New Gel Treats Precancerous Skin Condition in Days: Study

WEDNESDAY, March 14 (HealthDay News) — A newly approved gel
appears effective in treating a condition called actinic keratosis, which
is a common precursor to squamous cell skin cancer, a new study finds.

Earlier topical treatments took weeks or even months to treat the
condition, but the new product — Picato (ingenol mebutate) gel — can
work in a matter of days, according to the report in the March 15 issue of
the New England Journal of Medicine.

“There are a number of agents available to treat precancerous skin
lesions,” said study author Dr. Mark Lebwohl, a professor and chairman of
dermatology at Mount Sinai School of Medicine in New York City.

“Most of the other ones are applied over a period of weeks to months
and have a reaction that lasts for a long time, so it interferes with your
life for a good period of time. This one is unique in that it is applied
for only one to three days,” he said.

The U.S. Food and Drug Administration approved Picato for use on
actinic keratoses in January. The new study was funded by LEO Pharma, the
maker of Ingenol.

For the study, more than 900 people with actinic keratoses on their
face or scalp, or elsewhere on their body (trunk, arms or legs) were
randomly assigned to treatment with either Picato or an inactive
placebo.

The researchers found that when used on the face or scalp, the gel
cleared the condition nearly 43 percent of the time, compared with nearly
4 percent for the placebo.

When used on the trunk or extremities, the gel was again more effective
than placebo — about 34 percent for the gel versus nearly 5 percent for
the placebo, the study authors noted.

Local skin reactions such as redness and crustiness developed within
several days, but were gone quickly, and side effects were mild to
moderate and went away without any problem, according to the report.

And because treatment takes less time, patients are more likely to
adhere to their treatment, said study co-author Dr. Neil Swanson, director
of dermatologic surgery at Oregon Health and Science University in
Portland.

“It is an option to treat these lesions, a good percentage of which
will go on to evolve to skin cancer,” Swanson said.

In addition to skin gels, doctors treat actinic keratosis in other ways
that include burning or scraping with an electric or laser device, cutting
the tumor out, or freezing the tumor in a procedure called
cryotherapy.

Commenting on the study treatment, Dr. Doris Day, a dermatologist at
Lenox Hill Hospital in New York City, said that “it is efficacious and
it’s good for patients who can’t tolerate other treatment.”

However, Day said she would most likely use this gel in combination
with other methods to treat the condition.

“I don’t think I would use it as monotherapy,” she said. “I don’t think
it penetrates deeply into the skin. So I would mix this with my other
treatments such as laser and cryotherapy.”

Day stressed that it is important to treat actinic keratosis before it
becomes skin cancer.

More information

To learn about actinic keratosis, visit the U.S. National Library of Medicine.

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