Ingenol Mebutate for Recalcitrant Chronic Actinic Cheilitis

Area of Science:

• Dermatology
• Oncology

Background:

• Actinic cheilitis (AC) is a premalignant condition of the lip, often caused by chronic sun exposure.
• Traditional treatments for AC include topical therapies and photodynamic therapy, but some cases are refractory.

Observation:

• A 76-year-old man with a hyperkeratotic lower lip lesion diagnosed as AC had failed previous treatments with red light photodynamic therapy and topical imiquimod cream.
• The patient received two cycles of ingenol mebutate gel (150 μg/g) applied thrice daily at 3-week intervals.

Findings:

• Complete clearance of actinic cheilitis lesions was observed after ingenol mebutate gel treatment.
• Unexpectedly, no significant side effects such as pustulation or crusting were reported, despite the intensive application regimen.
• The remission was stable for 10 months, indicating a durable response, although recurrence was later noted.

Implications:

• Ingenol mebutate gel presents a feasible and safe therapeutic option for recalcitrant actinic cheilitis.
• This case highlights the potential of ingenol mebutate in managing difficult-to-treat premalignant lip conditions.
• Further research is warranted to explore the efficacy and safety profile of ingenol mebutate in a broader patient population with actinic cheilitis.