expression was observed in the current study.. Despite being a safe therapeutic method, the absence of histopathological or immunohistochemical response suggests that clinical improvement may not be accompanied by histopathological cure for AC treated with IM.

Topics: Cheilitis; Diterpenes; Genes, p53; Humans; Keratosis, Actinic; Treatment Outcome; Tumor Suppressor Protein p53

Topics: Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Antineoplastic Agents; Cheilitis; Diclofenac; Diterpenes; Female; Follow-Up Studies; Humans; Imiquimod; Male; Middle Aged

Actinic cheilitis (AC) can precede the development of squamous cell carcinoma (SCC) of the lip, a location with higher risk of invasiveness and metastasis. Herein, we reported the use of ingenol mebutate (IngMeb) 0.015% gel on three consecutive days to treat three patients suffering from AC. All the three patients achieved complete clearance of AC with rapid clinical effect, favorable safety profile, good patient's compliance related to short time of applications, and few local skin reactions. So IngMeb is an attractive new therapy for AC. Moreover, the present case report adds further evidence to the usefulness of dermoscopy and Reflectance confocal microscopy (RCM) in the assessment and monitoring of treatment outcome.

Topics: Administration, Topical; Aged; Aged, 80 and over; Cheilitis; Dermoscopy; Diterpenes; Female; Gels; Humans; Lip; Male; Microscopy, Confocal; Predictive Value of Tests; Remission Induction; Time Factors; Treatment Outcome

Actinic cheilitis (AC) can precede the development of squamous cell carcinoma of the lip, a location with high risk of invasiveness and metastasis. We communicate the good results that we obtained when treating seven patients suffering from AC with ingenol mebutate (IM) 0,015% concentration gel on three consecutive days. Three patients achieved complete clearance and four significant improvement. IM is a topical field treatment approved for actinic keratosis. To our knowledge, reported experience in the management of AC with IM is very limited. Local skin responses grade 3 were the main adverse event observed and they resolved in all patients without specific therapy within 1 to 2 weeks. IM is characterized by its rapid clinical effect, its favorable safety profile and its dosing period of only 3 days, shorter than with other field therapies. All these facts make it an attractive new therapy for AC, with need for further study.

Topics: Administration, Topical; Aged; Aged, 80 and over; Antineoplastic Agents; Cheilitis; Disease Management; Diterpenes; Drug Administration Schedule; Female; Gels; Humans; Lip Neoplasms; Male; Middle Aged; Precancerous Conditions; Treatment Outcome

We present the case of a healthy 76-year-old man with a whitish, hyperkeratotic lesion of the lower lip diagnosed as actinic cheilitis (AC) previously treated with classic red light photodynamic therapy 5 years ago. Initial treatment with 5% imiquimod cream - also with intensified application - failed. After 2 cycles thrice daily, consecutive applications of 150 μg/g ingenol mebutate gel at 3 weeks' interval, the lesions cleared completely. Surprisingly, no pustular or crusting reaction or other side effect occurred contrary to expectation. Remission was stable for 10 months, when recurrence occurred. Ingenol mebutate proved to be a feasible and safe treatment in this otherwise refractory case of AC.

Topics: Administration, Cutaneous; Aged; Antineoplastic Agents; Cheilitis; Chronic Disease; Diterpenes; Humans; Lip; Lip Neoplasms; Male; Neoplasm Recurrence, Local; Precancerous Conditions; Skin Neoplasms