Treatment of Bowen’s Disease with Ingenol Mebutate: A Retrospective Study

Montserrat Salleras; Mònica Quintana; Jorge Arandes; Ignasi Figueras

doi:doi:10.11648/j.js.20190701.13

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Treatment of Bowen’s Disease with Ingenol Mebutate: A Retrospective Study

Montserrat Salleras, Mònica Quintana, Jorge Arandes, Ignasi Figueras

Published in Journal of Surgery (Volume 7, Issue 1)

Received: 25 January 2019 Accepted: 15 March 2019 Published: 12 April 2019

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Abstract

Management of BD is widely variable and there is little evidence for the most appropriate treatment. Our aim was to evaluate the effectiveness of ingenol mebutate (IM) gel in the treatment of patients with Bowen’s disease (BD). We performed a retrospective analysis of 24 cases of biopsy-confirmed BD treated with IM. Data retrieved from the patients’ file included age, sex, anatomic sites, clinical images of lesions, histopathological data of skin biopsies, local skin reactions, clinical and histological response to treatment, alternative treatments tried and follow-up. The majority of patients were females (18/24, 75%), with an average age of 79.5 years (range 53-90 years). Four of the 24 patients were lost to follow-up. The average duration of follow-up was 10.4 months (range 0.5-44 months). After treatment with IM, 41.7% of patients showed complete clinical resolution. Retreatment with IM of six non-responder patients led to three more cases of successful healing. Therefore, 54.2% of patients with BD lesions achieved complete resolution after treatment with one or two cycles of IM. Local skin reactions were mostly mild or moderate, and only 12.5% were regarded as severe. The results indicate that topical IM gel may be considered as a safe and beneficial non-invasive treatment option for BD, especially in patients who are poor candidates for surgery and anatomical sites that are unsuitable for other treatments. The acceptable safety profile, short treating course and easy self-application of IM gel may improve patient compliance.

Published in	Journal of Surgery (Volume 7, Issue 1)
DOI	10.11648/j.js.20190701.13
Page(s)	14-18
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Bowen’s Disease, Ingenol Mebutate, Dermatopathology, in situ Squamous Cell Carcinoma

References

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[2]	Jaeger AB, Gramkow A, Hjalgrim H, et al. Bowen disease and risk of subsequent malignant neoplasms: a population based cohort study of 1147 patients. Arch Dermatol 1999; 135:790–793.
[3]	Morton CA, Birnie AJ, Eedy DJ. British Association of Dermatologists' guidelines for the management of squamous cell carcinoma in situ (Bowen's disease) 2014. Br J Dermatol 2014; 170(2):245-260.
[4]	Neubert T, Lehmann P. Bowen's disease - a review of newer treatment options. Ther Clin Risk Manag 2008; 4(5):1085-1095.
[5]	Bath-Hextall FJ, Matin RN, Wilkinson D, Leonardi-Bee J. Interventions for cutaneous Bowen's disease. Cochrane Database Syst Rev 2013 Jun 24; (6):CD007281.
[6]	Morton CA, Birnie AJ, Eedy DJ. British Association of Dermatologists’ guidelines for the management of squamous cell carcinoma in situ (Bowen's disease) 2014. Br J Dermatol 2014; 170:245–260.
[7]	Lee JH, Lee JH, Bae JM, Kim GM. Successful treatment of Bowen's disease with ingenol mebutate 0.05% gel. J Dermatol 2015;42(9):920-921.
[8]	Alkhalaf A, Hofbauer GF. Ingenol Mebutate 150 mg as Physician-Directed Treatment of Bowen's Disease Under Occlusion. Dermatology 2016; 232 Suppl 1:17-19.
[9]	Mainetti C, Guillod C, Leoni-Parvex S. Successful Treatment of Relapsing Bowen's Disease with Ingenol Mebutate: The Use of Dermoscopy to Monitor the Therapeutic Response. Dermatology 2016; 232 Suppl 1:9-13.
[10]	Mohanna MT, Hofbauer GF. Bowenoid Actinic Keratosis and Bowen's Disease Treated Successfully with Ingenol Mebutate. Dermatology 2016; 232 Suppl 1:14-16.
[11]	Salleras Redonnet M, Quintana Codina M. Ingenol mebutate gel for the treatment of Bowen's disease: a case report of three patients. Dermatol Ther 2016; 29(4):236-239.
[12]	Kostovic K, Gulin SJ, Mokos ZB, Ceovic R. Topical Ingenol Mebutate: A New Treatment Modality for Multiple Actinic Keratoses and Field Cancerization. Anticancer Agents Med Chem 2017; 17(10):1304-1311.
[13]	Lee DW, Ahn HH, Kye YC, Seo SH. Clinical experience of ingenol mebutate gel for the treatment of Bowen's disease. J Dermatol 2018; 45(4):425-430.
[14]	Cox NH, Eedy DJ, Morton CA. Guidelines for management of Bowen’s disease. Br J Dermatol 1999; 141(4):633-641.
[15]	Kossard S, Rosen R. Cutaneous Bowen’s disease: an analysis of 1001 cases according to age, sex, and site. J Am Acad Dermatol 1992; 27:406-410.
[16]	Truchuelo M, Fernández-Guarino M, Fleta B, et al. Effectiveness of photodynamic therapy in Bowen's disease: an observational and descriptive study in 51 lesions. J Eur Acad Dermatol Venereol 2012; 26(7):868-874.
[17]	Neubert T, Lehmann P. Bowen’s disease – a review of newer treatment options. Therapeutics and Clinical Risk Management 2008; 4(5):1085-1095.

