Ingenol mebutate treatment for actinic cheilitis: clinical, histopathological and p53 profile of 14 cases

Abstract

Introduction

Actinic cheilitis (AC) is part of a spectral disease of keratinocyte carcinomas considered by some authors an early stage of in situ squamous cell carcinoma. Treatment options for AC can be lesion and field-directed therapies. Ingenol mebutate (IM) induces rapid and direct cell death and immune responses being able to destruct dysplastic cells.

Materials and methods

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%.

Results

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.

Conclusions

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.

Keywords:

• Actinic Cheilitis
• ingenol mebutate
• precancerous conditions
• tumor suppressor protein p53

Acknowledgments

We thank Márcia Olandoski for the statistical data.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data supporting the results can be obtained by request to the correspondent author.