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APA Style

Montserrat Salleras, Mònica Quintana, Jorge Arandes, Ignasi Figueras. (2019). Treatment of Bowen’s Disease with Ingenol Mebutate: A Retrospective Study. Journal of Surgery, 7(1), 14-18. https://doi.org/10.11648/j.js.20190701.13

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ACS Style

Montserrat Salleras; Mònica Quintana; Jorge Arandes; Ignasi Figueras. Treatment of Bowen’s Disease with Ingenol Mebutate: A Retrospective Study. J. Surg. 2019, 7(1), 14-18. doi: 10.11648/j.js.20190701.13

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AMA Style

Montserrat Salleras, Mònica Quintana, Jorge Arandes, Ignasi Figueras. Treatment of Bowen’s Disease with Ingenol Mebutate: A Retrospective Study. J Surg. 2019;7(1):14-18. doi: 10.11648/j.js.20190701.13

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@article{10.11648/j.js.20190701.13,
  author = {Montserrat Salleras and Mònica Quintana and Jorge Arandes and Ignasi Figueras},
  title = {Treatment of Bowen’s Disease with Ingenol Mebutate: A Retrospective Study},
  journal = {Journal of Surgery},
  volume = {7},
  number = {1},
  pages = {14-18},
  doi = {10.11648/j.js.20190701.13},
  url = {https://doi.org/10.11648/j.js.20190701.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20190701.13},
  abstract = {Management of BD is widely variable and there is little evidence for the most appropriate treatment. Our aim was to evaluate the effectiveness of ingenol mebutate (IM) gel in the treatment of patients with Bowen’s disease (BD). We performed a retrospective analysis of 24 cases of biopsy-confirmed BD treated with IM. Data retrieved from the patients’ file included age, sex, anatomic sites, clinical images of lesions, histopathological data of skin biopsies, local skin reactions, clinical and histological response to treatment, alternative treatments tried and follow-up. The majority of patients were females (18/24, 75%), with an average age of 79.5 years (range 53-90 years). Four of the 24 patients were lost to follow-up. The average duration of follow-up was 10.4 months (range 0.5-44 months). After treatment with IM, 41.7% of patients showed complete clinical resolution. Retreatment with IM of six non-responder patients led to three more cases of successful healing. Therefore, 54.2% of patients with BD lesions achieved complete resolution after treatment with one or two cycles of IM. Local skin reactions were mostly mild or moderate, and only 12.5% were regarded as severe. The results indicate that topical IM gel may be considered as a safe and beneficial non-invasive treatment option for BD, especially in patients who are poor candidates for surgery and anatomical sites that are unsuitable for other treatments. The acceptable safety profile, short treating course and easy self-application of IM gel may improve patient compliance.},
 year = {2019}
}

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TY - JOUR
T1 - Treatment of Bowen’s Disease with Ingenol Mebutate: A Retrospective Study
AU - Montserrat Salleras
AU - Mònica Quintana
AU - Jorge Arandes
AU - Ignasi Figueras
Y1 - 2019/04/12
PY - 2019
N1 - https://doi.org/10.11648/j.js.20190701.13
DO - 10.11648/j.js.20190701.13
T2 - Journal of Surgery
JF - Journal of Surgery
JO - Journal of Surgery
SP - 14
EP - 18
PB - Science Publishing Group
SN - 2330-0930
UR - https://doi.org/10.11648/j.js.20190701.13
AB - Management of BD is widely variable and there is little evidence for the most appropriate treatment. Our aim was to evaluate the effectiveness of ingenol mebutate (IM) gel in the treatment of patients with Bowen’s disease (BD). We performed a retrospective analysis of 24 cases of biopsy-confirmed BD treated with IM. Data retrieved from the patients’ file included age, sex, anatomic sites, clinical images of lesions, histopathological data of skin biopsies, local skin reactions, clinical and histological response to treatment, alternative treatments tried and follow-up. The majority of patients were females (18/24, 75%), with an average age of 79.5 years (range 53-90 years). Four of the 24 patients were lost to follow-up. The average duration of follow-up was 10.4 months (range 0.5-44 months). After treatment with IM, 41.7% of patients showed complete clinical resolution. Retreatment with IM of six non-responder patients led to three more cases of successful healing. Therefore, 54.2% of patients with BD lesions achieved complete resolution after treatment with one or two cycles of IM. Local skin reactions were mostly mild or moderate, and only 12.5% were regarded as severe. The results indicate that topical IM gel may be considered as a safe and beneficial non-invasive treatment option for BD, especially in patients who are poor candidates for surgery and anatomical sites that are unsuitable for other treatments. The acceptable safety profile, short treating course and easy self-application of IM gel may improve patient compliance.
VL - 7
IS - 1
ER -

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Author Information

Montserrat Salleras

Department of Dermatology, Sagrat Cor University Hospital, Barcelona, Spain
Mònica Quintana

Department of Dermatology, Sagrat Cor University Hospital, Barcelona, Spain
Jorge Arandes

Department of Dermatology, Sagrat Cor University Hospital, Barcelona, Spain
Ignasi Figueras

Department of Dermatology, Bellvitge University Hospital, Barcelona, Spain

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Plain Text BibTeX RIS

APA Style

Montserrat Salleras, Mònica Quintana, Jorge Arandes, Ignasi Figueras. (2019). Treatment of Bowen’s Disease with Ingenol Mebutate: A Retrospective Study. Journal of Surgery, 7(1), 14-18. https://doi.org/10.11648/j.js.20190701.13

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ACS Style

Montserrat Salleras; Mònica Quintana; Jorge Arandes; Ignasi Figueras. Treatment of Bowen’s Disease with Ingenol Mebutate: A Retrospective Study. J. Surg. 2019, 7(1), 14-18. doi: 10.11648/j.js.20190701.13

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AMA Style

Montserrat Salleras, Mònica Quintana, Jorge Arandes, Ignasi Figueras. Treatment of Bowen’s Disease with Ingenol Mebutate: A Retrospective Study. J Surg. 2019;7(1):14-18. doi: 10.11648/j.js.20190701.13

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@article{10.11648/j.js.20190701.13,
  author = {Montserrat Salleras and Mònica Quintana and Jorge Arandes and Ignasi Figueras},
  title = {Treatment of Bowen’s Disease with Ingenol Mebutate: A Retrospective Study},
  journal = {Journal of Surgery},
  volume = {7},
  number = {1},
  pages = {14-18},
  doi = {10.11648/j.js.20190701.13},
  url = {https://doi.org/10.11648/j.js.20190701.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20190701.13},
  abstract = {Management of BD is widely variable and there is little evidence for the most appropriate treatment. Our aim was to evaluate the effectiveness of ingenol mebutate (IM) gel in the treatment of patients with Bowen’s disease (BD). We performed a retrospective analysis of 24 cases of biopsy-confirmed BD treated with IM. Data retrieved from the patients’ file included age, sex, anatomic sites, clinical images of lesions, histopathological data of skin biopsies, local skin reactions, clinical and histological response to treatment, alternative treatments tried and follow-up. The majority of patients were females (18/24, 75%), with an average age of 79.5 years (range 53-90 years). Four of the 24 patients were lost to follow-up. The average duration of follow-up was 10.4 months (range 0.5-44 months). After treatment with IM, 41.7% of patients showed complete clinical resolution. Retreatment with IM of six non-responder patients led to three more cases of successful healing. Therefore, 54.2% of patients with BD lesions achieved complete resolution after treatment with one or two cycles of IM. Local skin reactions were mostly mild or moderate, and only 12.5% were regarded as severe. The results indicate that topical IM gel may be considered as a safe and beneficial non-invasive treatment option for BD, especially in patients who are poor candidates for surgery and anatomical sites that are unsuitable for other treatments. The acceptable safety profile, short treating course and easy self-application of IM gel may improve patient compliance.},
 year = {2019}
}

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